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0. Y SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> \\, 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> c , ; (209)468-3420 - Fax: (209)464-3433- Web:www.sigov.org/ehd <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE JEHDLOG#1 <br /> EMERGENCY LEVEL: <br /> � <br /> t I-No Evacuation/Local Response Only [III-Evacuation and/or In-County Mutual Aid Needed ❑III-Evacuation and/or Regional/State Mutual Aid Needed <br /> SOURCE OF INFORMATION <br /> NAME: Michelle Henry PHONE: (209)468-3454 <br /> COMPANY: San Joaquin County Environmental Health Department CITY: Stockton <br /> ADDRESS: 1868 E. Hazelton Ave. <br /> DESIGNATED EMPLOYEE NAME: Michelle Henry PHONE: (209)468-3454 <br /> REPORTING AGENCY NAME: San Joaquin County Environmental Health Department <br /> ADDRESS: 1868 E. Hazelton Ave., Stockton, CA 95205-6232 <br /> LOCATION AND DATE OF DISCHARGE <br /> LOCATION: Incorporated <br /> Best Physical 2905 W Benjamin Holt DR CITY Stockton <br /> Description ❑X Unincorporated <br /> DATE OF Saturday, January 18, 2020 <br /> DISCHARGE: <br /> DATE Monday, January 20, 2020 TIME: 9:00am <br /> NOTIFIED: <br /> RESPONSIBLE PERSON/BUSINESS <br /> NAME OF BUSINESS: Chevron (customer) <br /> CONTACT PERSON: Gerardo ACuna PHONE. 925 766 6939 <br /> PHYSICAL ADDRESS: 2905 W Benjamin Holt Dr Stockton CA 95207 <br /> MAILING ADDRESS: Same <br /> DESCRIPTION <br /> TYPE OF DISCHARGE: leak <br /> VOLUME: —2 gallons <br /> CHEMICALS: gasoline <br /> CIRCUMSTANCES: Customer gas tank had a hole In It <br /> ACTION TAKEN <br /> Chevron employees containerized release. Cleaned up impacted area, placed clean-up <br /> material in the hazardous waste drum on site for disposal during routine pick-up. <br /> SITE DISPOSITION <br /> No further follow-up. <br /> Revised 6/01/2015 Page 1 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br />