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Feb 05 07 02: 19p San Joaquin County OES 2094662600 p• 4 <br /> 6. <br /> oP.4'?IN.; SAN JOAQULV COUNTY-OFFICE OF EMERGENCY SERVICES <br /> a� % HAZARDOUS MATERIALS DIVISION <br /> 6. '' ` '` 222 East Weber Avenue,Room 610,Stockton,CA 95202 <br /> Telephone(209)468-3969 <br /> • C2 P <br /> S�%FOVt�\ <br /> ADDENDUM TO <br /> CALIFORNIA HAZARDOUS MATERIALS INCIDENT REPORT <br /> Date Incident Occured Time Incident Dam At Scene Time At Scene SIDES Incident No. <br /> Oecured <br /> 12/1/1996 0718 IR-00308 <br /> Initial Information Reported Wind Speed/Dimetion <br /> A small hydrogen peroxide release caused by a mechanical failure. Unknown <br /> Reporting Party Name Address Telephone No. <br /> Stockton Fire Stockton (209)937-8021 <br /> Responsible Party Name .Address Telephone No. <br /> N City of Stockton-MUD Stu250 NCA 9r. (209)937-8750 <br /> Responsible Party Representative Name Address Telephone No. <br /> Jim Butler 2144 Fontana (209)937-8731 <br /> Stockton.CA 95203 <br /> OFS tiazMat Team OES Personnel on Scene <br /> Activated <br /> N/A <br /> No <br /> Joint Team Activated? DateMme Activated Members On Scene <br /> Q No N/A N/A <br /> Fite District Slitigation/Remaval Actions <br /> -. Stockton 22 Leak was stopped and system was repaired <br /> Agency Notifications and/or Referrals <br /> Name of Agency Dara of Notification Time of Notification Name of Representative <br /> Notified <br /> Stockton Fire 12/1196 Tony Moudakis <br /> State Warning Center 12/1/96 1518 BIG <br /> I' <br /> County OES 12/2/96 Voice Mail Message <br /> Repotting Officer Signature CHM1R Fled? Incident Type <br /> Q Yes I Fixed Facility,Accident <br /> V <br /> Page 2 <br /> V <br />