Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 09/23/2024
    TIME: 1635
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-5382
    NRC - 1411722
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
NRC
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. Motor oil=u UnknownPETROLEUMNoNo
2. Transmission fluid=u UnknownCHEMICALNoNo
3. = NoNo
g. DESCRIPTION: Per NRC report: Caller is reporting that outside of his business there is an individual that is working on cars in the street and dumping the used oil and transmission fluid onto the ground. It is unknown if any storm drains were impacted
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Unknown if stoppedUnknownStorm drain No
l. MARITIME VESSEL
No
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 1172 Lick Ave
b. CITY:c. COUNTY: d. ZIP:
San Jose
Santa Clara CountyBAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
09/23/20241600 Merchant/Business Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Santa Clara County Department of Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

2
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: 24-5382 *********

Created by: Warning Center on: 09/23/2024 04:35:18 PM Last Modified by: Warning Center on: 09/23/2024 04:39:51 PM