Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 12/06/2023
    TIME: 2105
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-7500
    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. Unleaded Gasoline=1.5 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per reporting party, a customer overfilled their gas tank causing the release of 1.5 gallons of unleaded gasoline onto the concrete pad. The release is stopped and contained. No waterways were impacted. Chevron personnel conducted the 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: 15320 Bear Valley Rd
b. CITY:c. COUNTY: d. ZIP:
Victorville
San Bernardino County92395MOJAVE DESERT AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
12/06/20231606 Merchant/Business Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoChevron Personnel
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Victorville Fire Departmente. SEC. AGENCY: San Bernardino County Fire Department
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

6B
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-7500 *********

Created by: Warning Center on: 12/06/2023 09:05:38 PM Last Modified by: Warning Center on: 12/06/2023 09:18:07 PM