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SAN 10 A Q U I N Environmental Health Department <br /> C= C)U "N I Y <br /> EMERGENCY RESPONSE RECORD <br /> Date: June 02, 2021 Short Term#: C00053865 <br /> Premise Address: 5169 GADWALL CIR City: STOCKTON <br /> Premise DBA: Cross Street: <br /> Premise Owner: KENNAMORE MARLENE Owner's Phone: <br /> Mailing Address: 5169 GADWALL CIR Owner City: STOCKTON <br /> Facility Contact: KENNAMORE MARLENE Contact Phone: <br /> RP DBA: CITY OF STOCKTON <br /> Onsite RP Name: CITY OF STOCKTON Onsite RP Phone: (209) 937-8719 <br /> Mailing Address: 2500 NAVY DRIVE RP City: STOCKTON <br /> RP Contact: BRYAN TOLEDO Contact Phone: (209) 937-8719 <br /> NATURE OF RESPONSE (explosion, spill, leak, fire, or abandoned/dumped material <br /> COMPLAINT ALLEGES THERE IS ANTIFREEZE RUNNING DOWN THE DRIVE WAY FROM THIS HOUSE AND INTO <br /> THE STORM DRAIN. <br /> Time Received: 1:54 pm Time of Arrival: 2:42 pm Time of Departure: 3:30 pm <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> JOHN ALANIZ SJC EHD (209) 616-3053 2:42 pm 3:30 pm <br /> FREDERICK ERNEST SJC EHD (209)616-3026 2:42 pm 3:30 pm <br /> MATERIAL/CLASSIFICATION chemical involved <br /> MATERIAL AMOUNT SOLID(lbs) LIQUID(oaf GAS(cu ft t COMMENTS <br /> ANTIFREEZE 1.00 ❑ 19 ❑ <br /> ❑ ❑ ❑ <br /> ❑ ❑ ❑ <br /> REFERRALS AND NOTIFICATIONS <br /> REFERRED TO(NAME AND ADDRESS) DATE MAILED <br /> Date Prop 65 Completed: June 03, 2021 Date LIAR Completed: <br /> IF PERSONS EXPOSED and/or INJURED,"PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD"COMPLETED? ❑YES ONO <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 />