Laserfiche WebLink
i r � <br /> + � `a a:Cal EMA (State Warning Center) 91684.58910 04/0612010 17:07 #689 P.0011002 <br /> California Emergency Management Age Q <br /> Hazardous Materials Spill Repo <br /> DATE: 04/06/2010 RECEIVED BY: CONTROL#: <br /> TIME.• 1651 Cal EMA- Courtland Ellis Cal EMA- 10-2214 /� <br /> OSPR - NRC- /`J] <br /> La. PERSON NOTIFYING Cal EMA: <br /> I. NAME: 2. AGENCY: 3. PHONE#: 4.Ext: 5.PAG/CEL U <br /> O <br /> Roger Hoffdahl Coni Products lnteinational, 209-982-1920 233 <br /> Inc <br /> III <br /> I.b. PERSON REPORTING SPILL(If different from above): <br /> 1. NAME: 2. AGENCY: 3. PHONE#: 4.Ext: 5.PAG/CELL: <br /> 2. SUBSTANCE TYPE: <br /> 2.a.SUBSTANCE: b.QTY:>=< Amount Measure c.TYPE: d.OTHER: <br /> 1. Hydrochloric acid - 180 G81(s) CHEMICA[. <br /> diluted <br /> 2. _ <br /> 3. <br /> e.DESCR1P`1,II3N: This release was caused by a line leak and was contained in a in house system <br /> E CONTAINED: g.WATER h.WATERWAY: i.DRINXING WATER IMPACTED <br /> INVOLVED: <br /> Yvi No No <br />€ j.KNOWN IMPACT None <br /> 3. a.INCIDENT LOCATION: 1021 Industrial Dr <br /> b.CITY: c.COUNTY: d.ZIP: <br /> Stockton San Joaquin County 95206 <br /> 4.INCIDENT DESCRIPTION: <br /> a.DATE: b. TIME (Military): c.SITE: d. CAUSE <br /> 04/06/2010 1330 Industrial Plant Mechanical <br /> e. Ilal-€RIES 1'. FATALITY g.EVACLTATION to.CLEANUP:1 Y— <br /> Responsible Party <br /> 5. SUSPECTED RESPONSIBLE PARTY: <br /> a.NAME: b. AGENCY: c.PHONE#: d.EXT.: <br /> Com Products 209-982-1924 233 <br /> International,Inc <br /> e.MAIL ADDRESS: f.CITY: g.STATE: h.ZIP: <br /> 1021 Industrial Dr Stockton CA 95205 <br /> 6. NOTIFICATION INFORMATION: <br /> [a.ON SCENE: b.OTHER ON SCENE: c.OTHER NOTIFIED: <br /> County Health,City of Stockton <br /> d.ADMIN.AGENCY: sail e.SEC.AGENCY: <br /> 7oagifti Country Emergency <br /> services <br /> L ADDITIONAL g.ADMIN.AGENCY: <br /> COUNTY: <br /> h.NOTIFICATION LIST: <br /> DOG Unit: RWQCB Unit: 5B <br /> ®AA/CUPA ®USFWS ❑CDPH-D.O. ❑FEMA ❑Cal E.MAREG ❑USMMS ❑OTHER <br /> ®DFO-OSPR ❑AIR RESOURCES BD ❑DO* ❑FOOD&AL3 ❑OSHA ❑USCG <br /> ®DISC ❑CALTRANS ❑DPR ❑LANDS ❑PARKS&REC ❑COMP <br /> ®RWQCB ❑CAF ❑EB PARKS ❑Cal EMAHAZMAV=❑PUC ❑CoMlth <br /> ®US EPA ❑COASTAL COM ❑EMSA ❑Cal EMAPLANS UMT ❑SFM ❑Cof)iHlth <br /> �Af17i11�,c8nECr ax3+:S.f'a.gUv; RRC*,@E+uPA.G0'%�DTSC.FR1ftl118i1x'-0 n <br />