Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 03/27/2023
    TIME: 1346
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-2238
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Sacramento County Environmental Management
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. Carbon Monoxide=Unknown UnknownVAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Suspecting that a fryer at a restaurant had incomplete combustion causing carbon monoxide to release into the atmosphere. Building evacuated, unknown number occupants, two people were transported to the hospital. Leak has been stopped and gas utility company are currently conducting an investigation of the source.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, Not containedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 6021 Mack Road (Jollibee)
b. CITY:c. COUNTY: d. ZIP:
Sacramento
Sacramento County95823SACRAMENTO METROPOLITAN AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
03/27/20231250 Merchant/Business Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoYes
Evacs #: Unknown		Unrecoverable
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fire Dept., OtherHazmat
d. ADMIN. AGENCY: Sacramento City Fire Departmente. SEC. AGENCY: Sacramento County Environmental Management
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, AIR RESOURCES BD, CDPH-D.O., Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-2238 *********

Created by: Warning Center on: 03/27/2023 01:46:30 PM Last Modified by: Warning Center on: 03/27/2023 01:53:31 PM