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SAN JOAQUIN COUNTY EDV <br />'•N(3 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />101 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />(209) 468-3420 • Fax: (209) 464-3433 • Web: www.siqov.orgiehd <br />.. , .. <br />NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br />EMERGENCY LEVEL NI ii fl iii <br />SOURCE OF INFORMATION <br />EHD LOG# <br />NAME: Ray von Flue PHONE: (209) 468-9848 <br />COMPANY: San Joaquin County Environmental Health Department CITY: Stockton <br />ADDRESS: 1868 E. Hazelton Ave. <br />DESIGNATED EMPLOYEE NAME: Ray von Flue PHONE: (209) 468-9848 <br />REPORTING AGENCY NAME: San Joaquin County Environmental Health Department <br />ADDRESS: 1868 E. Hazelton Ave., Stockton, CA 95205-6232 <br />LOCATION AND DATE OF DISCHARGE <br />LOCATION: <br />Best Physical <br />Description <br />8503W. Windmill Cove Rd. APN 13122006 CITY Stockton 0 Incorporated <br />0 Unincorporated <br />DATE OF DISCHARGE: Unknown <br />DATE NOTIFIED: July 17, 2012 - Analytical Sample Results TIME: <br />RESPONSIBLE PERSON/BUSINESS <br />NAME OF BUSINESS: Unknown <br />CONTACT PERSON: <br />PHONE: <br />PHYSICAL ADDRESS: <br />MAILING ADDRESS: <br />DESCRIPTION <br />TYPE OF DISCHARGE: Hazardous Waste Disposal to Soil <br />VOLUME: Unknown <br />CHEMICALS: Asbestos, Lead, and Zinc <br />CIRCUMSTANCES: <br />Analytical samples were taken of the soil at the location. The results indicated hazardous <br />waste levels for Lead and Zinc. Fibrous material was identified as Asbestos. <br />ACTION TAKEN <br />Business owner has removed some of the waste containers stored at the location. <br />SITE DISPOSITION <br />No activity associated with remediation of the contaminated soil. Business owner is in the process of moving operations <br />off of the location. <br />Revised 08/02/12 <br />Page 1 of 2 <br />NOTIFICATION OF HAZ WASTE DISCHARGE