Governor's Office Emergency Services |
TIME: 1653 |
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Cal OES - 24-2745 NRC - |
1. NAME: | 2. AGENCY: | 3. PHONE#: | 4. Ext: | 5. PAG/CELL: |
![]() | City of Mill Valley | ![]() | ![]() | ![]() |
1. NAME: | 2. AGENCY: | 3. PHONE#: | 4. Ext: | 5. PAG/CELL: |
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2. a. SUBSTANCE: | b.QTY:>=< | Amount | Measure | c. TYPE: | d. OTHER: | e. PIPELINE | f. VESSEL >= 300 Tons |
1. Sewage | = | 25 | Gal(s) | SEWAGE | No | No | |
2. | = | No | No | ||||
3. | = | No | No |
g. DESCRIPTION: | Per reporting party, an overflow caused by gravel stuck in the main line resulted in the release of approximately 25 gallons of sewage onto land. No waterways were impacted by this release. Cleanup was conducted by the City of Mill Valley Department of Public Works Sewer crew. | ||
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h. STOPPAGE/CONTAINMENT: | i. WATER INVOLVED: | j. WATERWAY: | k. DRINKING WATER IMPACTED |
Stopped, Contained | No | N/A | No |
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l. MARITIME VESSEL No | ![]() | m. KNOWN IMPACT None | ![]() |
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3. a. INCIDENT LOCATION: 202 Marlin Ave | |||
b. CITY: | c. COUNTY: | d. ZIP: | ![]() |
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Mill Valley | Marin County | 94941 | BAY AREA AQMD |
4. INCIDENT DESCRIPTION: | |||
a. DATE: | b. TIME (Military): | c. SITE: | d. REPORTED CAUSE |
05/11/2024 | 1720 | Residence | Overflow |
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e. INJURIES | f. FATALITY | g. EVACUATION | h. CLEANUP BY: |
No | No | No | Contractor |
6. NOTIFICATION INFORMATION: | ||
a. ON SCENE: | b. OTHER ON SCENE: | c. OTHER NOTIFIED: |
d. ADMIN. AGENCY: Marin County Waste Management Office | ![]() | e. SEC. AGENCY: |
f. ADDITIONAL COUNTY: | ![]() | g. ADMIN. AGENCY: |
h. NOTIFICATION LIST: | ![]() | ![]() |
Cal GEM: | RWQCB Unit: | 2 |
Cal OES Region: | ![]() | |
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Photo Attachment: | ![]() |