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Company Name <br />SECTION 1 <br />NOTIFICATION <br />Mailing Address <br />Telephone <br />Street Address of Facility <br />Assessor's Parcel Number <br />Facility Telephone (if different from <br />Primary Emergency Coordinator <br />Address <br />Telephone (Office) <br />'� f® 'R f. t 7 _5 <br />Alternate Emergency Coordinator <br />Address <br />Headq.uarters) <br />(Home) 1� & q 12 V V O <br />Telephone (Office) -:9G4' 6 (Home) <br />24 -Hour On -Site Contact (if available) <br />FEDERAL, STATE, AND LOCAL EMERY RESPONSE CONTACTS <br />Organization Telephone <br />*Emergency Response Agencies (Fire, Law, Medical) 9-1-1 <br />*San Joaquin Count Office of Emergencl Services 944-2111 (8a.m.-5 .m. <br />944--2181 (24 -Hour) <br />*State Warning Center (800) 852-7550 <br />National Res onse Center (800) 424-8802 <br />Chemtrec - Emergency Res2onse Information Service (800) 424-9300 <br />Toxic Information Hotline (800) 233-3360 <br />San Joaquin Local Health District T-3 <br />Regional Water Quality Control Board (916) O <br />*A business is required to report any release or threatened release of a <br />hazardous material to these agencies. <br />