Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 01/22/2023
    TIME: 1721
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-0676
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Fish and Wildlife
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. Potential release, Motor Oil=Estimated 25 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: ***Potential Release***Reporting party states they found abandoned motor oil in open top buckets on the side of the road due to illegal dump.***Potential Release***
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: 16th St at Kasser Rd, 38.7279396 - 121.4294205
b. CITY:c. COUNTY: d. ZIP:
Elverta
Sacramento CountySACRAMENTO METROPOLITAN AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
01/22/20231720 Other
Description for Other : Unincorporated		Other
Description for Other : Illegal dump
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Sacramento County Environmental Managemente. SEC. AGENCY: Placer County Health Department
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5B
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-0676 *********

Created by: Warning Center on: 01/22/2023 05:21:13 PM Last Modified by: Warning Center on: 01/22/2023 05:31:25 PM