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2. <br /> - ----------------------------------------------------------------- <br /> 3. <br /> ------------------------------------------------------------------- <br /> g. DESCRIPTION: RP advises that due to a customer top off the release <br /> occured to the concrete pad only. No waterways or storm drains were affected. RP applied absorbent to the area and it <br /> is now clean of the substance. <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 d.ZIP: 95330 <br /> 4. INCIDENT DESCRIPTION: <br /> a. DATE: 11/28/2017 1 b.TIME(Military): 0800 hours c.SITE: <br /> Service Station I d. CAUSE: Human Error e. INJURIES: No I f. FATALITY: No g. EVACUATIONS: No h. <br /> CLEANUP BY: Reporting Party <br /> e. INJURIES#: I f. FATALS#: I g. EVACS#: <br /> 5. SUSPECTED RESPONSIBLE PARTY: <br /> a. NAME: Unknown I b. AGENCY: <br /> c. PHONE#: I d. EXT: <br /> e. MAILADDRESS: Unknown <br /> f. CITY: I g. STATE: CA I h. ZIP: <br /> 6. NOTIFICATION INFORMATION: <br /> a. ON SCENE: I b. OTHER ON SCENE: <br /> c. OTHER NOTIFIED: <br /> d. ADMIN.AGENCY: San Joaquin County Environmental Health e. SEC.AGENCY: <br /> f.ADDITIONAL COUNTY: g. ADMIN.AGENCY: <br /> h. NOTIFICATION LIST: DOG Unit: RWQCB Unit: 5B <br /> AA/CUPA, DTSC, RWQCB, US EPA, USFWS <br /> CONFIDENTIAL REMARKS: <br /> Created by Warning Center on 11/28/2017 11:59:44 AM Last <br /> Modified by Warning Center on 11/28/2017 12:04:45 PM <br /> California State Warning Center <br /> Governor's Office Emergency Services <br /> Phone: (916)845-8911 <br /> Warning.Center@oes.ca.gov <br /> Link to Spill Report: <br /> httP:Hw3.ca lema.ca.gov/operationa I/malhaz.nsf/Spi I lAil Docs/133316F5 F1C2 B05D882581 E6006DD70D?Open Docu me nt <br /> 2 <br />