Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 09/25/2021
TIME: 1216
RECEIVED BY: CONTROL#:
Cal OES - 21-5274
NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
PG&E
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. Insulating Oil (non PCB)<25 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: RP States: A third party damage a pad mounted transformer causing insulating oil to spill onto the concrete floor, no waterways were impacted. PG&E has completed clean up of the spill.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoneNo
l. MARITIME VESSEL
No
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 188 Constitution Dr
b. CITY:c. COUNTY: d. ZIP:
Menlo Park
San Mateo County94025BAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
09/24/20211941 Other
Description for Other : Industrial Park
Other
Description for Other : Third Party Damage
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fire Dept.San Mateo County Environmental Health
d. ADMIN. AGENCY: San Mateo County Environmental Healthe. 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, Co/WP, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 21-5274 *********

Created by: Warning Center on: 09/25/2021 12:16:11 PM Last Modified by: Warning Center on: 09/25/2021 12:27:27 PM