Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/07/2024
    TIME: 1056
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6281
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Chevon Station
1.b. PERSON REPORTING SPILL (If different from above):
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Chevron
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Petroleum=5 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per reporting party 5 gallons of unlead fuel was spilled on the asphalt when a customer went to fill their vehicle. The vehicle fuel tank had a hole in it causing the spill. The spill has been stopped and contained, no waterways were impacted. The cleaned up was conducted by the fire department and the Chevron station attendant.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 1145 Tavern Road
b. CITY:c. COUNTY: d. ZIP:
Alpine
San Diego County91901SAN DIEGO COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/06/20240452 Service Station Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoFire Dept.
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fire Dept.
d. ADMIN. AGENCY: San Diego County Health Services Departmente. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

9
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-6281 *********

Created by: Warning Center on: 11/07/2024 10:56:01 AM Last Modified by: Warning Center on: 11/07/2024 11:11:13 AM