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COW7NCVWX (2)
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2500 – Emergency Response Program
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COW7NCVWX (2)
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Last modified
4/14/2021 12:09:58 PM
Creation date
4/14/2021 11:36:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COW7NCVWX
PE
2546
STREET_NUMBER
3900
STREET_NAME
HOLLY
STREET_TYPE
DR
City
TRACY
Zip
95304
APN
NEAR 21223006
ENTERED_DATE
1/27/2021 12:00:00 AM
SITE_LOCATION
3900 HOLLY DR
RECEIVED_DATE
1/27/2021 12:00:00 AM
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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SAN JOAQUIN <br />CCUN F Y <br />Environmental Health Department <br />EMERGENCY RESPONSE RECORD <br />Date: January 27, 2021 Short Term #: COW7NCVWX <br />Premise Address: 3900 HOLLY DR City: TRACY <br />Premise DBA: Cross Street: LARCH <br />Premise Owner: Owner's Phone: <br />Mailing Address: Owner City: <br />Facility Contact: Contact Phone: <br />RP DBA: TRACY WATER TREATMENT - (PRIMARY) <br />Onsite RP Name: ALOKE VAID Onsite RP Phone: (209) 831-6328 <br />Mailing Address: 3900 HOLLY DR RP City: TRACY <br />RP Contact: ALOKE VAID Contact Phone: (209) 831-6328 <br />NATURE OF RESPONSE (explosion, spill, leak, fire, or abandoned/dumped material <br />2400 pounds of 19% liquid ammonia released. <br />Time Received: 7:48 am Time of Arrival: 10:00 am Time of Departure: 11:00 am <br />PERSONS AT SCENE <br />NAME AGENCY PHONE TOA TOD <br />Lydia Baker SJC EHD (209) 616-3046 10:00 am 11:00 am <br />Haza Saeed SJC EHD (209) 953-6212 10:00 am 11:00 am <br />Aloke Vaid City of Tracy (209) 831-6328 <br />Deborah DeWolf City of Tracy (209) 831-6375 <br />ATERIAL / CLASSIFICATION chemical involved <br />MATERIAL AMOUNT SOLID (lbs) LIQUID (cial) GAS (Cu ft) COMMENTS <br />19% Ammonia 2,500.00 1=1 0 0 <br />0 D D <br />111 D 0 <br />REFERRALS AND NOTIFICATIONS <br />REFERRED TO (NAME AND ADDRESS) DATE MAILED <br />Date Prop 65 Completed: January 27, 2021 Date UAR Completed: <br />IF PERSONS EXPOSED and/or INJURED, "PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD' COMPLETED? EIYES ENO <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
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