Carrollton Volunteer Fire Department was dispatched 1253 Thursday 27 October 2011 to a reported truck vs. car head-on MVC on Smith's Neck Road with the "trucked flipped over." Carrollton units Quint-10 and Chief-10 responded initially with subsequent responses by Rescue-10, Squad-10 and Tanker-10. First arriving units reported two ALS trauma patients and one entrapment involving a passenger car and an overturned fuel tanker truck with 1500 gal. of #2 heating oil and 500 Gal. kerosene. Upon arrival CVFD Chief J. Acree assumed incident command and automatic aid was requested from Smithfield VFD for unit Heavy Rescue-50 and Isle of Wight VRS ALS units to arrive via Titus Creek Dr. due to wreckage and debris blocking access from the Route 17 approach. Q-10 crew deployed foam-charged hand lines to the overturned tanker in case of ignition. IWVRS units Zone-60 and Medic-63 arrived and immediately initiated patient care for the driver of the tanker truck who had extricated himself and was able to maneuver away from his overturned vehicle. SVFD R-50 arrived to begin extrication operations for the patient in the sedan and IWVRS Medic-64 arrived for patient care of the entrapped driver. R-50 and Q-10 crews conducted HAZMAT mitigation operations for the spilled fuel on the roadway crown. IWVRS M-63 transported the tanker driver to RRMC Trauma Center and Nightingale air ambulance was requested due to possibility of extended extrication operations for the sedan driver. Newport News Fire Department was requested to dispatch HAZMAT units to the scene and an LZ for the air ambulance was established by CVFD Deputy Chief J. Acree with R-10 and S-10 crews in the vacant lot on the NW corner of Rte. 17 and Smith's Neck adjacent to Old Point Bank. Following successful patient extrication, M-64 transported the sedan driver to the LZ who was flown to Sentara Norfolk General Hospital. T-10 arrived at 1413 to provide primary water source for HAZMAT operations. Isle of Wight Public Schools were notified to detour school busses because VDOT had established emergency traffic control points at Reynolds Drive and Titus Creek Drive. Chuckatuck VFD responded with Engine-9 and full crew to back-fill Station-10 due to all-hands commitment by Carrollton crews. NNFD units Squad-6, Hazmat-2 and the All-Purpose Materials Response Team semi-tractor unit arrived at 1420 to begin grounding and bonding operations around the overturned tanker to mitigate any HAZMAT danger. CVFD Assistant Chief G. Rawls assumed incident command at 1525 and the HEPACO Emergency Response Environmental Remediation unit from Norfolk arrived at 1636 to transfer fuel from the overturned vehicle into another tanker supplied by the S.W. Rawls Company. At 1917 the fuel transfer operation was reported complete and all NNFD HAZMAT units and crews were cleared from the scene to return to their home quarters. Vehicle wreckage removal operations were reported complete by 2110 and Carrollton VFD units and crews were cleared from the scene.