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04-17-2002 13:31 From-OES HQ SA NTO W g" - _ 916-845_8910 T-622 P.001/001 F-704 <br />Wo <br />;�.�- iLz ous Materials till Report <br />DATE: 04/17/2002 RECEIVED BY: CONTROL#: <br />TIME: 1314 OES- Karen Jensen OES - 02-2113 <br />OSPR NRC - <br />1.a. PERSON NOTIFYING GOVERNOR'S OES: <br />I. NAME: 2. AGENCY: 3. PHONE#: 4. Ext: S. PAG/CELL: <br />Curt Lance National Guard/Stockton 209-983-5331 <br />Date4, I _ 2 <br />Airport <br />RWQCB Unit: 5S <br />1.b. PERSON REPORTING SPILL (If different from above): <br />AAlCUPA DPG-OSPA - <br />1. NAME: 2. AGENCY: 3. PRONE#: <br />4. Ext: 5. PAG/CELL: <br />Phone # <br />U AIR RESOURCES 13P ❑ DHS-D.O. <br />2. SUBSTANCE TYPE: <br />❑ OP9 FrG <br />2. a. STJOSTANCE: b.QTir:>�a Anwant Mearnre <br />c. TYPE- d. OTHER: <br />1. jet fuel JP -8 = 1500 Gal(s) <br />PETROLEUM <br />2• <br />(M12 <br />X US EPA ❑ OTHM <br />3. <br />❑ CDP DTSC <br />e. DESCRIPTION: The spill occurred due to a tank overfill. All contain in a dual containment dyke area beneath <br />the tank. The spill will be pumped back into a fuel truck. <br />El USMMS <br />f. CONTAINED: C. WATER INVOLVED: <br />h. WATERWAY: <br />Yes No <br />❑ usco <br />3. a. INCIDENT LOCATION: 2000 Stimpson Road 4 <br />b. CIT'Y': e. COUNTY: d. ZIP: <br />Stockton San Joaquin Courcy 95206 <br />4. INCIDENT DESCRIPTION: <br />a. DATE:04/17/2002 b. TIME (Military): 1145 C. SITE: Airport <br />d. INJURIES# e. FATALS #: £ EVACS #: g. CLEANUP BY: <br />0 0 0 Reporting party <br />S. SUSPECTED RESPONSIBLE PA <br />a. NAME: b. AGENCY: c. PHONE#: d, EXT.: <br />Curt Lance National Guard/Stockton Airpon 209-983-5331 <br />e. MAIL ADDRESS: f, CITY: g. STATE: h. ZIP: <br />2000 Stimpson Road Stockton CA 95206 <br />6. NOTIFICATION INFORMATION: <br />la. ON SCENE: b, OTHER ON SCENE: c. OTHER NOTIFIED: <br />Co Health, Co OES, fire Dept. <br />d. ADMIN. AGENCY; San Joaquin County Emcrgency Snrvirm e. SEC. AGENCY: <br />f. NOTIFICATION LIST; DOG Unit: <br />Date4, I _ 2 <br />Pages 00. <br />RWQCB Unit: 5S <br />From C <br />AAlCUPA DPG-OSPA - <br />BMSA <br />OIIS YLANS UNIT X US$WS <br />Phone # <br />U AIR RESOURCES 13P ❑ DHS-D.O. <br />❑ FEMA <br />❑ OP9 FrG <br />16LWQCH <br />12 SFM ❑ US= <br />U CALTRANS ❑ DOC? <br />❑ FOOD &: AG <br />❑ OSHA <br />(M12 <br />X US EPA ❑ OTHM <br />❑ CDP DTSC <br />❑ LAND, <br />❑ PARKS & REC <br />El USMMS <br />COASTAL. COM ❑ IIS PARKS <br />❑ OES KAZMATUN IT PUC <br />❑ usco <br />Post -it® Fax Note 7671 <br />Date4, I _ 2 <br />Pages 00. <br />To C <br />J <br />From C <br />Co./Dept. <br />Co. <br />Phone # <br />Phone # <br />Fax # <br />-��tS <br />[Fax —# <br />