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Kimberly Blackwell [EH] ll ill )JFP <br /> From: Warning Center <Warning.Center@oes.ca.gov> <br /> Sent: Friday, August 26, 2016 5:09 PM <br /> To: Kimberly Blackwell [EHj <br /> Subject: Hazardous Materials Spill Report: Cal OES Control #:16-5208 <br /> Governor's Office of Emergency Services <br /> Hazardous Materials Spill Report <br /> DATE: 08/26/2016 1 RECEIVED BYCal OES: Jennifer Gordon Cal DES <br /> CNTRL#:16-5208 <br /> TIME: 1706 1 RECEIVED BY OSPR: I NRC#: <br /> 1.a. PERSON NOTIFYING Cal DES <br /> 1. NAME: Sarah Samuels 2. AGENCY: BP <br /> 3. PHONE#: 360-255-9743 4. EXT: I 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: / b.QTY:/Amount/Measure/c.TYPE/d. OTHER /e. <br /> PIPELINE /f.Vessel Over=>300 tons <br /> 1. Gasoline/=/6/Oz./ PETROLEUM/ No No <br /> ------------------------------------------------------------------- <br /> 2. <br /> ------------------------------------------------------------------- <br /> 3. <br /> ------------------------------------------------------------------- <br /> g. DESCRIPTION: RP states: Customer top off resulting in the release of <br /> 6 oz of gasoline to the pavement. Release is contained and no longer releasing. No waterways impacted. Service <br /> station personnel conducted clean up. <br /> h. CONTAINED: Yes I.WATER INVOLVED: No <br /> j.WATERWAY: n/a k. DRINKING WATER IMPACTED: No <br /> I. KNOWN IMPACT: None <br /> 3.a. INCIDENT LOCATION: 85 E. Louise Ave <br /> b. CITY: Lathrop I c. COUNTY: San Joaquin County I d. ZIP: <br /> 4. INCIDENT DESCRIPTION: <br /> a. DATE: 8/26/2016 1 b.TIME(Military): 0745 1 c.SITE: Service Station d.CAUSE: Human Error e. INJURIES: No <br /> f. FATALITY: No I g. EVACUATIONS: No I h. <br /> 1 <br />