Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 08/05/2022
TIME: 1014
RECEIVED BY: CONTROL#:
Cal OES - 22-4485
NRC - 1343632
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
NRC
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. Unknown =Unknown UnknownVAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: PER NRC: THE CALLER STATED THAT THE AIR QUALITY AT THE LOCATION PROVIDED IS VERY POOR AND IS CAUSING HEALTH COMPLICATIONS TO NEARBY RESIDENTS. THE CALLER BELIEVES THE CAUSE OF THIS IS GASES RELEASING FROM CLEAR LAKE. THE AMOUNT OF MATERIAL THAT RELEASED IS CURRENTLY UNKNOWN AT THIS TIME. THIS HAS BEEN AN ONGOING INCIDENT FOR THE LAST MONTH. THE EXACT MATERIAL THAT IS RELEASING IS UNKNOWN TO THE CALLER.

REMEDIAL ACTIONS: THE CALLER STATED THAT NO ACTION HAS BEEN TAKEN.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Unknown if stopped, Unknown if containedNoNoneNo
l. MARITIME VESSEL
No
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 13150 LAKESHORE DR
b. CITY:c. COUNTY: d. ZIP:
Clearlake
Lake County95422LAKE COUNTY AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
08/05/20221200 Residence Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnrecoverable
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
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, DFW-OSPR, AIR RESOURCES BD, CDPH-D.O., Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 22-4485 *********

Created by: Warning Center on: 08/05/2022 10:14:53 AM Last Modified by: Warning Center on: 08/05/2022 10:22:04 AM