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Time of Arrival: Time of Departure: Time Received: <br />PERSONS AT SCENE <br />TOA TOD PHONE AGENCY NAME <br />ALLEGEDLY NOT FOLLOWING HAZARDOUS WASTE STANDARDS/PROCEDURES <br />MATERIAL/ CLASSIFICATION (chemical involved) <br />AMOUNT SOLID (lbs) LIQUID (oal) GAS (Cu ft COMMENTS MATERIAL <br />0 <br />SAN .10AQUIN <br /> Environmental Health Department <br />COUN I Y <br />EMERGENCY RESPONSE RECORD <br />Date: December 06, 2019 Short Term #: C00051317 <br />Premise Address: 16330 MCKINLEY AVE City: LATHROP <br />Premise DBA: Cross Street: LOUISE <br />Premise Owner: RIG MASTER Owner's Phone: <br />Mailing Address: 16330 MCKINLEY AVE Owner City: LATHROP <br />Facility Contact: RIG MASTER Contact Phone: <br />RP DBA: RIG MASTER <br />Onsite RP Name: Onsite RP Phone: <br />Mailing Address: 16330 MCKINLEY AVE RP City: LATHROP <br />RP Contact: DILBAGH SINGH Contact Phone: (209) 907-3121 <br />NATURE OF RESPONSE (explosion, spill, leak, fire, or abandoned/dumped material <br />REFERRED TO (NAME AND ADDRESS) DATE MAILED <br />Date Prop 65 Completed: Date UAR Completed: <br />IF PERSONS EXPOSED and/or INJURED, "PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD" COMPLETED? OYES ONO <br />Page 1 of 2 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/EHD