Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 10/18/2024
    TIME: 1719
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-5915
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Fluid Resource Management
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. Sewage=100-200 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per the Reporting Party: A failure of the air vac system in a lateral sewer line caused the release of material through a man hole cover on a golf course impacting the golf cart path and some of the grass. No waterways were affected. The release has been stopped; the air vac system has been shut down pending repairs. A vacuum truck was utilized to remove the material from the impacted surface and clean up was completed utilizing a bleach/water solution. The area of the release was cordoned off using caution tape.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoN/ANo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 1606 Trilogy Parkway - LAT: 35.032830 / LON : -120.560324
b. CITY:c. COUNTY: d. ZIP:
Nipomo
San Luis Obispo County93444SAN LUIS OBISPO COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
10/18/20241545 Other
Description for Other : Golf Course		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: San Luis Obispo County Public Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

3
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-5915 *********

Created by: Warning Center on: 10/18/2024 05:19:39 PM Last Modified by: Warning Center on: 10/18/2024 05:31:58 PM