Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 06/09/2023
    TIME: 0827
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-3773
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
G and M Oil Company #90
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. Yellow, Blue, Red Foam Detergent Concentrate=45 Gal(s)CHEMICALNoNo
2. Clean Cut 360 Pre Soak=15 Gal(s)CHEMICALNoNo
3. = NoNo
g. DESCRIPTION: ***Historical Report***12/23/2021***
Reporting party states due to vandalism there was a fire causing the release of the reported substances. The release was stopped and contained. No waterways impacted. Fire Department was on scene to stop the fire. A contractor 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: 13712 Goldenwest St
b. CITY:c. COUNTY: d. ZIP:
Westminster
Orange County92683SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
12/23/20210200 Merchant/Business Other
Description for Other : Vandalism
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fire Dept.
d. ADMIN. AGENCY: Westminster Fire Prevention Bureaue. SEC. AGENCY: Orange County Emergency Management Division
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: 23-3773 *********

Created by: Warning Center on: 06/09/2023 08:27:31 AM Last Modified by: Warning Center on: 06/09/2023 08:40:17 AM