Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 03/30/2023
    TIME: 2019
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-2341
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Cal Trans
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. Used motor oil=Estimated 10 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Reporting party states they were notified by dispatch that there was an oil spill on the shoulder of the highway. Fire Department is on the scene requesting assistance from Cal Trans. The cause of the release is unknown but the release might be due to illegal dumping. The spill is on the dirt shoulder in a large puddle of rain water. No waterways are impacted. The spill is stopped and contained. Cal Trans is conducting 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: Lake County Highway 20 Post Mile 27.35, cross Street Island Drive
b. CITY:c. COUNTY: d. ZIP:
Clearlake Oaks
Lake CountyLAKE COUNTY AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
03/30/20231900 Road Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoCalTrans
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Cal Trans, Fire Dept.
d. ADMIN. AGENCY: Lake County Health Departmente. 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
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-2341 *********

Created by: Warning Center on: 03/30/2023 08:19:04 PM Last Modified by: Warning Center on: 03/30/2023 08:29:53 PM