Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 09/30/2022
    TIME: 1500
    RECEIVED BY:
    CONTROL#:
    Cal OES - 22-5772
    NRC - 1348726
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:
SPILL CENTER INC.
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. LIFELINE HERBICIDE=5 Gal(s)CHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: PER NRC: CALLER STATED A THIRD PARTY DRIVER DAMAGED A SMALL CONTAINER AT THE LOCATION PROVIDED. THERE WAS 5 GALLONS OF HERBICIDE THAT RELEASED ONTO THE GRAVEL. THE CAUSE OF THE INCIDENT WAS DUE TO THIRD PARTY ERROR.

REMEDIAL ACTIONS: COMPANY HAS CLEANED UP THE SPILL.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 4707 TWIN CITIES RD
b. CITY:c. COUNTY: d. ZIP:
Elk Grove
Sacramento CountySACRAMENTO METROPOLITAN AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
09/30/20221345 Merchant/Business Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoResponsible Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Sacramento County Environmental Managemente. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5B
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 22-5772 *********

Created by: Warning Center on: 09/30/2022 03:00:22 PM Last Modified by: Warning Center on: 09/30/2022 03:07:09 PM