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SAN JOAOUIN COPY <br />Environmental Health Department <br />EMERGENCY LEVEL: <br />C] I - No Evacuation/Local Response Only <br />NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br />EHD LOG # - o <br />El I - Evacuation and/or In-County Mutual Aid Needed <br /> D III - Evacuation and/or State/Regional Mutual Aid Needed <br />• SOURCE OF INFORMATION: <br />Name: CHASE MAESER Phone: (206) 913-7662 <br />Company: BROADBENT AND ASSOCIATES City: CHICO <br />Address: 1370 RIDGEWOOD DR <br />Designated Employee: Gabriela Garcia-Mejia <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 <br />Physical Description: <br />FLYING J AT 345 ROTH ROAD, LATHROP CA 95330 (APN <br />19333039) <br />City: LATHROP <br />ID Incorporated El Unincorporated <br />Date of Discharge: January 24, 2023 Date Notified: January 24, 2023 Time Notified: 7:54 pm <br />RESPONSIBLE PERSON/BUSINESS <br />Name of Business: NEW PRIME INC. <br /> <br />Contact Person: DENNIS DAVIS <br /> <br />Contact Phone: (417) 521-3931 <br />Mailing Address: 2740 N MAYFAIR AVENUE <br /> <br />City: SPRINGFIELD <br />State: MO <br /> ZIP: 65803 <br />DESCRIPTION <br />Material: DIESEL Amount: 15.00 CI lbs 0 gal D cu ft <br />Type of Discharge: RELEASE <br />Circumstances: PUNCTURED SADDLE TANK ON SEMITRUCK CAUSED THE RELEASE <br />Material: Amount: 1:1 lbs I=Igal CI cu ft <br />Type of Discharge: <br />Circumstances: <br />Material: Amount: 1=1 lbs CI gal El cu ft <br />Type of Discharge: <br />Circumstances: <br />ACTION TAKEN <br />RESPONSIBLE PARTY RETAINED ANCON ENVIRONMENTAL TO CONDUCT CLEAN UP <br />SITE DISPOSITION <br />CLEAN UP WAS COMPLETED. PROVIDE FINAL DISPOSAL RECORDS TO THE EHD. <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