Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 10/30/2024
    TIME: 1541
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6134
    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 drinking water =27,500 Gal(s)OTHERwaterNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per reporting party: Due to deterioration of an under ground pipe that broke there was a release of 27.500 gallons of potable water out to the San Anselmo Creek. There is fish in this creek. No other information.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesSan Anselmo CreekNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 14 Richmond Rd
b. CITY:c. COUNTY: d. ZIP:
San Anselmo
Marin County945960BAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
10/30/20240830 Waterways Broken Pipe
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoNA
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, DWP-DO, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-6134 *********

Created by: Warning Center on: 10/30/2024 03:41:26 PM Last Modified by: Warning Center on: 10/30/2024 04:00:19 PM