Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/30/2023
    TIME: 0455
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-7358
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
3E Company
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. Fuel, Diesel=100 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: A box truck owned by a vendor incurred a fuel line failure while located on the premises of the listed business. This mechanical issue led to an approximate leakage of 100 gallons of fuel onto the asphalt, with an estimated 20 gallons flowing into a nearby storm drain. The ultimate destination of the drain remains unknown. Both the California Highway Patrol and the local fire department responded to the incident. The affected areas were cordoned off, and an environmental specialist was notified. There were no fires, injuries, or evacuations required. The business remains operational, while cleanup efforts are currently pending.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, Not containedYesStorm DrainNo
l. MARITIME VESSEL
No
m. KNOWN IMPACT
Unknown
3. a. INCIDENT LOCATION: 25501 South Gateway - Costco #0179
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
11/30/20230245 Merchant/Business Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
CHP, Fire Dept.None
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, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-7358 *********

Created by: Warning Center on: 11/30/2023 04:55:10 AM Last Modified by: Warning Center on: 11/30/2023 05:15:57 AM