Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 06/08/2023
    TIME: 1915
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-3766
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Chevron
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 =32 Oz.PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Caller stated that due to mechanical failure, the automatic shut off didnt turn on and caused a release of 32 oz of gasoline onto the concrete. Spill has been stopped and contained with no waterways being impacted. On scene personnel conducted clean up.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 100 East Katella
b. CITY:c. COUNTY: d. ZIP:
Anaheim
Orange County92802SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
06/08/20230440 Merchant/Business Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Anaheim Fire Departmente. SEC. AGENCY: Orange County Emergency Management Division
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

8
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-3766 *********

Created by: Warning Center on: 06/08/2023 07:15:50 PM Last Modified by: Warning Center on: 06/08/2023 07:22:48 PM