Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 12/03/2024
    TIME: 1734
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6741
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
San Mateo EVH
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. Elemental Mercury=.16 Oz.CHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Reporting party states a resident called their office to report a break of an antique barometer resulting in a tsp (.16 oz) of mercury on their kitchen table. The spill in isolated inside house and has been stopped and contained. There has been some contamination within the residence, but no injuries have been reported. San Mateo EVH and Reg 9 USEPA has responded and completed of survey of the site. Clean-up is being discussed. No waterways were impacted.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNANo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
Unknown
3. a. INCIDENT LOCATION: 484 Gardenside Ave
b. CITY:c. COUNTY: d. ZIP:
South San Francisco
San Mateo County94080BAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
12/02/20241445 Residence Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
EPA, EVH, Weston EVH
d. ADMIN. AGENCY: e. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

2
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, CDPH-D.O., Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-6741 *********

Created by: Warning Center on: 12/03/2024 05:34:52 PM Last Modified by: Warning Center on: 12/03/2024 05:51:11 PM