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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 E Main Street Stockton - CA 95202 W. (209) 468-3420 - Fax: (209) 464-0138 •Web: vwuw.sjgov.ora/ehd 9 j'j F:O Rpt EMERGENCY RESPONSE RECORD DATE: Wednesday, July 28, 2010 SHORT TERM#: 3 PREMISE ADDRESS: 12121 Zuckerman Rd. Stockton, CA 95206 CITY: Stockton DBA: I PG&E McDonald Island PREMISE OWNER: PG&E PHONE: (209) 993-9486 OWNER'S ADDRESS: 2121 Zuckerman Rd. Stockton, CA 95206 CITY: Stockton FACILITY CONTACT: Ralph Roberts PHONE: (209) 323-9492 RESPONSIBLE PARTY (RP) DBA: I PG&E McDonald Island RP NAME: I Ralph Roberts PHONE: (209) 323-9492 RP ADDRESS: 2121 Zuckerman Rd. Stockton, CA 95206 CITY: Stockton RP CONTACT: Ralph Roberts PHONE: (209) 323-9492 NATURE OF COMPLAINT (explosion, spill, leak, fire, or abandoned/dumped material Less than 5 gallons of hydraulic oil released from the hydraulic system on the natural gas platform. TIME RECEIVED: 12:30pm TIME OF ARRIVAL: 3:30pm TIME OF DEPARTURE: 4:15pm PERSONS AT SCENE NAME AGENCY PHONE TOA TOD Ads Cacapit SJC EHD (209) 468-3453 3:30pm 4:15pm Michael A. Farling PG&E (209) 993-9486 Ralph Roberts PG&E (209) 323-9492 IDENTIFICATION OF MATERIAL (CHEMICAL INVOLVED) SUBSTANCE FORM I ❑ SOLID POWDER ❑ GAS ❑x LIQUID ❑ GRANULE REFERRALS TO: PHONE DATE MAILED: DATE COMPLETED.... PROP 65: Jul 30, 2010 LIAR: PFRRCINC FXPC1CFn nnri/nr IN_II IRFr1 NAME ADDRESS PHONE "PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD" COMPLETED? ❑ YES ❑ NO E. R. BINDER COPIES: X1 SHORT-TERM ON TOP Q NARRATIVEANALYTICAL DATA x PROP 65 / LIAR ❑ EXPOSURE RECORD Ll MANIFEST ❑ CLEAN UP REPORT ❑ OTHER AGENCY REPORTS ❑ REFERRALS I x MAP I Ej FILE CREATED ER RECORD 06/01/10 Page 1