Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 03/20/2023
    TIME: 0827
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-2040
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Amador Water Agency
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. Treated Wastewater=9000 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Caller states that approx. 9000 gallons of treated Wastewater (currently releasing 6 gallons per minute) into the spillway, the release is still ongoing, and no waterways were impacted, this is due to storm surge, Caller will notify the warning center for an update of the total amount released.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
NoNoNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 21530 Gayla Dr.
b. CITY:c. COUNTY: d. ZIP:
Pine Grove
Amador CountyAMADOR COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
03/20/20232400 Treatment/Sewage Facility Overflow
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Amador County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5B
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-2040 *********

Created by: Warning Center on: 03/20/2023 08:27:52 AM Last Modified by: Warning Center on: 03/20/2023 08:41:19 AM