Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 04/14/2021
TIME: 0715
RECEIVED BY: CONTROL#:
Cal OES - 21-1965
NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Bolt House Farms
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. Diluted Sodium Hydroxide=Unknown UnknownCHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: RP states that there was a discharge of Diluted Sodium Hydroxide from a pipe into a drain. The Diluted Sodium Hydroxide then splashed out of the drain and onto an employee who has sought medical attention for skin irritation. No additional release is reported and no waterways impacted.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNo
l. MARITIME VESSEL
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 7200 E Brundage Ln
b. CITY:c. COUNTY: d. ZIP:
Bakersfield
Kern County93307SAN JOAQUIN VALLEY UNIFIED APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
04/14/20210640 Industrial Plant Other
Description for Other : Splash Back
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:
Kern Co EH,
d. ADMIN. AGENCY: Bakersfield Fire Departmente. SEC. AGENCY: Kern Co. Environmental Health Services Department
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
i. Cal GEM:
j. RWQCB Unit:

5C
k. Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, Co/Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 21-1965 *********

Created by: Warning Center on: 04/14/2021 07:15:56 AM Last Modified by: Warning Center on: 04/14/2021 07:36:24 AM