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SANJ O A Q U I N Environmental Health Department <br /> `= = iv J i y <br /> EMERGENCY RESPONSE RECORD <br /> Date: June 19, 2018 Short Term#: C00046943 <br /> Premise Address: 15100 Thornton RD City: LODI <br /> Premise DBA: Flying J Travel Plaza Cross Street: HWY 12 <br /> Premise Owner: Pilot Travel Centers LLC Owner's Phone: <br /> Mailing Address: P.O. Box 54470 Owner City: Lexington <br /> Facility Contact: Contact Phone: <br /> RP DBA: Pilot Travel Centers LLC <br /> Onsite RP Name: Matthew Duce Onsite RP Phone: (209) 339-4066 <br /> Mailing Address: 5508 Lonas Rd RP City: Knoxville <br /> RP Contact: Matthew Duce Contact Phone: (209) 339-4066 <br /> NATURE OF RESPONSE(explosion, spill, leak, fire, or abandoned/dumped material <br /> 5 gallons of waste oil spilled out of a truck into the pavement and into a storm drain that has a catch basin. Cause is <br /> unknown. The release is stopped and contained. A storm drain leading into an onsite retention pond was impacted, and they <br /> were able to recover the release <br /> Time Received: 10:00 am Time of Arrival: 11:30 am Time of Departure: <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> Cesar Ruvalcaba SJCEHD (209) 953-6213 11:30 am <br /> Ponder Environmental 12:00 pm <br /> MATERIAL/CLASSIFICATION chemical involved <br /> MATERIAL AMOUNT SOLID(lbs) LIQUID(gap GAS(cu ft) COMMENTS <br /> Used Oil 5.00 ❑ ❑ <br /> ❑ ❑ ❑ <br /> ❑ ❑ ❑ <br /> REFERRALS AND NOTIFICATIONS <br /> REFERRED TO(NAME AND ADDRESS) DATE MAILED <br /> Date Prop 65 Completed: June 19, 2018 Date UAR Completed: <br /> IF PERSONS EXPOSED and/or INJURED,"PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD"COMPLETED? ❑YES ❑NO <br /> Page 1 of 2 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />