Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 08/21/2024
    TIME: 1532
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-4737
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
City of Stockton Municipal Utilities
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. Sewage=1,943 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: The reporting party states that due to a pipe failure, 1,943 gallons of sewage were released from a private sewer lateral. The release impacted the asphalt, concrete, a storm catch basin, and a storm drain. The release has been stopped and contained. A contractor will conduct the cleanup and repair the pipe.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesStorm DrainNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 302 West Ben Holt Drive
b. CITY:c. COUNTY: d. ZIP:
Stockton
San Joaquin County95207SAN JOAQUIN VALLEY UNIFIED APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
08/21/20241015 Residence Other
Description for Other : Pipe Failure
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: San Joaquin 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, DWP-DO, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-4737 *********

Created by: Warning Center on: 08/21/2024 03:32:15 PM Last Modified by: Warning Center on: 08/21/2024 03:42:49 PM