Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 03/27/2023
    TIME: 0843
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-2224
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Humboldt County Division of Environmental Health
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. Raw Sewage=5 GPM Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: RP States: A private lateral has been leaking do to unknown reasons causing sewage to flow onto the ground an a near by storm drain that flows into a unnamed drainage. This release has been going on for approximately 2 weeks. The released sewage is unrecoverable. The owner of the private lateral has contracted a plumber to fix the line.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Not stopped, Not containedYesStorm Drain, Unnamed DrainageNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 2844 Sunnygrove Ave
b. CITY:c. COUNTY: d. ZIP:
McKinleyville
Humboldt County95519NORTH COAST UNIFIED AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
03/24/20230900 Residence Broken Pipe
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnrecoverable
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Co Health, OtherCity of McKinleyville
d. ADMIN. AGENCY: Humboldt County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

1
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DFW-OSPR, CDPH-D.O., LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-2224 *********

Created by: Warning Center on: 03/27/2023 08:43:57 AM Last Modified by: Warning Center on: 03/27/2023 08:59:36 AM