Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 12/10/2024
    TIME: 1503
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6880
    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. Gasoline=2 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per the reporting party, due to a mechanical failure of a gas pump resulted in the release of approximately 2 gallons of gasoline onto a concrete pad. No waterways were impacted. The release has been stopped and contained, and the material used for cleanup has been properly disposed of in a 55-gallon drum. The reporting party managed the cleanup efforts.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNon/aNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 920 S Seaward Ave
b. CITY:c. COUNTY: d. ZIP:
Ventura
Ventura County93001VENTURA COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
12/10/20241130 Merchant/Business Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Ventura City Fire Departmente. SEC. AGENCY: Ventura County Environmental Health
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

4
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: 24-6880 *********

Created by: Warning Center on: 12/10/2024 03:03:09 PM Last Modified by: Warning Center on: 12/10/2024 03:17:31 PM