Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 03/02/2021
TIME: 2313
RECEIVED BY: CONTROL#:
Cal OES - 21-1148
NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Sacramento City FD
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. Solvent - mixed with Adhesive (Sarnacol) and Concrete<100 Gal(s)CHEMICAL, VAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Two chemicals were mixed with dry concrete resulting in a reaction that caused the release, material vented directly into the atmosphere causing a vapor cloud, approximately 6 subjects from the surrounding area were evacuated and have been allowed to return, apparently this event was in preparation for an illegal disposal at a landfill facility, FD handled the containment, EH is supervising clean up.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNo
l. KNOWN IMPACTRoad Closure
3. a. INCIDENT LOCATION: 1685 Helena Ave, Alliance Roofing Co
b. CITY:c. COUNTY: d. ZIP:
Sacramento
Sacramento County95815SACRAMENTO METROPOLITAN AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
03/02/20212003 Merchant/Business Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoYes
Evacs #: 6
Unknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Co Health, Fire Dept., Police Dept.Sac City DA
d. ADMIN. AGENCY: Sacramento City Fire Departmente. SEC. AGENCY: Sacramento County Environmental Management
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
i. Cal GEM:
j. RWQCB Unit:

5B
k. Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, AIR RESOURCES BD, CDPH-D.O., Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 21-1148 *********

Created by: Warning Center on: 03/02/2021 11:13:47 PM Last Modified by: Warning Center on: 03/02/2021 11:28:36 PM