Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 06/08/2023
    TIME: 2240
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-3768
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Kern County Fire
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. Fire Suppression Water=Unknown UnknownCHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Structure fire on tesla wall mount full house unit caused a release of fire suppression water. Fire mitigation is complete and release has been stopped and contained. Tesla Hazmat will conduct clean up.
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: 8334 Entrada Blvd
b. CITY:c. COUNTY: d. ZIP:
South Lake
Kern CountyKERN COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
06/08/20231806 Residence Other
Description for Other : Fire
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
CHP, Fire Dept., Sheriff Ofc.SDEEnvironmental Health, Bureau of land management, united states forest service
d. ADMIN. AGENCY: Kern Co. Environmental Health Services Departmente. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5C
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-3768 *********

Created by: Warning Center on: 06/08/2023 10:40:56 PM Last Modified by: Warning Center on: 06/08/2023 10:49:02 PM