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COTLS1U9N
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2500 – Emergency Response Program
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Last modified
3/6/2023 3:32:51 PM
Creation date
3/6/2023 3:32:05 PM
Metadata
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Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COTLS1U9N
PE
2546
FACILITY_NAME
SHINN, MATHEW D & EVONNE A TR
STREET_NUMBER
21600
Direction
N
STREET_NAME
DAVIS
STREET_TYPE
RD
City
LODI
Zip
95242
APN
01308043
ENTERED_DATE
11/29/2022 12:00:00 AM
SITE_LOCATION
21600 N DAVIS RD, LODI, CA 95242
RECEIVED_DATE
11/29/2022 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\bmascaro
Tags
EHD - Public
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SAN JOAQUIN <br /> COPY <br />Environmental Health Department <br />COUNTY- <br />EMERGENCY LEVEL: <br />NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br />EHD LOG # 1/2 <br /> <br />I - No Evacuation/Local Response Only <br /> <br />El II - Evacuation and/or In-County Mutual Aid Neede I=1 III - Evacuation and/or State/Regional Mutual Aid Needed <br /> <br />SOURCE OF INFORMATION. RECORD ID. COTLS1 <br />Name: BRIAN CLOSS Phone: (209) 468-3074 <br />Company: SAN JOAQUIN PUBLIC WORKS City: STOCKTON <br />Address: 1810 E HAZELTON AVE <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 />LOCATION AND DATE OF DISCHARGE: <br />Location - Best ON THE ROAD AT 21600 N DAVIS RD, LODI <br />Physical Description: <br />City: LODI <br />0 Incorporated 1=I Unincorporated <br />Date of Discharge: November 26, 2022 Date Notified: November 29, 2022 Time Notified: 8:30 am <br />RESPONSIBLE PERSON/BUSINESS <br />Name of Business: <br />Contact Person: UNKNOWN Contact Phone: <br />Mailing Address: <br />City: State: ZIP: <br />DESCRIPTION <br />Material: HYDRAULIC FLUID Amount: Ill lbs I=1 gal 1=1 cu ft <br />Type of Discharge: RELEASED <br />Circumstances: FROM A BROKEN TRACTOR <br />Material: Amount: D lbs 111 gal 0 cu ft <br />Type of Discharge: <br />Circumstances: <br />Material: Amount: 0 lbs 1=1 gal 1=1 cu ft <br />Type of Discharge: <br />Circumstances: <br />ACTION TAKEN <br />CLEAN UP COMPLETED BY SAN JOAQUIN COUNTY PUBLIC WORKS ON 11/26/2022. <br />SITE DISPOSITION <br />EHD TO FOLLOW UP WITH SAN JOAQUIN COUNTY PUBLIC WORKS TO INVESTIGATE IF ADDITIONAL CLEAN UP IS <br />REQUIRED AND BE COMPLETED. <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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