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CO0055495 (3)
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4200 – Liquid Waste Program
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CO0055495 (3)
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Last modified
11/19/2024 3:47:16 PM
Creation date
1/25/2023 4:43:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
RECORD_ID
CO0055495
PE
4200
STREET_NUMBER
14900
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95242
APN
05503015
ENTERED_DATE
1/9/2023 12:00:00 AM
SITE_LOCATION
14900 W HWY 12, LODI
RECEIVED_DATE
1/9/2023 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\ymoreno
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EHD - Public
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Governor's Office of Emergency Services <br />Hazardous Materials Spill Report <br />DATE: 01/09/2023 I RECEIVED BY Cal OES: Zane Martens I Cal OES CNTRL <br />#:23-0247 <br />TIME: 1214 I RECEIVED BY OSPR: I NRC#: <br />PERSON NOTIFYING Cal OES <br />1. NAME: Ryan Lamunyon I 2. AGENCY: Valley Operators LLC <br />3. PHONE #: 925-250-6814 I 4. EXT: I 5. PAGER #: <br />PERSON REPORTING SPILL (If different from above): <br />1. NAME: I 2. AGENCY: <br />3. PHONE #: I 4. EXT: I 5. PAGER #: <br />2. SUBSTANCE TYPE: <br />a. SUBSTANCE: / b.QTY: / Amount / Measure / c. TYPE / d. OTHER / e. <br />PIPELINE / f. Vessel Over => 300 tons <br />1. Potential Release (Sewage) / = / U / Gal(s) / SEWAGE / / No / No <br />2. <br />3. <br />DESCRIPTION: ***Potential Release*** ***Potential Release*** <br />***Potential Release*** <br />Reporting Party states the Waste Water Treatment discharges partial treated sewage to a land application area. The <br />purpose of the land application area is that partially treated sewage will evaporate naturally. A portion of the land <br />application area is inundated with water, and could mix with sewage if that part of the land application area is utilized. <br />CONTAINED: Other I i. WATER INVOLVED: No <br />j. WATERWAY: N/A I k. DRINKING WATER IMPACTED: No <br />I. MARITIME VESSEL: No I m. KNOWN IMPACT: None <br />3.a. INCIDENT LOCATION: 14900 West Highway 12 <br />b. CITY: Lodi I c. COUNTY: San Joaquin County I d. ZIP: 95242 <br />4. INCIDENT DESCRIPTION: <br />a. DATE: 1/9/2023 I b. TIME(Military): 1200 I c. SITE: <br />Treatment/Sewage Facility I d. CAUSE: Other Reason for Other: Potential Release e. INJURIES: No f. <br />FATALITY: No I g. EVACUATIONS: No I h. <br />CLEANUP BY: Unknown <br />e. INJURIES #: I f. FATALS #: I g. EVACS #: <br />5. SUSPECTED RESPONSIBLE PARTY: <br />a. NAME: Denise Arnerich I b. AGENCY: Stockton Delta Resorts LLC <br />c. PHONE#: 209-482-8559 d. EXT: <br />MAIL ADDRESS: 14900 West Highway 12 <br />CITY: Lodi I g. STATE: CA I h. ZIP: 95242 <br />6. NOTIFICATION INFORMATION: <br />a. ON SCENE: I b. OTHER ON SCENE: <br />4
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