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04-03-2008 05;40am From-OES HQ SACRAIENTO W/C 916-845-8910 T-123 P.002/002 ' F-231 <br /> GOVERNOR'S OFFICE OF EMERGENCY / <br /> SERVICES <br /> ° Hazardous Materials Spill Report <br /> DACE: 04/03/2008 RECEIVED BY: CONTROL#. <br /> TIME: 1322 OES- Ruk:en Rodriguez OES- 08-2535F�* n <br /> IOSPR - INRC- LJ <br /> La. PERSON NOTIFYING GOVERNOR'S OES: <br /> 1. NAME: 2. AGENCY: 3. PHONE#; 4.Ext: S.FAGICELL: <br /> Laura LazzeAe City of Stockton,Municipal 209-937-8852 209423-6244 <br /> Utilities <br /> Lb. PERSON REPORTING SPILL(If different from above): <br /> 1. NAME: 2. AGENCY: 3. PHONE#.- 4.Ext: S.PAG/CELL: <br /> 2. SUBSTANCE TYPE: <br /> 2.a.SUBSTANCE: b.QTY:>=< Amoanr Measure e.TYPE: d.OTIMR, <br /> 1.Diesel Ic 20 Gal(s) PETROLEUM <br /> 2. - <br />�� 3. - <br /> e.DESCRIPTION: Vandals broke into rhe Smith Canals Pumping Facility and stole diesel from the above ground <br /> tank. As a result,some release reached the ground in the containment arca. <br /> I <br /> L CONTAINED: g.WATER INVOLVED: h.WATERWAY: L DRINIONG WATER IMPACTED <br /> Yes No <br /> 3. a.INCIDENT LOCATION: 2144 Fontana Drive @ Country Club <br /> b.CITY: c.COUNTY: d.ZIP: <br /> Stockton San Joaquin County 95244 <br /> 4.INCIDENT DESCRIPTION: <br /> u.DATIr:04/03/2408 6. TIME (Milrtary).00:00 C.SITE: Other <br /> d. INJURIES# e.FATALS#: L EVACS#: g.CLEANUP BY: <br /> 0 0 0 Contractor <br /> Same as#7"PERSON NOTIFYING OES"] <br /> S. SUSPECTED RESPONSIBLE PARTY: <br /> a.NAME; b. AGENCY: c.PHONE#: d.EXT.: <br /> Unknown vandals <br /> e.MAIL ADDRESS; f.CITY: g.STATE: h.ZIP: <br /> CA <br /> 6. NOTIFICATION INFORMATION: <br /> �a.ON SCENE: b.OTHER ON SCENE: c.OTHER NOTIFIED: <br /> Co OBS <br /> d.ADMIN.AGENCY: San Joaquin County Emergency Service, e,SEC.AGENCY: <br /> f.NOTIFICATION LIST: DOG Unit. r I RWQCB Unit: 5R <br /> �[®AAICUPA f©I UShws (L'_I AHS-D O. Ll <br /> FOOD&AO ❑OSHA I❑,USCG <br /> DFG-OSPI n❑AIR RPSOURCES 00 11 Poo LJ LANDS ❑P-,K &PkC fLJ�UsDor <br /> LJ DTSC I , CALTRANS ❑ED PAR[CS ❑OFS HAZMATUMT 71 PITC LJ orf= <br /> ©RwQCg U CDF LJ SMSA ❑ons PLANS uNrr ❑sFM <br /> ®us L'PA ❑coAmu.Cpm Li izam ❑ons RPG ❑USMMS <br />