Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 10/29/2024
    TIME: 1531
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6117
    NRC - 1415089
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:
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Refrigerant gas=Unknown UnknownVAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: *** POTENTIAL RELEASE REPORT ***
Per NRC report:The caller is reporting a potential release refrigerant into the atmosphere from the hvac cooling unit. The caller states that the srp did not take enough time to properly to collect the refrigerant. But it is unknown if there was a release or not
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
StoppedNoNoNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 1550 Valley Glen Dr
b. CITY:c. COUNTY: d. ZIP:
Dixon
Solano County95620YOLO/SOLANO AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
10/29/20241500 Residence Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoNA
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Solano County Environmental Managemente. 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, AIR RESOURCES BD, CDPH-D.O., Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-6117 *********

Created by: Warning Center on: 10/29/2024 03:31:31 PM Last Modified by: Warning Center on: 10/29/2024 03:41:25 PM