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PORT OF STOCKTON <br />TENANTS/NON-TENANTS RELEASE NOTIFICATION CHECKLIST <br />HAZARDOUS/REGULATED SUBSTANCES NOTIFICATION CHECKLIST <br />Tenant Business Name: American Biofuels dba Community Fuels <br />Facility location within the Port where spill occurred: (Attach a map) <br />Outside tank farm on south side of facility, North West Corner of Tank Farm See attached map <br />Facility Environmental Manager/Foreman/or person in charge: J. D. Williamson EHS Manager <br />Facility Phone tt: 209.222.6286 <br /> <br />Cell It: 209 471 9996 <br /> <br />Date of release: 11.20.20 Time of release: 18:30 PST <br />Describe type of substances/material released: (Liquid or Solid; include common and chemical name; attach MSDS and waste <br />manifest) <br />Bio-Diesel <br />Amount of released material: (Pounds or Gallons) Less Than 5.0 Galleons. <br />Give a description of how the release occurred and whether the material reached the storm drain system: <br />After loading a KAG Tanker with BioDiesel, while hoses being disconnected, back flow occured. <br />Nothing reached either dirt, nor the storm drain system. <br />In the event of a release; verbal notification must be made to the Port Police Dept. at (209) 946-0246 <br />11.23.20 09.00 Officer McConnell Date reported: Time reported: Reported to: <br />Provide details of immediate action taken and subsequent clean-up action taken to stop release. <br />Raised hose to stop back flow. Put down 6 spill pads and three bags of absorbent to clean it up <br />Used mild degreaser and a power washer to clean the Asphalt. <br />Submit this document and all written copies to the Port's Environmental Department within 6 hours of the incident. <br />(On weekends; note time of submittal) <br />Port's Environmental Department <br />Submitted by: Debbie Cali Time: 10:00 PST <br />A report describing the emergency response measures taken, post-emergency clean-up actions, the storage and <br />disposition of any materials recovered from the clean-up actions, list all Best Management Practices, pollution <br />prevention and corrective action measures necessary to prevent future reoccurrence. This report must be submitted <br />to the Port's Environmental Department within 48 hours of the Incident. <br />** Any questions regarding the use, completion, and scope of this checklist should be directed to the <br />Port's Environmental Department at (209) 946-0246. <br />FOR PORT USE ONLY <br />List follow-up actions required with respect to this incident.