Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 09/21/2022
TIME: 1632
RECEIVED BY: CONTROL#:
Cal OES - 22-5553
NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
City of Fremont
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 - Diesel Type=15-30 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: A fuel line from the belly tank ruptured causing the release, material flowed onto asphalt and possibly went into a storm drain, approximately one gallon entered drain, RP handled the containment, contractor is performing clean up.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesStorm Drain
l. MARITIME VESSEL
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 3300 Capitol Ave, Rear of City Hall
b. CITY:c. COUNTY: d. ZIP:
Fremont
Alameda County94538BAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
09/21/20221350 Other
Description for Other : City Property
Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fremont FD, EH
d. ADMIN. AGENCY: Fremont City Fire Departmente. SEC. AGENCY: Alameda County Environmental Health
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/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 22-5553 *********

Created by: Warning Center on: 09/21/2022 04:32:50 PM Last Modified by: Warning Center on: 09/21/2022 04:41:21 PM