Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 06/01/2023
    TIME: 1650
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-3601
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Marin Municipal Water District
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. Potable Water=40,000 Gal(s)OTHERPotable WaterNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: RP states: A pipeline main break occurred resulting in the release of the material. The release impacted the San Anselmo Creek. The release is stopped and contained. The material is unrecoverable and there is a Potential threat to aquatic Wildlife in creek.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
StoppedYesSan Anselmo CreekNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 124 Tunstead Ave
b. CITY:c. COUNTY: d. ZIP:
San Anselmo
Marin County94960BAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
06/01/20230920 Residence Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnrecoverable
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Marin County Waste Management Officee. 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: 23-3601 *********

Created by: Warning Center on: 06/01/2023 04:50:56 PM Last Modified by: Warning Center on: 06/01/2023 05:32:20 PM