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COTQBW0JS
Environmental Health - Public
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2500 – Emergency Response Program
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COTQBW0JS
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Entry Properties
Last modified
7/25/2022 8:25:36 AM
Creation date
2/8/2019 6:47:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COTQBW0JS
PE
2546
FACILITY_NAME
PGE
STREET_NUMBER
0
STREET_NAME
LIBERTY
STREET_TYPE
RD
City
GALT
Zip
95632
ENTERED_DATE
5/7/2017 12:00:00 AM
SITE_LOCATION
E Liberty and Elliott Rd
RECEIVED_DATE
5/7/2017 12:00:00 AM
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\L\LIBERTY\0\COTQBW0JS.PDF
Tags
EHD - Public
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�4r�Fo <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E. Hazelton Ave., Stockton • CA 95205 <br /> (209) 468-3420 • Fax;(209) 468-3433 • Web:www.sjgov.org/ehd <br /> iFa'N <br /> EMERGENCY RESPONSE RECORD <br /> DATE: 05/07/2017 SHORTTERM#: COTQBWOJS <br /> PREMISE ADDRESS:Elliott Road CITY: Galt <br /> DBA:NA ICROSS STREET:Liberty Road <br /> PREMISE OWNER:NA PHONE: NA <br /> OWNER'SADDRESS:NA CITY:NA <br /> FACILITY CONTACT:NA PHONE:NA <br /> RESPONSIBLE PARTY(RP)DBA:PG&E <br /> RP NAME:PG&E PHONE:(209) 337-8902 <br /> RP ADDRESS: 1108 Murphys Grade Road CITY:Angels Camp <br /> RP CONTACT:Alex Steele PHONE,(209) 337-8902 <br /> NATURE OF RESPONSE(explosion,spill,leak,fire,or abandoned/dumped material) <br /> Approximately 60 gallons of transformer oil spilled onto the ground and impacted the roadway, the <br /> shoulder and the irrigation ditch adjacent to 12445 E Liberty Road, Galt, CA. <br /> TIME RECEIVED:08.15am ITIME OF ARRIVAL: 10:52am ITIME OF DEPARTURE: 11.05am <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> Haza Saeed SJC EHD 2099536212 10:52am 11:05am <br /> Elena Manzo SJC EHD (209)953-7699 10:52am 11:05am <br /> Alex Steele PG&E (209) 337-8902 10:54am Unknown <br /> MATERIAL/CLASSIFICATION(aEMIu IN veD) <br /> IDENTIFICATION SPILLED? SOLIDI}I IIID +SAS COMMENTS <br /> (LBS) (GA (CU FTI <br /> Mineral Oil XY U N 60 Approximately 60 gallons reported <br /> UY UN <br /> UY UN <br /> ❑Y ❑N <br /> ❑Y ❑N <br /> ❑Y UN <br /> REFERRALS AND NOTIFICATIONS <br /> REFERRED TO(NAME AND ADDRESS) DATE MAILED <br /> NA <br /> NA <br /> DATE PROP 65 COMPLETED: 05/08/17 DATE UAR COMPLETED: NA <br /> IF PERSONS EXPOSED and/or INJURED,"PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD"COMPLETED? ❑ YES ❑ NO <br /> ER BINDER COPIES: <br /> XSHORT-TERM ON TOP )3( NARRATIVE }( MAP X ANALYTICALDATA XPROP 65/UAR ❑ FILE CREATED <br /> )3( MANIFEST O REFERRALS O CLEAN UP REPORT D OTHERAGENCY REPORTS O EXPOSURE RECORD I $( PHOTOS <br /> ER RECORD Page 1 10/03/12 <br />
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