Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/03/2024
    TIME: 1757
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6192
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
El Dorado Irrigation District
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=200 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: In response to a sewage complaint, a crew from the El Dorado Irrigation District was sent to the listed location. Upon arrival, technicians traced the source of the sewage overflow to a private sewer lateral. The incident caused an estimated 200 gallons of sewage to spill from a nearby manhole, affecting a storm drain, the destination of which remains unknown. Although the overflow has been contained, an inspection revealed that the problem may be more extensive than initially assessed. Additional personnel from the district have been contacted to assist with the service call.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Unknown if stopped, Not containedYesStorm DrainNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
Unknown
3. a. INCIDENT LOCATION: Forni Road & Golden Center Drive
b. CITY:c. COUNTY: d. ZIP:
Placerville
El Dorado County95677EL DORADO COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/03/20241600 Merchant/Business Blockage
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
None
d. ADMIN. AGENCY: El Dorado 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, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-6192 *********

Created by: Warning Center on: 11/03/2024 05:57:37 PM Last Modified by: Warning Center on: 11/03/2024 06:20:53 PM