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r P0 <br /> oPg�.id.. SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> ` 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 1\ (209)468-3420 • Fax:(209)464-3433• Web:www.siqov,org/ehd <br /> 9(I•F O.RN: <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE EHDLOG# -I <br /> EMERGENCY LEVEL: <br /> QX I-No Evacuadonkocal Response Only ❑II-Evacuation andlor In-County Mutual Aid Needed ❑III-Evacuation and/or Regional/State Mutual Aid Needed <br /> SOURCE OF INFORMATION PHONE: (209) 953-7699 <br /> KEIenaena Manzo <br /> n Joaquin County Environmental Health Departent CITY: Stockton <br /> 68 E. Hazelton Ave.PLOYEE NAME: ElenaManzOPHONE: (209) 953-7699 <br /> NCY NAME: San Joaquin County Environmental Health Department <br /> 1868 E. Hazelton Ave., Stockton, CA 95205-6232 <br /> LOCATION AND DATE OF DISCHARGE <br /> LOCATION: San Joaquin River Club/1 A26 parcel at 30000 CITY Tracyloco posted <br /> Best Physical KaSSOn Road FE] <br /> Unincorporated <br /> Description <br /> DATE OF Wednesday, October 19, 2016 <br /> DISCHARGE: <br /> DATE Wednesday, October 19, 2016 TIME: 7 pm <br /> NOTIFIED: <br /> RESPONSIBLE PERSON/BUSINESS <br /> NAME OF BUSINESS: San Joaquin River Club <br /> y <br /> CONTACT PERSON: <br /> Dan Divine PHONE: <br /> PHYSICAL ADDRESS: 30000 KaSson Road, Tracy, CA <br /> MAILING ADDRESS: As above <br /> DESCRIPTION <br /> TYPE OF DISCHARGE: Leak from an abandoned tank <br /> VOLUME: estimated at 20 gallons <br /> CHEMICALS: petroleum hydrocarbon fuel <br /> CIRCUMSTANCES: Leak from an abandoned above ground tank <br /> ACTION TAKEN <br /> The leak was stopped, reme ial excavation was initiated <br /> SITE DISPOSITION <br /> Clean-up is in progress <br /> Revised 6/01/2015 Page 1 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br />