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o.P� '"•..c SAN JOAQUIN COUNTY- OFFICE OF EMERGENCY SERVICES <br /> HAZARDOUS MATERIALS DIVISION <br /> 222 East Weber Avenue, Room 610, Stockton, CA 95202 <br /> Telephone (209)468-3969 <br /> c'�G/FORa�P <br /> CALIFORNIA HAZARDOUS MATERIALS REPORT ADDENDUM <br /> Date Incident Occured Time Incident Date On Scene Time On Scene SJOES Incident No. <br /> Occured <br /> 09/29/96 1800 IR-00270 <br /> M Initial Information Reported Wind Speed/Direction <br /> Pressure relief opened releasing ammonia <br /> Repotting Party Name Address Telephone No. <br /> Steve Rap 12001 S. Highway 99 (209)239-1215 <br /> Responsible Parry Name Address Telephone No. <br /> N SAME <br /> Responsible Party Representative Name Address Telephone No. <br /> SAME <br /> OES HazMat Team DES Personnel On Scene <br /> Activated <br /> No No response <br /> Joint Team Activated? Date/Time Activated Members On Scene <br /> O no <br /> Fire District Mitigmion/Removal Actions <br /> Manteca Lathrop System was isolated and shut down. <br /> Agency Notifications and/or Referrals <br /> Name of Agency Date of Notification Time of Notification Name of Representative <br /> Notified <br /> State OES 9/30/96 1000 <br /> P <br /> Reporting Officer Signature CHMIR Filed Incident Type <br /> Q 015772 Fixed Facility, Accident <br /> Page 2 <br />