Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/30/2023
    TIME: 0335
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-7357
    NRC - 1385449
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Tracy Fire Dept
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. Diesel=65-80 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per reporting party-At Costco, a Semi with a torn fuel line, released between 65-80 gallons of diesel on the property. It did run down into the storm drain, absorbents have been placed by company and they will be getting a contractor to help with the cleanup.

Per NRC report: CALLER IS REPORTING THAT A TRACTOR TRAILER TRUCK HAD A FUEL LINE THAT FAILED AND CAUSED A DISCHARGE OF DIESEL ONTO THE GROUND AND
INTO A STORM DRAIN. THE CAUSE OF THE INCIDENT IS UNKNOWN
Vehicle Number: 16993
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesStorm drainUnknown
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 25501 S Gateway Blvd
b. CITY:c. COUNTY: d. ZIP:
Tracy
San Joaquin County95377SAN JOAQUIN VALLEY UNIFIED APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/30/20230315 Service Station Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Enviromental
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, DFW-OSPR, DWP-DO, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-7357 *********

Created by: Warning Center on: 11/30/2023 03:35:09 AM Last Modified by: Warning Center on: 11/30/2023 04:30:23 AM