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CONKGIT0F (2)
EnvironmentalHealth
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2500 – Emergency Response Program
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CONKGIT0F (2)
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Last modified
5/20/2021 1:55:11 PM
Creation date
5/20/2021 12:29:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CONKGIT0F
PE
2546
STREET_NUMBER
1501
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
22811023
ENTERED_DATE
9/24/2020 12:00:00 AM
SITE_LOCATION
1501 N JACK TONE RD
RECEIVED_DATE
9/24/2020 12:00:00 AM
P_LOCATION
05
P_DISTRICT
004
QC Status
Approved
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SJGOV\ymoreno
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EHD - Public
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SAN 10 A Q U I N Environmental Health Department <br /> EMERGENCY RESPONSE RECORD <br /> Date: September 24,2020 Short Term#: CONKGITOF <br /> Premise Address: 1501 N JACK TONE RD City: RIPON <br /> Premise DBA: Cross Street: SANTOS <br /> Premise Owner: PILOT TRAVEL CENTERS LLC Owner's Phone: (865)474-2826 <br /> Mailing Address: PO BOX 54470 Owner City: LEXINGTON <br /> Facility Contact: PILOT TRAVEL CENTERS LLC Contact Phone: (865)474-2826 <br /> RP DBA: PILOT TRAVEL CENTERS LLC <br /> Onsite RP Name: ANTOINETTE Onsite RP Phone: (209)599-4141 <br /> Mailing Address: PO BOX 54470 RP City: LEXINGTON <br /> RP Contact: CHIP HUGHES Contact Phone: (865)474-2438 <br /> NATURE OF RESPONSE(explosion,spill, leak, fire,or abandoned/dumped material <br /> 35 GALLONS OF DIESEL RELEASED INTO A STORM DRAIN. <br /> Time Received: 9:05 am Time of Arrival: 9:55 am Time of Departure: <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> Lydia Baker SJC EHD (209)616-3046 9:55 am <br /> Mike Pole City of Ripon (209)599-2108 <br /> Paul Rourick Ripon Police Department (209)599-2102 <br /> Antoinette Flying J (209)599-4141 <br /> Bob Morrill Morrill Industries, Inc. (209)838-2550 <br /> MATERIAL/CLASSIFICATION chemical involved <br /> MATERIAL AMOUNT SOLID(lbs) LIQUID(gaIj GAS(cu ft) COMMENTS <br /> Diesel 35.00 ❑ ❑D ❑ <br /> ❑ ❑ ❑ <br /> ❑ ❑ ❑ <br /> REFERRALS AND NOTIFICATIONS <br /> REFERRED TO(NAME AND ADDRESS) DATE MAILED <br /> Date Prop 65 Completed: September 24, 2020 Date UAR Completed: <br /> IF PERSONS EXPOSED and/or INJURED,"PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD"COMPLETED? ❑YES ❑NO <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.sjgov.org/EHD <br />
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