Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 09/25/2023
    TIME: 0724
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-6128
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
CHP Humbolt
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. Ready mix =200 Lbs.CHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per caller: Tank trailer collision, over turned rolled on to the side blocking the road, driver is hurt, transported to hospital for minor injuries. The release is contained to the road shoulder, 200 lbs of mix and 200 yds into the road, will be closed up to 6 hours. No waterways were impacted.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedUnknownNoNo
l. MARITIME VESSEL
No
m. KNOWN IMPACT
Road Closure
3. a. INCIDENT LOCATION: MM 96.42, North of Standish-Hickey State Park
b. CITY:c. COUNTY: d. ZIP:
Leggett
Mendocino CountyMENDOCINO COUNTY AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
09/25/20230620 Road Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
Yes
Injuries #: 1
NoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Cal Trans, CHPHealth
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, CALTRANS, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-6128 *********

Created by: Warning Center on: 09/25/2023 07:24:48 AM Last Modified by: Warning Center on: 09/25/2023 07:43:57 AM