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1 V <br /> S A N t 0����� Environmental Health Department <br /> ---- C G-I U "'J ( Y _ �y <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> EMERGENCY LEVEL: EHD LOG# ,J_93 <br /> ❑x 1-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: COVEZDHGC <br /> Name: Dan Tynan Phone: (209)346-5176 <br /> Company: Inframark City: Mountain House <br /> Address: 18045 Kelso Rd. <br /> Designated Employee: Aaron Hang <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 18045 Kelso Rd. Mountain House, CA 95391 City: MOUNTAIN HOUSE <br /> Physical Description: <br /> ❑ Incorporated ❑D Unincorporated <br /> Date of Discharge: March 19, 2018 Date Notified: March 19, 2018 Time Notified: 11:58 am <br /> RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: Mountain House CSD Water Treatment Plant <br /> Contact Person: Michael Buckley Contact Phone: (209)604-4870 <br /> Mailing Address: 18045 Kelso Rd. <br /> City: Mountain House State: CA ZIP: 95391 <br /> DESCRIPTION <br /> Material: Red Diesel Amount: 50.00 ❑ lbs NO gal ❑cu ft <br /> Type of Discharge: Liquid Release <br /> Circumstances: Damaged/cracked diesel filter <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 <br /> ircumstances:ACTION TAKEN <br /> Site has contracted Clean Harbors to perform remediation. <br /> SITE DISPOSITION <br /> EHD waiting for disposal records. <br /> Page 1 of 2 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />