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Discharge Notification Form <br /> MOUNTAIN VALLEY EXPRESS <br /> 1019 Bessemer Avenue, Manteca, California <br /> Part A: Discharge Information <br /> General information when reporting a spill to outside authorities <br /> Basic Information <br /> Facility name, address and contact number: Mountain Valley Express <br /> 1019 Bessemer Avenue <br /> Manteca, California 95336 <br /> (209) 823-2168 (Office) <br /> Owner/Operator, address and contact number: Dan Souza <br /> 1019 Bessemer Avenue <br /> Manteca, California 95336 <br /> (209) 823-2168 (Office) <br /> Emergency Coordinator, office address and Dan Souza <br /> contact number: 1019 Bessemer Avenue <br /> Manteca, California 95336 <br /> (209) 823-2168 (Office) <br /> (209)456-0415 (Cell) <br /> Alternate Facility Employee: Mr.Tony Huddleston <br /> Work (Office): (209) 823-2168 <br /> Cell (24 hour): (209)456-4083 <br /> Spill Information <br /> Type of oil: Discharge Date and Time: <br /> Quantity released: Discovery Date and Time: <br /> Quantity released to a water body: Discharge Duration: <br /> Location/Source: <br /> Actions taken to stop, remove, and mitigate impacts of the discharge: <br /> Advanced GeoEnvironmental,Inc. <br />