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Discharge Notification Form <br /> T & T TRUCKING, INC. <br /> 11396 North Highway 99, Lodi, California <br /> Part A: Discharge Information <br /> General information when reporting a spill to outside authorities <br /> Basic Information <br /> Facility name, address, and contact number: T&T Trucking, Inc. <br /> 11396 North Highway 99 <br /> Lodi, California <br /> Office: (800)692-3457 <br /> President/Operator, address, and contact: Mr. Terry Tarditi <br /> 11396 North Highway 99 <br /> Lodi, California <br /> Work(Office): (800) 692-3457 <br /> Cell: (209)639-3900 <br /> Emergency Coordinator, office address and Mr. Tom Corralez <br /> contact number: 11396 North Highway 99 <br /> Lodi, California <br /> Work (Office): (800) 692-3457 ext. 220 <br /> Cell (24 hour): (209)400-8339 <br /> Alternate Facility Employee: Mr. Grant Galli <br /> Work(Office): (800) 692-3457 ext. 218 <br /> Cell (24 hour): (209) 747-2396 <br /> Spill Information <br /> Type of oil: Discharge Date and Time: <br /> Quantity released: Discovery Date and Time: <br /> Quantity released to a water body: Discharge Duration: <br /> Location/Source: <br /> Actions taken to stop, remove, and mitigate impacts of the discharge: <br /> Affected media: <br /> ❑ air ❑ storm water sewer/POTW <br /> ❑ water ❑ dike/berm/oil-water separator <br /> ❑ soil ❑ other: <br /> Notification <br /> Person Notified: Agency/Department: <br /> Nature of discharges, environmental/health effects and damages (if any): <br /> Injuries, fatalities or evacuation required? <br /> Date: Time: Name: <br />