Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 10/04/2022
    TIME: 1114
    RECEIVED BY:
    CONTROL#:
    Cal OES - 22-5840
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Pacific Gas & Electric (PG&E)
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. Mud, Drilling=20 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: A frac-out during an underground conduit installation occurred at the listed location. The incident resulted in 20 gallons of drilling mud to be released onto a dry creek bed (non flowing). An on-site vacuum truck responded to the site and a cleanup is in progress.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesCreekNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: COORDINATES: Latitude: 40.632795 / Longitude: -122.304040
b. CITY:c. COUNTY: d. ZIP:
Unincorporated county area Shasta
Shasta CountySHASTA COUNTY AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
10/04/20220800 Other
Description for Other : Construction site		Other
Description for Other : Drilling operations
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
None
d. ADMIN. AGENCY: Shasta County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5A
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DFW-OSPR, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 22-5840 *********

Created by: Warning Center on: 10/04/2022 11:14:52 AM Last Modified by: Warning Center on: 10/04/2022 11:50:51 AM