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KimberlX Blackwell EH �M <br /> From: Warning Center[Warning.Center@ops.calema.ca.gov] <br /> Sent: Monday, November 19, 2012 6:31 AM <br /> To: Kimberly Blackwell [EH] <br /> Subject: Hazardous Materials Spill Report: Cal EMA Control#:12-6997 <br /> California Emergency Management Agency <br /> Hazardous Materials Spill Report <br /> DATE: 11119/2012 J RECEIVED BY Cal EMA: Ronald Demayo Cal EMA <br /> CNTRL#:12-6997 <br /> TIME: 0626 RECEIVED BY OSPR: I NRC#: <br /> 1.a. PERSON NOTIFYING Cal EMA <br /> 1. NAME: Chris Weber 1 2. AGENCY: BP Arco <br /> 3. PHONE #: 512-695-4869 f 4. EXT: f 5. PAGER #: <br /> 1.b. PERSON REPORTING SPILL (If different from above): <br /> 1. NAME: 2. AGENCY: <br /> 3. PHONE #: 4. EXT: 1 5. PAGER #: <br /> 2. SUBSTANCE TYPE: <br /> a. SUBSTANCE: 1 b.QTY., 1 Amount/ Measure 1 c. TYPE 1 d. OTHER 1 e. <br /> PIPELINE 1 f. Vessel Over => 300 tons <br /> 1. Gasoline 1 = 11/2 1 Gal(s) 1 PETROLEUM 1 1 No 1 No <br /> ------------------------------------------------------------------- <br /> 2. <br /> ------------------------------------------------------------------- <br /> 3. <br /> ------------------------------------------------------------------- <br /> g. DESCRIPTION: Caller states a customer drove off with the nozzle <br /> still attached to the vehicle which resulted in the release of substance onto to the cement slab next to the <br /> dispenser. On-site personnel and local fire department performed clean up. <br /> h. CONTAINED: Yes I i. WATER INVOLVED: No <br /> j. WATERWAY: I k. DRINKING WATER IMPACTED: <br /> I. KNOWN IMPACT: None <br /> 3.a. INCIDENT LOCATION: 85 East Louise Avenue, BP Arco Gas Station # <br /> 6080 <br /> b. CITY: Lathrop I c. COUNTY: San Joaquin County E d. ZIP: 95330 <br /> 4. INCIDENT DESCRIPTION: <br /> a. DATE: 11/19/2012 1 b. TIME(Military): 0200 1 c. SITE: Service Station d. CAUSE: Human Error e. <br /> INJURIES: No I f. FATALITY: No I g. EVACUATIONS: No I h. <br /> CLEANUP BY: On-site personnel and Local Fire Dept <br /> e. INJURIES #: I f. FATALS #: I g. EVACS #: <br /> 5. SUSPECTED RESPONSIBLE PARTY: <br /> i <br />