Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/17/2023
    TIME: 0752
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-7156
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Sacramento County Environment Management Department
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=5 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per reporting party a customer had a punctured gas tank causing the release of 5 gallons of gasoline onto the pavement. Reporting party states of the 5 gallons released, less than 2 gallons of gasoline got into a storm drain. The release is stopped and contained. Arco AMPM staff will conduct the clean up of the pavement and County Drainage will conduct clean up of the storm drain.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesStorm DrainNo
l. MARITIME VESSEL
No
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 4400 Sunrise Blvd
b. CITY:c. COUNTY: d. ZIP:
Sacramento
Sacramento County95628SACRAMENTO METROPOLITAN AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/17/20230715 Merchant/Business Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoCounty Drainage
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fire Dept.
d. ADMIN. AGENCY: Sacramento City Fire Departmente. SEC. AGENCY: Sacramento County Environmental Management
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5B
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DFW-OSPR, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-7156 *********

Created by: Warning Center on: 11/17/2023 07:52:28 AM Last Modified by: Warning Center on: 11/17/2023 08:01:48 AM