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CO6XWF0VS (2)
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2500 – Emergency Response Program
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CO6XWF0VS (2)
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Last modified
1/20/2023 2:58:21 PM
Creation date
1/20/2023 2:56:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO6XWF0VS
PE
2546
STREET_NUMBER
0
Direction
W
STREET_NAME
I 580
STREET_TYPE
EXPY
City
TRACY
Zip
95377
ENTERED_DATE
11/1/2021 12:00:00 AM
SITE_LOCATION
WB I 580 EAST OF MOUNTAIN HOUSE PARKWAY
RECEIVED_DATE
10/31/2021 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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1 <br />SAN:JOAQUIN COPY <br /> <br />Environmental Health Department <br />COUNTY <br />EMERGENCY LEVEL: <br />NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br />EHD LOG # —V2A <br /> <br />0 I - No Evacuation/Local Response Only II - Evacuation and/or In-County Mutual Aid Needed 0 III - Evacuation and/or State/Regional Mutual Aid Needed <br />SOURCE OF INFORMATION: RECORD ID: CO6XWF0VS <br />Name: CHP Phone: (209) 943-8600 <br />Company: CHP City: STOCKTON <br />Address: <br />Designated Employee: Paul Nso <br />Reporting Agency: San Joaquin County Environmental Health Department <br />Agency Address: 1868 E Hazelton Ave, Stockton, CA 95205 <br />D DATE OF DISCHARGE <br />Location - Best <br />Physical Description: <br />WB1-580, EAST OF MOUNTAIN HOUSE PARKWAY. <br />ABOUT ONE MILE ON 1-580WB, FROM 1-580W/I-205 <br />INTERSFrTIC)N <br />City: TRACY <br />0Incorporated 1=1 Unincorporated <br />Date of Discharge: October 31, 2021 Date Notified: November 01, 2021 Time Notified: 1:30 am <br />BUSINE <br />Name of Business: J RUSSELL SHAFFER DISTRIBUTION INC <br />Contact Person: RAMON LOEN/MALU Contact Phone: (909) 746-7113 <br />Mailing Address: 1434 S WILLOW AVE <br />City: RIALTO State: CA ZIP: 92376 <br />Material: DIESEL Amount: 40.00 0 lbs El gal 0 Cu ft <br />Type of Discharge: LEAK <br />Circumstances: DUE TO VEHICLE ACCIDENT APPROXIMATELY 40GALLONS DIESEL RELEASED FROM THE SADD <br />Material: Amount: 0 lbs 0 gal 0 cu ft <br />Type of Discharge: <br />Circumstances: <br />Material: Amount: 0 lbs 0 gal 0 cu ft <br />Type of Discharge: <br />Circumstances: <br />ACTION TAKEN <br />AREA COVERED AND SECURED WITH CONES <br />SITE DISPOSITION <br />CLEAN UP PENDING. EHD TO FOLLOW UP CLEAN UP <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
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