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From:CALIFORHIA STATE WARNING CNTR 19168458910 10/22/2011 09:52 #949 P.001/001 <br /> California Emergency Management Agencyr�,� <br /> Hazardous Materials Spill Repo. <br /> DATE: 10/22/2011 RECEIVED BY: CONTROL#: <br /> TIME: 0935 Cal ENA- Kavin Godwin Cal EMA- 11-6302 <br /> OSPR - NRC- -� Y <br /> La. PERSON NOTIFYING Cal ENIA: ; �' ►.�� lJ <br /> 1. NAME: 2. AGENCY: 3. PHONE#: 4. Ext: 5.PAG/CEL � j; <br /> Kenneth Bryant }3N SF 817--234-2350 <br /> I.b. PERSON REPORTING SPILL(If different fi•otn above): <br /> 1. NANIE: 2. AGENCY: 3. PHONE#: 4. Ext: 5. PAG/CELL: <br /> 2. SUBSTANCE TYPE: <br /> 2.a.SUBSTANCE: b.QTY: Amount Measure e.TYPE: d.OTHER: e. PIPELINE f. VESSEL <br /> '=` —300 Tons <br /> 1. Diesel 1,400 Gal(s) PETROLEU-M O Yes 0 Tdo O Yes 0 No <br /> 2. - Q `r'es * No O Yes • No <br /> 3. = O Yes 0 No O Yes 9 No <br /> I. DESCRIPTION: Caller states a locomotive in the Stockton rallyard released substance to concrete in the <br /> roundhouse(Maintenance Facility). <br /> h. CONTAINED: i.WATER j. WATERWAY: k. DRINKING WATER INIPACTED <br /> INVOLVED: <br /> Yes No <br /> 1. KNOWN EUPACT Unknown <br /> 3. a.INCIDENT LOCATION:• ou _. St ('v orell Rai(!12r <br /> b. CITY: c. COUNTY: d.ZIP: <br /> Stockton San.foaquin County 95205 <br /> 4.INCIDENT DESCRIPTION: <br /> a. DATE: b. TIME (Mil;rary): c.SITE: d. CAUSE <br /> 10/22/2011 0900 Rail Road Unlmown <br /> e. IN-111RIES f. FAT.1 HT`S' h. I:.VAC€-iXTIO:N h.d LEAD— UP BY: <br /> O Yes 0 No O Yes *No O Yes *No Contractor <br /> 5. SUSPECTED RESPONSIBLE PARTY: <br /> a. NAME: K AGENCY: c.PHONE#: d. EXT.: <br /> BNSF 817-234-2350 <br /> e.MAIL ADDRESS: f.CITY: g.STATE: h.ZIP: <br /> 2500 Lou Menk Dr Fort!Forth TX 76131 <br /> 6. NOTIFICATION INFORMATION: <br /> Ia. ON SCENE: b. OTHER ON SCENE: c. OTHER NOTIFIED: <br /> Stockton Fire <br /> d. ADMIN.AGENCY: San Joaquin County Emergency Services e.SEC.AGENCY: <br /> f. ADDITIONAL COUNTY: g.ADNHN.AGENCY: <br /> h.NOTIFICATION LIST: <br /> DOG Unit: RWQCB Unit: 5B <br /> N AA/CUPA ❑AIR RESOURCES BD ❑DPR ❑Cal EMA HAZMAT=❑SFM ❑OTHER <br /> N DFG-OSPR ❑CALTRANS ❑EB PARKS ❑Cal EMAPLANS UNIT ❑USMMS ❑DFG/OSPR/MSU <br /> N DISC ❑CDF ❑EMSA ❑Cat EMA REG ❑USCG <br /> N RWQCB ❑COASTAL COM ❑FEMA ❑OSHA ❑Co/WP <br /> N US EPA ❑CDPH-D O ❑FOOD&AG ❑PARKS&REC N Co/Hlth <br /> N TJSFNS ❑DOG ❑LANDS ❑PUC ®Co/E-Hlth <br /> C'ONFIDENTLAL <br /> REMARKS: <br /> F1'arning.center rr>«ps.caiema.c�,�ov;R9_RRCJriI.•FYA.GOL';i?TSI.k:Ramaii.c�tt� <br /> fwScernaspilirptGld'tcsrov;mrcattonr Waterboards.ca.goy <br />