Governor's Office Emergency Services |
TIME: 0915 |
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Cal OES - 24-7222 NRC - |
1. NAME: | 2. AGENCY: | 3. PHONE#: | 4. Ext: | 5. PAG/CELL: |
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1. NAME: | 2. AGENCY: | 3. PHONE#: | 4. Ext: | 5. PAG/CELL: |
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2. a. SUBSTANCE: | b.QTY:>=< | Amount | Measure | c. TYPE: | d. OTHER: | e. PIPELINE | f. VESSEL >= 300 Tons |
1. Gasoline (Premium) | = | 20 | Gal(s) | PETROLEUM | No | No | |
2. | = | No | No | ||||
3. | = | No | No |
g. DESCRIPTION: | Per the Reporting Party: During a fuel transfer from a tanker truck to an underground fuel storage tank at a 7-11 store/service station the transfer hose came loose from the truck due to unknown reason causing the release of gasoline onto the surrounding concrete area. No waterways or storm drains were affected. The release was stopped. A contractor is in route to the location for clean up. Employees on site did not mention any efforts taken by them to contain the release. | ||
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h. STOPPAGE/CONTAINMENT: | i. WATER INVOLVED: | j. WATERWAY: | k. DRINKING WATER IMPACTED |
Stopped, Unknown if contained | No | N/A | No |
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l. MARITIME VESSEL No | ![]() | m. KNOWN IMPACT Unknown | ![]() |
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3. a. INCIDENT LOCATION: 204 East 17th Street | |||
b. CITY: | c. COUNTY: | d. ZIP: | ![]() |
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Costa Mesa | Orange County | 92627 | SOUTH COAST AQMD |
4. INCIDENT DESCRIPTION: | |||
a. DATE: | b. TIME (Military): | c. SITE: | d. REPORTED CAUSE |
12/29/2024 | 0815 | Service Station | Unknown |
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e. INJURIES | f. FATALITY | g. EVACUATION | h. CLEANUP BY: |
No | No | No | Contractor |
6. NOTIFICATION INFORMATION: | ||
a. ON SCENE: | b. OTHER ON SCENE: | c. OTHER NOTIFIED: |
CUPA |
d. ADMIN. AGENCY: Orange County Emergency Management Division | ![]() | e. SEC. AGENCY: |
f. ADDITIONAL COUNTY: | ![]() | g. ADMIN. AGENCY: |
h. NOTIFICATION LIST: | ![]() | ![]() |
Cal GEM: | RWQCB Unit: | 8 |
Cal OES Region: | ![]() | |
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Photo Attachment: | ![]() |