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I <br /> 10-14-2008 08:80 From-OES HQ SACRAMENTO w/C 916-845-8910 T-306 /51bll./q F-931 <br /> �• v' <br /> C.) Imo' GOVERNOR'S C CE OF EM9G��N��� f <br /> SERVICES "`�. ' <br /> <br /> <br /> OES- Bob Mcrae OES- 08-7411 <br /> OSPR - NRC- <br /> f.n. PERSON NOTIFYING GOVERNOR'S OTS: <br /> 1. NAME: 2, AGENCY: 3. PHONE#: 4.Ext: 5. PAG/CELL: U <br /> Chris fisher Exel Insurance 610-968-9+60 <br /> l.b. PERSON REPORTING SPILL(If different from above): <br /> 1. NAME: 2. AGENCY: 3. PHONE#: 4.Fxt: .5.PAG/CELT.,: <br /> 2, SUBS'T'ANCE TYPE; <br /> 2.a.SUBSTANCE: b.QTY-4 �3r+�a�sl �Lleusuie C.TYPE: d.OTHER: <br /> 1.Diesel = 100 Calls) PETROLEUM <br /> 2 = <br /> 3. _ <br /> e, DESCRIPTION: A tank Was overfilled during off-load. <br /> f. CONTAINED; g.WATER INVOLVE <br /> <br /> <br /> <br /> Lathrop San Joaquin County <br /> 4. INCIDENT DESCRIPTION: <br /> a. DATE: 10/14/2008 b. TIME (Military);0200 t~SITE: Other <br /> d. INJURIES# e,FATALS#-. f.EVACS#: g. CLEANUP BY: <br /> 0 0 0 Contractor <br /> Same as#1"PERSON NOTIFYING OES" <br /> 5. SUSPECTED RESPONSIBLE PARTY: <br /> a.NAME: b. AGENCY: c.PHONE,#: d.EXT.: <br /> Kenan Advantage Group 330-409-1077 <br /> e. MAIL ADDRESS: f. CITY: g.STATE: h. ZIP: <br /> 6. NOTIFICATION INFORMATION: <br /> la.ON SCENE: b. OTHER ON SCENE: c. OTT3ER NOTIFIED- <br /> IED: <br /> d. AD1VIiN.AGENCY: San Jnaquin County kmcrgency Services e.SEC.AGENCY: <br /> f.NO'T'IFICATION LIST: DOG Unit: RWQCIB Unit; 5B <br /> r1GG - L.I USMMS .---.'-.-_.I._I OTHFF -•-.�-- <br /> I• I n.vCDPn _ r —I <br /> DPG-OSPf I. A!R Rk>.UDf.CLS Br�_1DOG I"DOD S AG �I OSTIA <br /> I''':DTSC L..l(.AL.TRANS I'-DPr. L�II LANDS L...I°ARKS d lil C 11I CaWP <br /> I"'I IeWOCD I CDF fI_.J eta FAKI(S _I 0I2S HA'LMATUNIT F1 I'uC L <br /> /I US GPA i COA51W.COM l__�EWA I OL•S PLANS UNrf I ST 111 I [aE HLh <br />