Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 07/18/2024
    TIME: 1322
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-4110
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
City of Riverbank
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=1,950 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: The reporting party states there was a failure in a sewer main line at a sewer lift station, resulting in the release of 1,950 gallons of sewage that impacted the dirt and grass at the given location. The release has been stopped and contained. No waterways were impacted. The reporting party conducted the cleanup.
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: 5449 Roselle Ave
b. CITY:c. COUNTY: d. ZIP:
Riverbank
Stanislaus County95367SAN JOAQUIN VALLEY UNIFIED APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
07/18/20241145 Residence Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Stanislaus County Environmental Resourcese. 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, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-4110 *********

Created by: Warning Center on: 07/18/2024 01:22:36 PM Last Modified by: Warning Center on: 07/18/2024 01:30:08 PM