Laserfiche WebLink
e • D <br />SAN ,OAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />;; 1868 E. Hazelton Ave., Stockton - CA 95205 <br />k <br />(209) 468-3420 • Fax; (209) 468-3433 • Web: www.sjgov.org/ehd <br />EMERGENCY RESPONSE RECORD <br />DATE: Tuesday, April 8, 2014 <br />SHORTTERM#: C00037821 <br />PREMISE ADDRESS: 6633 Pacific Avenue <br />Cir,. Stockton <br />DBA: CHEVRON STATION #96171 * CROSS STREET: Ben Holt <br />PREMISE OWNER: CHEVRON <br />PHONE: <br />OWNER'S ADDRESS: PO BOX 6004 / L2375 -B3, <br />CiTY:San Ramon <br />FACILITY CONTACT: Gerardo Acuna <br />PHONE: 925-766-6939 <br />RESPONSIBLE PARTY (RP) DBA: See Above <br />RP NAME: <br />PHONE: <br />RP ADDRESS: <br />CITY: <br />RP CONTACT: <br />PHONE: <br />NA I URL OF KLSPUNSt (explosion, spill, leak, tire, or abandoned/oumpeo material) <br />Approximately 3 gallons of supreme fuel was released during fuel transfer from the tanker truck to the <br />underground storage tank <br />I TIME RECEIVED: 4:08 pm I TIME OF ARRIVAL: 5:11 pm I TIME OF DEPARTURE: 5.21 pm <br />PFRr,nNS AT SCFNF <br />NAME AGENCY <br />PHONE <br />TOA TOD <br />Elena Manzo SJC EHD <br />(209) 953-7699 <br />COMMENTS <br />Supreme fuel <br />XY ❑ N <br />3 <br />No water impact <br />❑Y o <br />o o <br />MATERIAL/CLASSIFICATION I[NEMIMINVOLVED) <br />IDENTIFICATION <br />SPILLED? <br />SOLID <br />(LBS) <br />LIQUID <br />(GAL) <br />GAS <br />(CU FT) <br />COMMENTS <br />Supreme fuel <br />XY ❑ N <br />3 <br />No water impact <br />❑Y o <br />o o <br />o o <br />CI o <br />o o <br />REFERRALS AND NOTIFICATIONS <br />REFERRED TO (NAME AND ADDRESS) DATE MAILED <br />DATE PROP 65 COMPLETED: 4-8-2014 DATE LIAR COMPLETED: <br />IF PERSONS EXPOSED and/or INJURED, "PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD" COMPLETED? ❑ YES ❑ NO <br />1a( SHORT-TERM ON TOP I X NARRATIVE I X MAP 1 ❑ ANALYTICAL DATA I X PROP 65 / LIAR ❑ FILE CREATED <br />❑ MANIFEST ❑ REFERRALS 1 ❑ CLEAN UP REPORT ❑ OTHER AGENCY REPORTS 1 ❑ EXPOSURE RECORD X PHOTOS <br />ER RECORD Page 1 10/03/12 <br />