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' SA J O ` QUI " Environmental Health Department <br /> i "Y' COPY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE spt <br /> EMERGENCY LEVEL: EHD LOG# <br /> ❑x I-No Evacuation/Local Response Only ❑ II-Evacuation and/or In-County Mutual Aid Needed ❑III-Evacuation and/or State/Regional Mutual Aid Needed <br /> SOURCE OF INFORMATION: RECORD ID: C00046835 <br /> Name: Paul Holt Phone: (916) 540-0496 <br /> Company: Union Pacific Railroad City: Roseville <br /> Address: 1600 Vernon St <br /> Designated Employee: John Alaniz <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 In the spill containment area at 1000 E Roth Rd. City: FRENCH CAMP <br /> Physical Description: <br /> ❑ Incorporated ® Unincorporated <br /> Date of Discharge: June 05, 2018 Date Notified: June 05, 2018 Time Notified: 4:00 pm <br /> RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: C.H. Robinson <br /> Contact Person: Katie Bevier Contact Phone: <br /> Mailing Address: 4225 Naperville Rd Suite 240 <br /> City: Lisle State: IL ZIP: 60532 <br /> DESCRIPTION <br /> Material: Hydraulic Oil Amount: 0.20 ❑ lbs 0 gal ❑ cu ft <br /> Type of Discharge: Leak from forklift. <br /> Circumstances: Notified by Union Pacific. <br /> Material: Amount: ❑ lbs ❑ gal ❑ cu ft <br /> Type of Discharge: <br /> Circumstances: <br /> Material: Amount: ❑ lbs ❑ gal ❑ cu ft <br /> Type of Discharge: <br /> Circumstances: <br /> ACTION TAKEN <br /> The spill has been cleaned-up and the site is contained. <br /> SITE DISPOSITION <br /> EHD is waiting for final disposal documents. <br /> Page 1 of 2 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />