Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/21/2023
    TIME: 1521
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-7229
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
JR Simplot Company
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. Processed Water=150-200 Gal(s)OTHERProcessed WaterNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per reporting party while emptying a tank of processed water a hose on the pump started leaking. There was a release of 150 to 200 gallons of processed water onto the soil at the given location. The release is stopped and contained. No waterways were impacted. The reporting party will conduct the 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: 16777 Howland Rd
b. CITY:c. COUNTY: d. ZIP:
Lathrop
San Joaquin County95330SAN JOAQUIN VALLEY UNIFIED APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/21/20231445 Other
Description for Other : Fertilizer Manufacturing Plant
Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
RWQCB
d. ADMIN. AGENCY: San Joaquin County Environmental Healthe. 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: 23-7229 *********

Created by: Warning Center on: 11/21/2023 03:21:23 PM Last Modified by: Warning Center on: 11/21/2023 03:30:46 PM