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SAVOAQUIN <br /> Environmental Health Department <br />COUNTY <br />EMERGENCY RESPONSE RECORD <br />Date: October 31, 2021 Short Term #: CO6XWFOVS <br />Premise Address: W I 580 EXPY City: TRACY <br />Premise DBA: Cross Street: INTERNATIONAL PKVVY/PATTERSO <br />Premise Owner: Owner's Phone: <br />Mailing Address: Owner City: <br />Facility Contact: Contact Phone: <br />RP DBA: J RUSSELL SHAFFER DISTRIBUTION INC <br />Onsite RP Name: Onsite RP Phone: <br />Mailing Address: 1434 S WILLOW AVE RP City: RIALTO <br />RP Contact: RAMON LOEN/MALU Contact Phone: (909) 746-7113 <br />NATURE OF RESPONSE (explosion, spill, leak, fire, or abandoned/dumped material <br />APPROXIMATELY 40 GALLONS OF DIESEL RELEASED FROM THE SADDLE TANK OF A J RUSSELL SHAFFER <br />DISTRIBUTION INC TRACTOR TRAILER DUE TO A SINGLE VEHICLE ACCIDENT. <br />Time Received: 1:30 am Time of Arrival: 2:20 am Time of Departure: 7:55 am <br />PERSONS AT SCENE <br />NAME AGENCY PHONE TOA TOO <br />PAUL NSO EHD (209) 616-3049 2:20 am 7:55 am <br />ESTHER HERSCHBACH CALTRANS (209) 482-8211 2:15 am <br />JUAN J ARMENDAREZ CATRANS (209) 483-3088 <br />OFFICER ALLEN-21822 CHP (209) 835-8920 <br />ERIAL / CLASSIFICATION chemical involved <br />MATERIAL <br />. <br />AMOUNT <br />, <br />SOLID (lbs) LIQUID (gab GAS (cu ft) COMMENTS <br />DIESEL 40.00 0 0 E] <br />0 0 El <br />0 0 CI <br />REFERRALS AND NOTIFICATIONS <br />REFERRED TO (NAME AND ADDRESS), DATE MAILED <br />Date Prop 65 Completed: November 01, 2021 Date UAR Completed: <br />IF PERSONS EXPOSED and/or INJURED, "PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD" COMPLETED? DYES ZNO <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