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CO0054827 (2)
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CO0054827 (2)
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Last modified
7/1/2022 4:30:57 PM
Creation date
7/1/2022 4:28:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0054827
PE
2546
STREET_NUMBER
3400
Direction
N
STREET_NAME
MACARTHUR
STREET_TYPE
DR
City
TRACY
Zip
95376
APN
21306016
ENTERED_DATE
4/20/2022 12:00:00 AM
SITE_LOCATION
3400 MACARTHUR DR
RECEIVED_DATE
4/20/2022 12:00:00 AM
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\ymoreno
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EHD - Public
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SANJOAQUIN <br /> Environmental Health Department <br />COUNTY <br />EMERGENCY RESPONSE RECORD <br />Date: April 20, 2022 Short Term #: C00054827 <br />Premise Address: 3400 N MACARTHUR DR City: TRACY <br />Premise DBA: Cross Street: PESCADERO <br />Premise Owner: JACKSONS FOOD STORES Owner's Phone: <br />Mailing Address: PO BOX 285 Owner City: HOUSTON <br />Facility Contact: JACKSONS FOOD STORES Contact Phone: <br />RP DBA: CHEVRON STATION #212470/2222 <br />Onsite RP Name: Onsite RP Phone: <br />Mailing Address: PO BOX 6004 RP City: SAN RAMON <br />RP Contact: ERIC ARANDA Contact Phone: (561) 235-8833 <br />NATURE OF RESPONSE (explosion, spill, leak, fire, or abandoned/dumped material <br />SPILL ONE GALLON OF REGULAR GASOLINE <br />Time Received: 9:30 am Time of Arrival: Time of Departure: <br />PERSONS AT SCENE <br />NAME AGENCY PHONE TOA TOD <br />MATERIAL / CLASSIFICATION chemical involved <br />MATERIAL AMOUNT SOLID (lbs) LIQUID (oal) GAS (Cu ftl COMMENTS <br />Gasoline 1.00 D 1=1 El <br />D III El <br />El El El <br />REFERRALS AND NOTIFICATIONS <br />REFERRED TO (NAME AND ADDRESS) DATE MAILED <br />Date Prop 65 Completed: April 20, 2022 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 952051 T 209 468-3420 I F 209 464-0138 I www.sjgov.org/EHD
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