Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 10/19/2021
TIME: 0909
RECEIVED BY: CONTROL#:
Cal OES - 21-5809
NRC - 1319836
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:
Lineage Logistics
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Ammonia- Anhydrous Type=Unk Lbs.VAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per NRC report: A machine room compressor released an unknown amount of material for an unknown reason, release secured.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNo
l. MARITIME VESSEL
m. KNOWN IMPACT
Unknown
3. a. INCIDENT LOCATION: 400 Polar Wy
b. CITY:c. COUNTY: d. ZIP:
San Leandro
Alameda CountyBAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
10/19/20210750 Merchant/Business Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: City of San Leandro Environmental Servicese. SEC. AGENCY: Alameda County Environmental Health
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

2
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, AIR RESOURCES BD, Co/WP
Photo Attachment:
11. Cal OES Reg.
********* Control No: 21-5809 *********

Created by: Warning Center on: 10/19/2021 09:09:25 AM Last Modified by: Warning Center on: 10/19/2021 09:17:25 AM