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COI3MOMWH (2)
Environmental Health - Public
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2500 – Emergency Response Program
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COI3MOMWH (2)
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Last modified
4/4/2023 2:16:46 PM
Creation date
4/4/2023 2:12:19 PM
Metadata
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Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COI3MOMWH
PE
2546
STREET_NUMBER
135
Direction
S
STREET_NAME
FINE
STREET_TYPE
RD
City
LINDEN
Zip
95236
APN
18336032
ENTERED_DATE
12/22/2022 12:00:00 AM
SITE_LOCATION
135 S FINE RD, LINDEN CA 95236
RECEIVED_DATE
12/22/2022 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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MATERIAL / CLASSIFICATION (chemical involved) <br />MATERIAL AMOUNT SOLID (lbs) LIQUID (aal) GAS (Cu ft) COMMENTS <br />FUEL WITH MOTOR OIL 50.00 <br />o <br />0 0 <br />SAN JOAQUIN <br /> Environmental Health Department <br />C OU N I Y <br />EMERGENCY RESPONSE RECORD <br />Date: December 22, 2022 Short Term #: C013MOMWH <br />Premise Address: 135 S FINE RD City: LINDEN <br />Premise DBA: Cross Street: COPPEROPOLIS <br />Premise Owner: ROY HARRISON & MICHELLE L Owner's Phone: <br />Mailing Address: 135 S FINE RD Owner City: LINDEN <br />Facility Contact: ROY HARRISON & MICHELLE L Contact Phone: <br />RP DBA: UNKNOWN <br />Onsite RP Name: Onsite RP Phone: <br />Mailing Address: UNKNOWN RP City: <br />RP Contact: Contact Phone: <br />NATURE OF RESPONSE (explosion, spill, leak, fire, or abandoned/dumped material <br />TRAFFIC ACCIDENT CAUSED THE RELEASE OF FUEL MIXED WITH MOTOR OIL MATERIAL FLOWED INTO <br />ASPHALT AND WET DRAINAGE DITCH <br />Time Received: 8:24 am Time of Arrival: 10:20 am Time of Departure: 12:05 pm <br />PERSONS AT SCENE <br />NAME AGENCY PHONE TOA -i-Q2 <br />GABRIELA GARCIA-MEJIA SJC EHD (209) 616-3037 10:20 am 12:05 pm <br />REFERRALS AND NOTIFICATIONS <br />REFERRED TO (NAME AND ADDRESS) DATE MAILED <br />Date Prop 65 Completed: December 22, 2022 Date UAR Completed: <br />IF PERSONS EXPOSED and/or INJURED, "PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD' COMPLETED? OYES ONO <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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