Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/07/2024
    TIME: 0720
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6275
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
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. Oil (Non PCB)=400 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per reporting party, a fire caused 2 poles to fall and break transformers open. This caused 400 gallons of mineral oil to release onto soil. Release has been stopped and contained with contractors on scene for clean up. No further impacts have been reported at this time.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: Across from 19955 Bowman Rd
b. CITY:c. COUNTY: d. ZIP:
Cottonwood
Shasta County96022SHASTA COUNTY AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/06/20240800 Residence Other
Description for Other : Fire
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fire Dept.
d. ADMIN. AGENCY: Shasta County Environmental Healthe. SEC. AGENCY: Tehama County Environmental Health
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5A
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-6275 *********

Created by: Warning Center on: 11/07/2024 07:20:01 AM Last Modified by: Warning Center on: 11/07/2024 07:26:11 AM