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URF Final Step '* Pagel of 2 <br /> ti <br /> REGULATORS HOME_I RESTART WTARD LOGOUT <br /> UNAUTHORIZED RELEAE FORM WIZARD <br /> -=YOUR URF HAS NOT YET BEEN SUBMI TED TO GEOTRACKER=- <br /> CLICK ON "SUBMIT UNAUTHORIZED RELEAS FORM" TO SUBMIT THE URF. <br /> THIS WILL BE YOUR URF TRACKING UMBER: 9589490592 <br /> UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASEICONTAMINATION SITE REPORT <br /> REPORT DATE HAZARDOUS MATERIAL INCIDENT REPORT FI ED WITH OES? <br /> 7119/07 <br /> I.REPORTED BY- <br /> LOCAL AGENCY-PRIMARY CASEWORKER <br /> CONTACT NAME INITIALS ORGANIZATION NAME EMAIL ADDRESS <br /> MARGARET LAGORIO ML SAN JOAQUIN COU TY LOP <br /> ADDRESS CONTACT DESCRIPTION <br /> 304 E WEBER <br /> STOCKTON,CA 95202 <br /> USA <br /> PHONE TYPE PHONE NUMBER EXTENSION <br /> PUBLIC AGENCY (209)-468-3449 <br /> II.RESPONSIBLE PARTY- <br /> RESPONSIBLE PARTY CONTACT <br /> CONTACT NAME INITIALS ORGANIZATION NAME EMAIL ADDRESS <br /> JOSEPH ROKOSZEWSKI JR JOSEPH ROKO' ZEWSKI <br /> ADDRESS CONTACT DESCRIPTION <br /> 2015 HARDING WAY <br /> STOCKTON,CA 95205 <br /> USA <br /> III.SITE LOCATION <br /> FACILITY NAME FACILITY ID <br /> R&L DIESEL <br /> FACILITY ADDRESS ORIENTATION OF SITE TO STREET <br /> 2417 WEST LANE <br /> STOCKTON,CA 95205 <br /> CROSS STREET <br /> SAN JOAQUIN COUNTY KLINGER r <br /> V.SUBSTANCES RELEASED <br /> SUBSTANCE RELEASED DESCRIPTION QUANTITY LOST <br /> WASTE OIL/USED OIL UNKNOWN <br /> VI.DISCOVERY/ABATEMENT <br /> DATE DISCHARGE BEGAN <br /> UNKNOWN <br /> DATE DISCOVERED HOW DISCOVERE DESCRIPTION <br /> 7/19/07 SAS I <br /> DATE STOPPED STOP METHOD DESCRIPTION <br /> OF <br /> VII.SOURCEICAUSE <br /> SOURCE OF DISCHARGE CAUS OF DISCHARGE <br /> UNK UNK <br /> DISCHARGE DESCRIPTION <br /> VIII.CASE TYPE <br /> https://geotracker.swrcb.ca.gov/urf3/urf final.asp 7/20/2007 <br />