Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 11/29/2022
TIME: 0955
RECEIVED BY: CONTROL#:
Cal OES - 22-6997
NRC - 1353682
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
NRC
1.b. PERSON REPORTING SPILL (If different from above):
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
PRIVATE CITIZEN
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. ARSENIC=Unknown UnknownCHEMICALNoNo
2. RADIUM=Unknown UnknownCHEMICAL, RADIOLOGICALNoNo
3. = NoNo
g. DESCRIPTION: Per NRC: "CALLER STATED A WELL MANAGED BY CARRICK WATER SYSTEMS, IN LOCAL PARK DRILLED BY THE COUNTY OF SISKUE NEVER PRODUCED GOOD WATER. THE WATER REPORTS WITH CCR INDICATE THERE IS RADIUM 328 AND ARSENIC IN THE WATER. 148 PEOPLE AFFECTED."
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Unknown if stopped, Unknown if containedYesWell WaterYes
l. MARITIME VESSEL
No
m. KNOWN IMPACT
Drinking Water
3. a. INCIDENT LOCATION: 19224 MAPLE AVE
b. CITY:c. COUNTY: d. ZIP:
Weed
Siskiyou County96094SISKIYOU COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/15/20221400 Other
Description for Other : Local Park
Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Siskiyou County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

1
Cal OES Region: Inland
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DFW-OSPR, CDPH-D.O., CSWC Managers, DWP-DO, LANDS, EDO, FDC, Cal OES REG, LDO, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth, RPU
Photo Attachment:
11. Cal OES Reg. lindsey.stanley@caloes.ca.gov, walt.kent@caloes.ca.gov
********* Control No: 22-6997 *********

Created by: Warning Center on: 11/29/2022 09:55:40 AM Last Modified by: Warning Center on: 11/29/2022 10:23:23 AM