Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 06/08/2023
    TIME: 1611
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-3759
    NRC - 1369527
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
NRC
1.b. PERSON REPORTING SPILL (If different from above):
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
PG&E
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Natural Gas=Unknown N/AVAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: PER NRC THE CALLER IS REPORTING A RELEASE OF NATURAL GAS INTO THE ATMOSPHERE FROM NATURAL GAS PIPELINE. THE CAUSE OF THE INCIDENT WAS DUE TO PLUG COMING LOOSE DURING REPAIRS.

THE CALLER STATES THAT THERE WAS ONE INJURED PARTY. THE TECH INSERTED THE PLUG, THE PLUG THEN DISLODGED AND STRUCK THE EMPLOYEES
WITH METAL SHAVINGS AND PIECES OF THE PLUG.

REMEDIAL ACTIONS:
DISSIPATE NATURALLY, REPAIRS MADE, CLEAN UP CREW ON-SITE, CLEANUP COMPLETED, INVESTIGATION UNDERWAY, THE INJURED PARTY WAS
TRANSPORTED TO THE BURN UNIT TO HAVE A SPECIALIST REMOVE THE FRAGMENTS OF THE PLUG AND METAL SHAVINGS. RELEASE WAS SECURED.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Unknown if stopped, Unknown if containedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 15660 ALUM ROCK AVE
b. CITY:c. COUNTY: d. ZIP:
San Jose
Santa Clara CountyBAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
06/08/20230300 Utilities/Substation Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
Yes
Injuries #: 1		NoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Santa Clara County Department of Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM: Northern
RWQCB Unit:

2
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DFW-OSPR, AIR RESOURCES BD, Cal GEM, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-3759 *********

Created by: Warning Center on: 06/08/2023 04:11:32 PM Last Modified by: Warning Center on: 06/08/2023 04:41:39 PM