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(F <br /> Con-Fab California, LLC <br /> Appendix F <br /> Spill Report <br /> [Instructions:Adapt this spill log to fit your organization's needs.] <br /> Site Name: Con Fab Ca, LLC Date of Spill: _2/6/2019 <br /> Spill started at(time): _9:50_ X AM ❑ PM Spill ended at(time): _10:25_ X AM ❑ PM <br /> This report filled out by: <br /> SPILL TYPE <br /> Spilled substance (common name): WDRA 64 <br /> Quantity spilled: 175 gallon <br /> Material concentration: 100 % <br /> SPILL LOCATION <br /> Describe location: North End of Aggregate storage by the Johnson Buckaroo Batch Plant <br /> Describe damage: Drum hit by loader punching a hole in the side <br /> X Outdoors ❑ Indoors If outdoors, describe weather: Sunny and Cool <br /> Did the spill reach water? ❑ Yes X No If yes, describe: <br /> RESPONDERS <br /> Spill discovered by: Johnnie Gallardo <br /> Name of additional responders Type of responder(operations-level, hazardous material <br /> technician contractor, etc. <br /> Nick Adams Plant Manager <br /> Rigo Garcia Warehouse Controller <br /> Mike Hein President <br /> ACTIONS TAKEN <br /> Communicating/evacuating N/A <br /> Containment of spill Covered with Sand to absorb and put on plastic and covered <br /> Cleanup of spill ACT called to remove material on 2/7/2019 <br /> Reporting and documentation Nick Adams <br /> Analysis and preventive measures Nick Adams <br /> Appendix G <br /> LATHROP SHAF-rER <br /> 1910 Lathrop Road Tel(209)2494700 www.confabca.com 701 Golds Avenue Tel(661)630-7162 <br /> Lathrop,CA 95330 Fax(209)249-4725 Shafter,CA 93263 Fax(661)630-7166 <br />