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SAN JOAQUIN <br />c-,,, I Y <br />Environmental Health Department <br />EMERGENCY RESPONSE RECORD <br />Date: June 08, 2020 Short Term #: COVOMOG3H <br />Premise Address: 2121 N ZUCKERMAN RD RD City: STOCKTON <br />Premise DBA: PG&E MCDONALD ISLAND Cross Street: LOWER JONES <br />Premise Owner: PG&E Owner's Phone: (415) 973-7000 <br />Mailing Address: 3401 CROW CANYON RD RM 176C Owner City: SAN RAMON <br />Facility Contact: PACIFIC GAS AND ELECTRIC COMPANY Contact Phone: (925) 415-6381 <br />RP DBA: PACIFIC GAS & ELECTRIC COMPANY <br />Onsite RP Name: Onsite RP Phone: <br />Mailing Address: PO BOX 770000 RP City: SAN FRANCISCO <br />RP Contact: RALPH ROBERTS Contact Phone: (209) 323-9492 <br />NATURE OF RESPONSE (explosion, spill, leak, fire, or abandoned/dumped material <br />APPROXIMATELY 500 GALLONS TRIETHYLENE GLYCOL RELEASED FROM TANK INTO SECONDARY <br />CONTAINMENT. <br />Time Received: Time of Arrival: Time of Departure: <br />NAME AGENCY PHONE TOA TOD <br />E I t.a nnq Pio, i do END (PO gar' 500 ct. tsent\ NA <br />......_....._. _ .__.. ._.... s <br />MATERIAL AMOUNT <br />, <br />SOLID fibs). LIQUID (oal) GAS (Cu ft) COMMENTS <br />TricKylene jlytol SOO D [v( EI <br />III El I=1 <br />III 0 CI <br />..--......_ ...._ .._ ... ._...._.._ <br />REFERRED TO (NAME AND ADDRESS) DATE MAILED <br />Date Prop 65 Completed: pals- Date UAR Completed: <br />IF PERSONS EXPOSED and/or INJURED, "PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD' COMPLETED? DYES NO <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