Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/25/2024
    TIME: 1930
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6616
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
ARCO AmPm Gas
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. Gas=10 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per reporting party, Due to human error, a private citizen overflowed their vehicle’s fuel tank while filling up, resulting in approximately 10 gallons of fuel spilling onto the asphalt at a gas station. The spill was stopped and contained, and the reporting party cleaned up the area. A contractor will be called to conduct additional cleaning. No waterways were affected. The local Fire Department responded, and there were no fires to address.
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: 10112 Mission Blvd
b. CITY:c. COUNTY: d. ZIP:
Riverside
Riverside County92509SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/25/20241600 Merchant/Business Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Co Health, Fire Dept.
d. ADMIN. AGENCY: City of Riverside Fire Marshale. SEC. AGENCY: Riverside County Environmental Health
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/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-6616 *********

Created by: Warning Center on: 11/25/2024 07:30:28 PM Last Modified by: Warning Center on: 11/25/2024 07:50:46 PM