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COTTO0ND2
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2500 – Emergency Response Program
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COTTO0ND2
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Last modified
3/7/2023 2:59:12 PM
Creation date
3/7/2023 2:58:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COTTO0ND2
PE
2546
FACILITY_NAME
TIKI LAGOONA MARINA
STREET_NUMBER
12988
Direction
W
STREET_NAME
MCDONALD
STREET_TYPE
RD
City
STOCKTON
Zip
95206
APN
13102026
ENTERED_DATE
12/1/2021 12:00:00 AM
SITE_LOCATION
12988 W MCDONALD ROAD
RECEIVED_DATE
12/1/2021 12:00:00 AM
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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SJGOV\bmascaro
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EHD - Public
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SAN JOAQUIN <br />Environmental Health Department <br /> <br />COUNTY <br /> <br />EMERGENCY RESPONSE RECORD <br />Date: December 01, 2021 Short Term #: COTTOOND2 <br />Premise Address: 12988 W MCDONALD RD City: STOCKTON <br />Premise DBA: TIKI LAGOONA MARINA Cross Street: MCDONALD RIVER BRIDGE <br />Premise Owner: TIKI LAGOONA MARINA Owner's Phone: (510) 912-4276 <br />Mailing Address: 12988 W MCDONALD RD Owner City: STOCKTON <br />Facility Contact: DAN DUMUS Contact Phone: (510) 912-4276 <br />RP DBA: DAN DUMAS <br /> <br />Onsite RP Name: DAN DUMAS <br /> <br />Onsite RP Phone: (510) 912-4276 <br /> <br />Mailing Address: 12988 W MCDONALD RD <br /> <br />RP City: STOCKTON <br /> <br />RP Contact: DAN DUMAS <br />Contact Phone: (510) 912-4276 <br />NATURE OF RESPONSE (explosion, spill, leak, fire, or abandoned/dumped material <br />ABANDON BOAT IN SLIP #16 C-1 IS LEAKING DYED DIESEL WITH UNKNOWN AMOUNT, SHEEN IS OBSERVED IN <br />BOAT SPLIT #15 AND #17 <br />Time Received: 7:03 pm Time of Arrival: 8:50 am Time of Departure: 2:30 pm <br />PERSONS AT SCENE <br />NAME AGENCY PHONE TOA TOD <br />PAUL NSO EHD (209) 616-3049 8:50 am 2:30 pm <br />KRISTINA SAETERN EHD (209) 616-3045 8:50 am 12:50 pm <br />MIGUEL VERA TIKI LAGOON MARINA (209) 623-6904 8:50 am <br />MIGUEL VERA JR TIKI LAGOON MARINA (209) 623-3622 8:50 am <br />DAN DUMAS TIKI LAGOON MARINA (510) 912-4276 10:10 am <br />MATERIAL / CLASSIFICATION (chemical involved) <br />MATERIAL AMOUNT SOLID (lbs) LIQUID (gal) GAS (cu ft) COMMENTS <br /> <br />DYED DIESEL KICA,0N-J <br /> 1 Ii <br />LI <br />LI 0 <br />REFERRALS AND NOTIFICATIONS <br />REFERRED TO (NAME AND ADDRESS) DATE MAILED <br />Date Prop 65 Completed: December 01, 2021 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! Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/EHD
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