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PRO 0.31 b <br /> Kimberly Blackwell [EH] <br /> From: Warning Center <Warning.Center@oes.ca.gov> <br /> Sent: Monday, September 22, 2014 11:43 AM <br /> To: Kimberly Blackwell [EH] <br /> Subject: Hazardous Materials Spill Report: Cal OES Control #:14-5363 <br /> Governor's Office of Emergency Services <br /> Hazardous Materials Spill Report <br /> DATE: 09/22/2014 RECEIVED BY Cal OES: Randall Perez Cal OES <br /> CNTRL#:14-5363 <br /> TIME: 1135 RECEIVED BY OSPR: I NRC#: <br /> 1.a. PERSON NOTIFYING Cal OES <br /> 1. NAME: Sarah Samuels 2. AGENCY: BP <br /> 3. PHONE #: 360-255-9743 4. EXT: 1 5. PAGER #: <br /> 1.b. PERSON REPORTING SPILL (If different from above): <br /> 1. NAME: 2. AGENCY: <br /> 3. PHONE #: 4. EXT: 1 5. PAGER#: <br /> 2. SUBSTANCE TYPE: <br /> a. SUBSTANCE: / b.QTY: /Amount/ Measure / c. TYPE / d. OTHER / e. <br /> PIPELINE /f. Vessel Over => 300 tons <br /> 1. Gasoline, Regular Grade / _ / 6 / Oz. / PETROLEUM / / No / No <br /> ------------------------------------------------------------------- <br /> 2. <br /> ------------------------------------------------------------------- <br /> 3. <br /> ------------------------------------------------------------------- <br /> g. DESCRIPTION: Caller states a customer overfilled their vehicle gas <br /> tank. This caused the release of gasoline onto the concrete slab. A clean-up has been completed. No <br /> waterways were impacted. <br /> h. CONTAINED: Yes i. WATER INVOLVED: No <br /> j. WATERWAY: None k. DRINKING WATER IMPACTED: No <br /> I. KNOWN IMPACT: None <br /> 3.a. INCIDENT LOCATION: 85 East Louise Ave <br /> b. CITY: Lathrop I c. COUNTY: San Joaquin County I d. ZIP: 95330 <br /> 4. INCIDENT DESCRIPTION: <br /> a. DATE: 9/20/2014 1 b. TIME(Military): 1030 1 c. SITE: Service Station d. CAUSE: Human Error e. <br /> INJURIES: No I f. FATALITY: No g. EVACUATIONS: No I h. <br /> CLEANUP BY: Site employees <br /> e. INJURIES #: I f. FATALS #: g. EVACS #: <br /> a•aa 20 �� ��� ►1:�13�u _ 1 � �' . zo•Zol y <br /> eatk sarcu. aw 3foc�-�5 - Q��3-�5'tn +e rr� �,cevk <br /> W0� P,C e.� �' ► I o-- C&Gor iv �k�Ced 1 <br /> W � <br />