Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 04/17/2024
    TIME: 1012
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-2258
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Placer County
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. Sewage =1,002 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per the Reporting Party : A contractor bored through a sewer pipe causing the release. The release has been stop. The material impacted surrounding asphalt and went into a seasonal drainage ditch. The material was contain to the drainage ditch/holding pond area. Placer County will be handling clean up. Placer County Environmental Health was also on scene.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesSeasonal drainage ditchNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 9736 Magellan Dr
b. CITY:c. COUNTY: d. ZIP:
Loomis
Placer CountyUnknown PLACER COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
04/17/20240900 Residence Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
County Environmental Health
d. ADMIN. AGENCY: Placer 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, CDPH-D.O., LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-2258 *********

Created by: Warning Center on: 04/17/2024 10:12:59 AM Last Modified by: Warning Center on: 04/17/2024 10:24:06 AM