Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 05/17/2024
    TIME: 1808
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-2841
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Crystal Creamery Dairy Company
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. Acid, Peracetic=300 Gal(s)CHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: A fork-lift operator accidentally hit a stored 300-gallon tote containing the listed substance, causing a chemical spill on the concrete floor of a facility building and into the on-site wastewater treatment system (septic system). The local fire department responded and assisted the fork-lift driver, who reported eye irritation. An environmental specialist was contacted and managed the cleanup of the spill without further incident. The dairy facility continued its operations throughout the event, and there were no impacts on the public.
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: 415 Kansas Avenue
b. CITY:c. COUNTY: d. ZIP:
Modesto
Stanislaus County95351SAN JOAQUIN VALLEY UNIFIED APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
05/17/20241630 Merchant/Business Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
Yes
Injuries #: 1		NoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fire Dept.None
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: 24-2841 *********

Created by: Warning Center on: 05/17/2024 06:08:19 PM Last Modified by: Warning Center on: 05/17/2024 07:07:16 PM