Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/20/2023
    TIME: 1616
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-7210
    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 Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Unleaded fuel=3 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per the reporting party: A customer left the fuel nozzle unattended causing an overflow of 3 gallons of unleaded fuel. 2 gallons remained on the pavement and 1 gallon entered an onsite catch basin. Upon return, the customer removed the nozzle and stopped the release. Chevron personnel have closed off the dispenser until it is properly inspected. Chevron employees cleaned up the pavement and a contractor is handling cleanup of the catch basin.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoNo
l. MARITIME VESSEL
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 18692 Macarthur Blvd
b. CITY:c. COUNTY: d. ZIP:
Irvine
Orange County92612SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/20/20231400 Service Station Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Local CUPA
d. ADMIN. AGENCY: Orange County Emergency Management Divisione. SEC. AGENCY:
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: 23-7210 *********

Created by: Warning Center on: 11/20/2023 04:16:54 PM Last Modified by: Warning Center on: 11/20/2023 04:29:12 PM