Date: Day/Month/YearAddress: Type of spill (e.g. oil, gasoline, etc.): Spill Location: Pavement Gravel Grass Estimated Quantity of Spill: < 1 Gal 1 Gallon to 5 Gallon > 5 Gallons Spill Contained: Yes No Spill Treated: Yes No Spill Cleaned Up: Yes No File:Comments: