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i <br /> NOTIFICATION OF REPORTABLE EVENT SPILL <br /> Date of Event <br /> Time of Event <br /> Location and number of tank where spill <br /> I <br /> occurred <br /> Type of"oil"and quantity of spill j <br /> I <br /> i <br /> I <br /> Reporter name and title <br /> j <br /> Dalwinder Dhoot: Yes No <br /> Avtar Singh: Yes No <br /> National Response Center: No <br /> i <br /> California /WB/ Y No j <br /> List all persons/agencies contacted from Fishd Game <br /> Emergency Notification Procedure <br /> (circle one) Cal Yes No j <br /> eder Yes No j <br /> San Joaquin EHio/CUPA Yes No <br /> i <br /> Lathrop-Manteca FD: Yes No1<6, j <br /> i <br /> City of Lathrop: Yes No <br /> 4trION i <br /> PERS Environmental: Yes No <br /> Was the spill contained Nb!_ft taken to mitigate spill: <br /> Media Affected Soil: Water: Other: <br /> Type of material recovered(quantity) <br /> I <br /> i� <br /> Signature: <br /> j <br /> i <br /> Joe's Travel Plaza Oil—Redding Bulk Plant <br /> 2940 Arcade Way,Redding,CA <br /> SPCC Plan <br /> I <br />