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Second Ouarter - 2015 <br />Stockton Terminal <br />Internal Exercise Documentation Form - Unannounced <br />Notification Exercise <br />1. Date Performed: 06/29/2015 <br />2. Exercise or actual response? Exercise <br />3. Facility or pipeline initiating exercise: Facility <br />4. Name of person notified: <br />5. Is this person identified in your response plan as qualified individual or designee? <br />Yes X (QI) <br />6. Time initiated: 16:34 Central Daylight Savings Time <br />Time in which qualified individual or designee responded: Dennis Leiker 1( 6:34) Dale Thurman (16:35) Dale Corbello <br />16:35 <br />7. Method used to contact: <br />Telephone: 209-466-4407 and dleikert2 buckeye.com <br />8. Description of notification procedure: <br />HSSE Compliance Specialist called and emailed Dennis Leikerrd, Lead Terminal Operator, Stockton Terminal, and notified <br />him that "This is an unannounced QI Notification Drill." A gasket on a gasoline loading hose blew out while driver was <br />loading. The driver ran to the emergency shutdown switch, but he slipped and fell and hit his head. He was knocked <br />unconscious temporarily. The gasoline fumes revived the driver, and he did push the emergency switch and stopped the <br />leak. Gasoline, though, still on the ground and flowing out of the loading rack area. <br />9. Identify which of the 15 core components of the response plan were exercised during this particular exercise: <br />Organizational Design <br />1. Notification Yes X or No _ <br />2. Staff mobilization Yes _ or No X <br />3. Ability to operate within the response <br />management system described in the plan Yes X or No <br />Operational Response <br />4. Discharge control <br />Yes <br />or <br />No <br />X <br />5. Assessment of discharge <br />Yes <br />_ <br />or <br />No <br />X <br />6. Containment of discharge <br />Yes <br />_ <br />or <br />No <br />X <br />7. Recovery of spilled material <br />_ <br />Yes _ <br />or <br />No <br />X <br />8. Protection of sensitive areas <br />Yes <br />or <br />No <br />X <br />9. Disposal of recovered material and <br />contaminated debris <br />Yes <br />or <br />No <br />X <br />Response Support <br />• Communications Yes X or No <br />• Transportation Yes _ or No X <br />• Personnel support Yes _ or No X_ <br />• Equipment maintenance and support Yes —or No X <br />• Procurement Yes or No X <br />• Documentation Yes X or No <br />Certifying Signature <br />S even G. Poling/Specialist II, H E and Compliance <br />Retain this form for a minimum of 5 years <br />