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SAN JOAQUIN <br /> Environmental Health Department <br />COUNTY— <br />EMERGENCY RESPONSE RECORD <br />Date: December 12, 2021 Short Term #: COMCNFAOT <br />Premise Address: 1442 COLONY DR City: RIPON <br />Premise DBA: CHEVRON Cross Street: HOFF DRIVE <br />Premise Owner: CHEVRON Owner's Phone: (209) 599-0149 <br />Mailing Address: PO BOX 6004 Owner City: SAN RAMON <br />Facility Contact: CHEVRON USA INC (GERARDO ACUNA) Contact Phone: (925) 766-6939 <br />RP DBA: DISH NETWORK MANTECA <br />Onsite RP Name: TRISTEN DELEON Onsite RP Phone: (209) 402-6548 <br />Mailing Address: 3079 E PALM AVE RP City: MANTECA <br />RP Contact: KEVIN MCGEE Contact Phone: (518) 248-8669 <br />NATURE OF RESPONSE (explosion, spill, leak, fire, or abandoned/dumped material <br />37 GALLONS OF GASOLINE WAS RELEASED WHILE A VAN WAS FUELING. A STORM DRAIN WAS IMPACTED. <br />Time Received: 3:43 pm Time of Arrival: 10:24 am Time of Departure: 2:18 pm <br />NAME AGENCY PHONE TOA TOO <br />KARINA GORDILLO CHEVRON (209) 636-3407 <br />VICKY VANG-LEE EHD (209) 616-3028 10:24 am 2:18 pm <br />MIKE POOLE RIPON PUBLIC WORKS (209) 599-2108 <br />MATERIAL AMOUNT SOLID (lbs) LIQUID (clan GAS (cu ft) COMMENTS <br />GASOLINE 37.00 0 0 0 <br />0 0 0 <br />0 0 0 <br />....... —.... .— ..._ .._ ... ._...._.._ <br />REFERRED TO (NAME AND ADDRESS) DATE MAILED <br />Date Prop 65 Completed: December 14, 2021 Date UAR Completed: <br />IF PERSONS EXPOSED and/or INJURED, "PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD' COMPLETED? OYES ONO <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