Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 01/31/2023
    TIME: 1257
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-0864
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Safeway - Environmental Manager for Northern California
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. Cooking Oil>1 Gal(s)OTHERCooking OilNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Reporting Party states during the transfer of material from tallow bins to a waste management truck, approximately less than one (1) gallon of cooking oil was spilled. Part of the spill went into a strorm drain, but the material was below the inlet/outlet pipe of the storm drain. No material made it in a waterway. A contractor has been hired to remove the product from the storm drain.
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: 660 South Main
b. CITY:c. COUNTY: d. ZIP:
Fort Bragg
Mendocino County95437MENDOCINO COUNTY AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
01/29/20232140 Merchant/Business Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Mendocino County Health Departmente. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

1
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-0864 *********

Created by: Warning Center on: 01/31/2023 12:57:35 PM Last Modified by: Warning Center on: 01/31/2023 01:12:18 PM