Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 12/19/2024
    TIME: 1807
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-7096
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Albertson / Safeway
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. Diesel =50 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per reporting party, a tractor trailer released 50 gallons of diesel onto the roadway due to a puncture in the tank. Release has been stopped with impacts into storm drain. Fire Dept is on scene for initial clean up. Reporting party is coordinating with contractors for further clean up and recovery. No further hazards or impacts reported at this time.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesStorm Drain No
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 838 Sir Francis Drake Blvd
b. CITY:c. COUNTY: d. ZIP:
San Anselmo
Marin County94960BAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
12/19/20241726 Road Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Marin County Waste Management Officee. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

2
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: 24-7096 *********

Created by: Warning Center on: 12/19/2024 06:07:29 PM Last Modified by: Warning Center on: 12/19/2024 06:17:44 PM