Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/29/2023
    TIME: 0952
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-7337
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Thatcher Company of California
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. Radiator Fluid/ Antifreeze=10 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Reporting party 3rd party driver on site had a hose fail on their truck and released 10 gallons of Antifreeze onto the pavement. No waterways impacted. Leak has been stopped and contained. Clean up is being done by reporting party. Caution tape was set up in the area to redirect traffic.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoneNo
l. MARITIME VESSEL
No
m. KNOWN IMPACT
Signs Posted
3. a. INCIDENT LOCATION: 8625 Unsworth Ave
b. CITY:c. COUNTY: d. ZIP:
Sacramento
Sacramento County95828SACRAMENTO METROPOLITAN AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/29/20230906 Road Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Sacramento City Fire Departmente. SEC. AGENCY: Sacramento County Environmental Management
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/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-7337 *********

Created by: Warning Center on: 11/29/2023 09:52:24 AM Last Modified by: Warning Center on: 11/29/2023 10:06:00 AM