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SAN JOAQUIN COUNTY <br />NOTIFICATION OF HAZARDOUS WASTE DISCHARG <br />HEALTH & SAFETY CODE 25180.7 (, (0 [Py <br />A. EMERGENCY LEVEL: J II III <br />(Circle One) <br />B. SOURCE OF INFORMATION <br />PHS -EH LOG #__24 <br />Name: Captain UQargovich Phone' 209 462-1094 <br />Company: Stockton Fire Department <br />Address: Station 1 <br />Designated Employee Name: Jerry Yoshioka Phone' 209 468-0335 <br />Reporting Agency Name: San Joaquin County Environmental Health <br />Address: 304 E. Weber Avenue, Stockton CA 95201 <br />C. LOCATION AND DATE OF DISCHARGE <br />Location: 1400 Waterloo Road / Stockton <br />(Best Physical Description) (City or County) Circle One <br />Date of Discharge: January 3. 1996 <br />Date Notified: January 3, 1996 Time' 0423 hours <br />D. RESPONSIBLE PERSON/BUSINESS <br />Name of Business: Van Den Berh Foods Company <br />Contact Person: Max Nicholson Telephone: �� 477 - 5 <br />Physical Address: 1400 water oo Roa <br />Mailing Address: P.O. Box 9200 Stockton CA 95208 <br />E. DESCRIPTION <br />Type of Discharge' Fixed facility release (accidental) <br />Volume: Unknown as of this notification <br />Chemicals: Chlorine (gaseous <br />Circumstances: Leak occurred in product line near outlet valve <br />F. ACTION TAKEN Stockton Fire personnel in protective clothing and self <br />contained reathi ng appara us urnc off the system. Bui ing <br />in the immediate area had been cleared. Air monitoring conducted <br />at perimeter of the facility after system shut -down. <br />No cases of ex osures re miring first aid or medical treatment. <br />SITE <br />to be ven <br />EH 22 013 (Rev.4/91) <br />and surveyed using Draeqer air s <br />nuitaing: <br />strument. <br />