Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 07/02/2024
    TIME: 0935
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-3754
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Cal Fire Mendocino
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. Structure Fire=N/A N/AOTHERStructure FireNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: The reporting party states there was a structure fire for unknown reasons. The fire has been stopped and contained. It is unknown at the time of the report if any hazardous materials were released. The situation is currently under investigation, and the reporting party will provide updates when available.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedUnknownUnknownUnknown
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 3515 Taylor Drive
b. CITY:c. COUNTY: d. ZIP:
Ukiah
Mendocino County95482MENDOCINO COUNTY AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
07/02/20240359 Other
Description for Other : Waste Facility		Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Co Health, Fire Dept., Police Dept.
d. ADMIN. AGENCY: Mendocino County Health Departmente. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

1
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DFW-OSPR, AIR RESOURCES BD, CALFIRE, DWP-DO, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-3754 *********

Created by: Warning Center on: 07/02/2024 09:35:18 AM Last Modified by: Warning Center on: 07/02/2024 10:25:51 AM