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Feb 20 07 09: 28a San Joaquin County CES 2094662600 p. 4 <br /> ,4•PR�!N.,.cA SAN JOAQUIN COUNTY-OFFICE OF EMERGENCY SERVICES <br /> HAZARDOUS MATERIALS DIVISION <br /> L " 222 East Weber Avenue,Room 610,Stockton,CA 95202 <br /> • �4<iic Q'HN�p. <br /> Telephone(209)468-3969 <br /> ADDENDUM TO <br /> CALIFORNIA HAZARDOUS MATERIALS INCIDENT REPORT <br /> Date Incident Occured Time Incident Date At Scene Time At Sane S10FS Incident No. <br /> Occurred <br /> 5/14/2002 1033 5/14/2002 1057 XSJ-01618 <br /> �l Initial Information Reported Wind Speed/Direction <br /> 1 gallon container with an unknown solid on Walker Lane South of Main St. NW @ 5 <br /> Reporting Party Name Address Telephone No. <br /> Janice 1810 Hazelton Ave. 209.469-3074 <br /> SIC Public Works Road Maint. Stockton,CA 95205 <br /> Responsible Party Name Address Telephone No. <br /> Unknown Unknown Unknown <br /> Responsible Party Representative Name Address Telephone No. <br /> Unknown Unknown Unknown <br /> OFS HazMat Team OPS Personnel On Scene <br /> Activated <br /> P. Cook, OES9 <br /> NO <br /> Joint Team Activated? DateTme Activated Members On Scene <br /> 0 NO <br /> Firc District Mitigation/Removal Action <br /> 18 Montezuma Referred to Public Works to dispose of. <br /> Agency Notifications and/or Referrals <br /> Name of Agency Date of Notification Time of Notification Name of Representative <br /> Noted <br /> County Road Maintenance 5/14/02 1110 Carla <br /> _ P <br /> Repotting Officer Signature CHMIR Filed? Incident Type <br /> Q No Abandoned Material <br /> Page 2 <br />