Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 10/02/2022
TIME: 1741
RECEIVED BY: CONTROL#:
Cal OES - 22-5809
NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Groveland Community Services 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<500 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: RP states: A blockage in the main was the cause of the release. The release impacted an unknown creek. The release is stopped and contained. Clean up is in progress through Groveland Community Services District.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
StoppedYesunknown creekNo
l. MARITIME VESSEL
No
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 11060 Black Road
b. CITY:c. COUNTY: d. ZIP:
Big Oak Flat
Tuolumne County95305TUOLUMNE COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
10/02/20221519 Waterways Blockage
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoGroveland Community Services District
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Tuolumne County Environmental Divisione. 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, DFW-OSPR, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 22-5809 *********

Created by: Warning Center on: 10/02/2022 05:41:38 PM Last Modified by: Warning Center on: 10/02/2022 05:51:09 PM