Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 05/23/2023
    TIME: 1627
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-3408
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Siskiyou County Department Public Health
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. Unknown Pesticide =3 Oz.CHEMICALNoNo
2. Unknown Pesticide =15 Oz.CHEMICALNoNo
3. Unknown Pesticide =20 Oz.CHEMICALNoNo
g. DESCRIPTION: During a cannabis raid, the listed unknown pesticides were found inside and outside parcel packaging.
Parcel Numbers -
Parcel #100-271-120
Parcel # 100-092-040
Parcel # 100-083-020
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
StoppedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: Siskiyou County Department Public Health - Yard Sharps Road
b. CITY:c. COUNTY: d. ZIP:
Yreka
Siskiyou County96097SISKIYOU COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
05/23/20231300 Merchant/Business Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Siskiyou County Environmental Healthe. 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, CDPH-D.O., DPR, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-3408 *********

Created by: Warning Center on: 05/23/2023 04:27:10 PM Last Modified by: Warning Center on: 05/23/2023 04:40:52 PM