Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/20/2023
    TIME: 1821
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-7215
    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. Mineral Oil "Unknown PCB"=1 Qt.(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per Reporting Party: Equipment failure on a overhead transformer caused Mineral Oil to spill onto the soil below and possibly leak into a seasonal drainage creek. PG&E performed the repair and a contractor performed the clean up.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesUnknown creekNo
l. MARITIME VESSEL
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 17820 Hwy 49
b. CITY:c. COUNTY: d. ZIP:
Plymouth
Amador County95669AMADOR COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/20/20231234 Other
Description for Other : In a field next to the drainage
Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
N/A
d. ADMIN. AGENCY: Amador County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5B
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: 23-7215 *********

Created by: Warning Center on: 11/20/2023 06:21:46 PM Last Modified by: Warning Center on: 11/20/2023 06:41:31 PM