Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 02/14/2024
    TIME: 2011
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-0967
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Albertsons/Safeway
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. Milk =40 Gal(s)OTHERMilkNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per reporting party: While unloading the truck during a delivery, a pallet tipped over, causing the spillage of an estimated 30-40 gallons, which then entered the storm drain. Waiting for contractors to assist with the cleanup process.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesStorm drain No
l. MARITIME VESSEL
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 900 Diablo Ave
b. CITY:c. COUNTY: d. ZIP:
Novato
Marin County94947BAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
02/14/20241845 Merchant/Business Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Marin County Waste Management Officee. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

2
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DFW-OSPR, DWP-DO, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-0967 *********

Created by: Warning Center on: 02/14/2024 08:11:13 PM Last Modified by: Warning Center on: 02/14/2024 08:36:28 PM