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CO0053721 (2)
Environmental Health - Public
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CO0053721 (2)
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Last modified
3/23/2022 2:07:40 PM
Creation date
3/23/2022 1:45:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0053721
PE
2546
STREET_NUMBER
2325
Direction
W
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
MANTECA
Zip
95337
APN
19811014
ENTERED_DATE
4/23/2021 12:00:00 AM
SITE_LOCATION
2325 W LOUISE AVE
RECEIVED_DATE
4/23/2021 12:00:00 AM
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\ymoreno
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EHD - Public
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SAN. JOAQUIN COPY Environmental Health Department <br /> <br />--COUNTY <br /> <br />EMERGENCY LEVEL: <br />- No Evacuation/Local Response Only <br />NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br />EHD LOG # 12A <br />El II - Evacuation and/or In-County Mutual Aid Needed <br /> 1=1 Ill - Evacuation and/or State/Regional Mutual Aid Needed <br />RECORD ID C00053721 <br />Name: KELLY DURRER Phone: (209) 305-0171 <br />Company: MEDLINE INDUSTRIES City: MANTECA <br />Address: 2325W LOUISE AVE <br />Designated Employee: Elianna Florido <br />Reporting Agency: San Joaquin County Environmental Health Department <br />Agency Address: 1868 E Hazelton Ave, Stockton, CA 95205 <br />Location - Best <br />Physical Description: <br />2325 W LOUISE AVE MANTECA, CA 95337 City: MANTECA <br />0 Incorporated 0 Unincorporated <br />Date of Discharge: April 23, 2021 Date Notified: April 23, 2021 Time Notified: 1:42 pm <br />Name of Business: MEDLINE INDUSTRIES <br />Contact Person: KELLY DURRER Contact Phone: (209) 305-0171 <br />Mailing Address: 2325 W LOUISE AVE <br />City: MANTECA State: CA ZIP: 95337 <br />___ _.... .._ . <br />Material: DIESEL FUEL Amount: 2.00 0 lbs 0 gal 0 cu ft <br />Type of Discharge: SPILL <br />Circumstances: FUELING CONTRACTOR OVERFILLED EMERGENCY BACKUP GENERATOR CAUSING THE RELEASE <br />Material: Amount: 0 lbs 0 gal 0 cu ft <br />Type of Discharge: <br />Circumstances: <br />Material: Amount: 0 lbs 0 gal E cu ft <br />Type of Discharge: <br />Circumstances: <br />ACTION TAKEN <br />RESPONSIBLE PARTY'S (RP) FUELING CONTRACTOR CONDUCTED THE INITIAL CLEAN-UP. EHD VERIFIED CLEAN-UP <br />IS NOT COMPLETE. EHD ISSUED RP A NOTICE TO ABATE. <br />SITE DISPOSITION <br />RP TO COMPLETE THE SPILL CLEAN-UP AND NOTIFY EHD TO VERIFY THE CLEAN-UP IS COMPLETE. RP TO <br />DISPOSE OF CLEAN-UP WASTE PROPERLY AND RETAIN WASTE DISPOSAL RECORDS FOR EHD VERIFICATION. <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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