Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 08/24/2024
    TIME: 1930
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-4788
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
San Jose Fire Department
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. Fuel, Gasoline=5 Gal(s)PETROLEUMNoNo
2. Chlorine, Liquid=5 Gal(s)CHEMICALNoNo
3. Foam, Class A=Unknown N/ACHEMICALNoNo
g. DESCRIPTION: A fire broke out in the garage of a duplex home for unknown reasons. The San Jose Fire Department and support teams responded to the scene, where they isolated the area and closed off a nearby road. During the firefighting efforts, several containers holding petroleum and chemical products were damaged and mixed with Class A Foam. This mixture, of unknown quantity, entered a residential storm drain. The fire was extinguished, and the property owner will be responsible for the cleanup. One minor injury was reported, though the current condition of the individual is unknown.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, Not containedYesStorm drainNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
Road Closure
3. a. INCIDENT LOCATION: 2859 Cicero Way
b. CITY:c. COUNTY: d. ZIP:
San Jose
Santa Clara County95148BAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
08/24/20241450 Residence Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
Yes
Injuries #: 1		NoNoResponsible Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fire Dept., Police Dept.None
d. ADMIN. AGENCY: Santa Clara County Department of Environmental Healthe. 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, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-4788 *********

Created by: Warning Center on: 08/24/2024 07:30:34 PM Last Modified by: Warning Center on: 08/24/2024 08:44:24 PM