Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 05/22/2024
    TIME: 1055
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-2917
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
CHP
1.b. PERSON REPORTING SPILL (If different from above):
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
CHP
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Transmission Fluid=7 ft x 3 ft SheenPETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per the reporting party: A vehicle collided with a rock causing the vehicle to release transmission fluid onto the ground and into a culvert. It is unknown whether the culvert is dry or contains water. The caller reported that there was at least one injury with which medical personnel took to the hospital. It is unknown who will be conducting the cleanup.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Unknown if stopped, Unknown if containedUnknownUnknownUnknown
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 30001 Lucas Valley Rd
b. CITY:c. COUNTY: d. ZIP:
Unincorporated county area Marin
Marin CountyBAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
05/22/20240858 Road Collision
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
Yes
Injuries #: 1		NoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
CHP, Fire Dept., Police Dept.
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, CDPH-D.O., DWP-DO, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-2917 *********

Created by: Warning Center on: 05/22/2024 10:55:36 AM Last Modified by: Warning Center on: 05/22/2024 11:10:26 AM