Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 05/16/2024
    TIME: 1307
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-2808
    NRC - 1399153
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. Unknown Oil=Unknown N/APETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per the NRC Report : "Caller is reporting there are several barrels of an unknown oil that is being discharged onto the ground and possibly into a nearby creek. Caller states that they are also working on car engines and just dumping that oil onto the ground as well." Remedial Actions : "None"
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Unknown if stopped, Unknown if containedYesUnknown CreekUnknown
l. MARITIME VESSEL
m. KNOWN IMPACT
Unknown
3. a. INCIDENT LOCATION: 9574 Rice Street
b. CITY:c. COUNTY: d. ZIP:
Upper Lake
Lake CountyUnknownLAKE COUNTY AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
05/16/20241200 Residence Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Lake County Health Departmente. 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, DFW-OSPR, CDPH-D.O., DWP-DO, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-2808 *********

Created by: Warning Center on: 05/16/2024 01:07:07 PM Last Modified by: Warning Center on: 05/16/2024 01:17:11 PM