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CO0DOQMS7 (2)
Environmental Health - Public
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2500 – Emergency Response Program
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CO0DOQMS7 (2)
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Last modified
1/5/2022 2:52:05 PM
Creation date
1/5/2022 2:47:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0DOQMS7
PE
2546
STREET_NUMBER
0
STREET_NAME
LA FOLLETTE
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
NEAR 12729015
ENTERED_DATE
10/4/2021 12:00:00 AM
RECEIVED_DATE
10/4/2021 12:00:00 AM
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\ymoreno
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EHD - Public
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SAN JOAQUIN <br />couN, <br />copy Environmental Health Department <br />NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br />EMERGENCY LEVEL: <br />- No Evacuation/Local Response Only <br />SOURCE OF INFORMATION: <br />EHD LOG # <br />Li ii - Evacuation and/or In-County Mutual Aid Needed CI iii - Evacuation and/or State/Regional Mutual Aid Needed <br />RECORD ID. <br />- <br />Name: CONCERNED RESIDENT Phone: <br />Company: City: <br />Address: <br />Designated Employee: John Alaniz <br />Reporting Agency: San Joaquin County Environmental Health Department <br />Agency Address: 1868 E HazeIton Ave, Stockton, CA 95205 <br />LOCATION AND DATE OF DISCHARGE: <br />Location - Best <br />Physical Description: <br />SPILL OCCURRED ON CORNER OF PALM AVE AND LA <br />FOLLETTE AVE NEAR APN NEAR 12729015 <br />City: STOCKTON <br />D Incorporated ID Unincorporated <br />Date of Discharge: Date Notified: October 04, 2021 Time Notified: 9:00 am <br />RESPONSIBLE PERSON/BUSINESS <br />Name of Business: SAN JOAQUIN COUNTY ROAD MAINTENANCE <br />Contact Person: BRIAN CLOSS Contact Phone: (209) 468-3074 <br />Mailing Address: 1810 E HAZLETON AVE <br />City: STOCKTON State: CA ZIP: 95205 <br />DESCRIPTION <br />Material: AUTOMOBILE FLUID Amount: 2.00 D lbs 1=1 gal 0 cu ft <br />Type of Discharge: RELEASE FROM CAR <br />Circumstances: EHD NOTIFIED BY CONCERNED RESIDENT <br />Material: Amount: D lbs D gal Illcu ft <br />Type of Discharge: <br />Circumstances: <br />Material: Amount: El lbs D gal I=1 cu ft , <br />Type of Discharge: <br />Circumstances: <br />ACTION TAKEN <br />ABSORBENT WAS PLACED ON SPILL BY RESIDENT <br />SITE DISPOSITION <br />EHD IS WORKING WITH SAN JOAQUIN COUNTY ROAD MAINTENANCE FOR FINAL CLEAN UP <br />Page 1 of 2 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/EHD
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