Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/18/2023
    TIME: 1201
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-7176
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Broadbent & Associates
1.b. PERSON REPORTING SPILL (If different from above):
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Gasoline=10 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per the reporting party, this spill occurred at a gas station when a customer drove up with a hole in their gas tank. The spill was absorbed by the ground, and about 1 cup went into a catch basin. The spill impacted the asphalt of the gas station. The clean up is being performed by Ancon Services a contractor. There were no injuries or evacuations.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoN/ANo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 15100 Thornton Road
b. CITY:c. COUNTY: d. ZIP:
Lodi
San Joaquin County95242SAN JOAQUIN VALLEY UNIFIED APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/18/20230930 Merchant/Business Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
San Joaquin County Environmental Health
d. ADMIN. AGENCY: San Joaquin County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5B
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-7176 *********

Created by: Warning Center on: 11/18/2023 12:01:39 PM Last Modified by: Warning Center on: 11/18/2023 12:16:35 PM