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A UN _ J O A Q U I NEnvironmental Health Department <br /> -COUNTY— �� ��� <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> EMERGENCY LEVEL: EHD LOG# i1-1 t') <br /> Zx I-No Evacuation/Local Response Only ❑II-Evacuation and/or In-County Mutual Aid Needed ❑III-Evacuation and/or State/Regional Mutual Aid Needed <br /> SOURCE OF INFORMATIONI: RECORD ID: COAYLKIFI <br /> Name: Kyle Collins Phone: (405) 834-0311 <br /> Company: LOVE'S TRAVEL STOP City: Phoenix <br /> Address: P.O. Box 29243 <br /> Designated Employee: Cesar Ruvalcaba <br /> Reporting Agency: San Joaquin County Environmental Health Department <br /> Agency Address: 1868 E Hazelton Ave, Stockton, CA 95205 <br /> LOCATION AND DATE OF DISCHARGE: <br /> Location - Best 15250 Thornton Rd in Lodi. By mechanics bay and parking lot. City: LODI <br /> Physical Description: <br /> ❑ Incorporated 0 Unincorporated <br /> Date of Discharge: October 07, 2017 Date Notified: October 07, 2017 Time Notified: 7:30 pm <br /> RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: SWIFT <br /> Contact Person: Dan Coberly Contact Phone: (602)477-7043 <br /> Mailing Address: P.O. Box 29243 <br /> City: Pheonix State: AZ ZIP: 85038 <br /> DESCRIPTION <br /> Material: Diesel Amount: 120.00 ❑ lbs N gal ❑ cu ft <br /> Type of Discharge: Spill <br /> Circumstances: Punctured fuel tank <br /> Material: Amount: ❑ lbs ❑ gal ❑ cu ft <br /> Type of Discharge: <br /> Circumstances: <br /> Material: Amount: ❑ lbs ❑ gal ❑ cu ft <br /> Type of Discharge: <br /> Circumstances: <br /> ACTION TAKEN <br /> Environmental cleanup company responded <br /> SITE DISPOSITION <br /> Additional cleanup to be performed after truck is towed. <br /> Page 1 of 2 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />