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SAN JOAQUIN COUNTY <br /> fu. ENVIRONMENTAL HEALTH DEPARTMENT <br /> oi­ <br /> 1868 E. Hazelton Ave., Stockton • CA 95205 <br /> ! P (209) 468-3420 • Fax:(209) 468-3433 • Web:www.sjgov.org/ehd <br /> EMERGENCY RESPONSE RECORD <br /> DATE: 6/6/2018 SHORT TERM#: C00046829 <br /> PREMISE ADDRESS:2303 Sandalwood Drive CIN:Stockton <br /> DBA:City Storm System CROSSSTREET: Ledgewood Avenue <br /> PREMISE OWNER:City of Stockton PHONE: 209-937-8740 <br /> OWNERS ADDRESS:2500 Navy Drive Stockton, CA 95206 CITY:Stockton <br /> FACILITY CONTACT:Richard Stlffler PHONE:209-937-8740 <br /> RESPONSIBLE PARTY(RP)DBA:As above <br /> RP NAME: PHONE: <br /> RP ADDRESS: CITY:Stockton <br /> RP CONTACT: PHONE: <br /> NATURE OF RESPONSE(explosion,spill,leak,fire,or abandoned/dumped material) <br /> Due to vandalizm, approximately 2x55-gallon drums of oily substance was dumped into a city storm drain <br /> TIME RECEIVED:NA TIME OF ARRIVAL: 3 pm ITIME OF DEPARTURE:4 pm <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> Elena Manzo SJC EHD 209-953-7699 3 pm 4 pm <br /> MATERIAL/CLASSIFICATION(CHEMICAL INVOLVED) <br /> IDENTIFICATION SPILLED? SOLID LIQUID GAS COMMENTS <br /> (LBS) (GAL) CU FT) <br /> Oily liquid XY ❑N 110 <br /> o o <br /> o c <br /> o o <br /> o ❑N <br /> ❑Y ❑N <br /> REFERRALS AND NOTIFICATIONS <br /> REFERRED TO(NAME AND ADDRESS) DATE MAILED <br /> DATE PROP 65 COMPLETED: 6/8/2018 1 DATE LIAR COMPLETED: <br /> IF PERSONS EXPOSED and/or INJURED,"PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD"COMPLETED? ❑ YES ❑ NO <br /> ER BINDER COPIES: <br /> X SHORT-TERM ON TOP Q NARRATIVE )( MAP ❑ ANALYTICAL DATA X PROP 65/LIAR ❑ FILE CREATED <br /> X MANIFEST ❑ REFERRALS ❑ CLEAN UP REPORT ❑ OTHER AGENCY REPORTS ❑ EXPOSURE RECORD X PHOTOS <br /> ER RECORD Page 1 10/03/12 <br />