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2500 – Emergency Response Program
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COEIRX5MW
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Last modified
11/17/2020 9:54:49 AM
Creation date
6/4/2020 3:48:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COEIRX5MW
PE
2546
STREET_NUMBER
13613
Direction
W
STREET_NAME
BYRON
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
20926020
ENTERED_DATE
10/30/2019 12:00:00 AM
RECEIVED_DATE
10/30/2019 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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rR <br /> A <br /> SANQ <br /> JOA U I N COPY <br /> Environmental Health Department <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> ERGENCY <br /> ELEVEL: EHD LOG# 00 -03(t) <br /> 1-No Evacuation/Local Response Only ❑II-Evacuation and/or In-County Mutual Aid Neede ❑III-Evacuation and/or State/Regional Mutual Aid Needed <br /> SOURCE OF INFORMATION: RECORD ID: COEIRX5MW <br /> Name: CLr) Phone: - <br /> Company: City: <br /> Address: <br /> Designated Employee: Christine Lawrence <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 PP'roX 9-0050V $ y'Or\ xuj City: TRACY <br /> Physical Description: VV h GJSTeN �V�t�r� -►0 - — <br /> ❑ Incorporated XUnincorporated <br /> Date of Discharge: Date Notified: 10 -3,0 -.?-c I Time Notified: �3 <br /> RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: PG&E <br /> Contact Person: NATHAN CHRISTMAN Contact Phone: (559) 410-5011 <br /> Mailing Address: 3136 BOING WAY <br /> r— City: STOCKTON State: CA ZIP: 95204 <br /> DESCRIPTION <br /> Material: BIO CLEAN SOLUTION Amount: 5.00 ❑ lbs 9 gal ❑ cu ft <br /> Type of Discharge: RELEASE OF CLEANING SOLUTION ONTO SOIL <br /> Circumstances: SOLN WAS RUN THROUGH PIPELINE AND SUCKED OUT WITH VACUUM. VACUUM OVERFILLED- <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 /> pA � t2�>t of a51Sa2-Sk- L 1 s �,o Q Ini�ri oo-t, <br /> SITE DISPOSITION <br /> ne <br /> uleow <br /> (- <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 />
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