Governor's Office Emergency Services
Hazardous Materials Spill Report |
DATE: 11/27/2023
TIME: 1204
|
|
CONTROL#:
Cal OES - 23-7293
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 | Measure | c. TYPE: | d. OTHER: | e. PIPELINE | f. VESSEL
>= 300 Tons |
1. Diesel | = | 5-9 | Gal(s) | PETROLEUM | | No | No |
2. | = | | | | | No | No |
3. | = | | | | | No | No |
g. DESCRIPTION: | Per the reporting party: A release of diesel fuel occurred due to there being a hole in a customer's gas tank. The customer attempted to put fuel into the vehicle causing diesel to spill onto the concrete.Chevron personnel have conducted cleanup and placed recovered diesel into waste drums. |
| | | |
h. STOPPAGE/CONTAINMENT: | i. WATER INVOLVED: | j. WATERWAY: | k. DRINKING WATER IMPACTED |
Stopped, Contained | No | No | No |
| | |
l. MARITIME VESSEL
| | m. KNOWN IMPACT
None | |
| | | |
3. a. INCIDENT LOCATION: 4300 Madison Ave |
b. CITY: | c. COUNTY: | d. ZIP: | |
| | | |
Sacramento
| Sacramento County | 95842 | SACRAMENTO METROPOLITAN AQMD |
4. INCIDENT DESCRIPTION: |
a. DATE: | b. TIME (Military): | c. SITE: | d. REPORTED CAUSE |
11/27/2023 | 1030 | Service Station | Mechanical |
| | |
| | | |
e. INJURIES | f. FATALITY | g. EVACUATION | h. CLEANUP BY: |
No | No | No | Reporting Party |
6. NOTIFICATION INFORMATION: |
a. ON SCENE: | b. OTHER ON SCENE: | c. OTHER NOTIFIED: |
| | |
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment: | |
11. Cal OES Reg.
********* Control No: 23-7293 *********
Created by: Warning Center on: 11/27/2023 12:04:21 PM Last Modified by: Warning Center on: 11/27/2023 12:22:04 PM