Governor's Office Emergency Services
Hazardous Materials Spill Report |
DATE: 05/16/2024
TIME: 1307
|
|
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 | Measure | c. TYPE: | d. OTHER: | e. PIPELINE | f. VESSEL
>= 300 Tons |
1. Unknown Oil | = | Unknown | N/A | PETROLEUM | | No | No |
2. | = | | | | | No | No |
3. | = | | | | | No | No |
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 contained | Yes | Unknown Creek | Unknown |
 |  |  |
l. MARITIME VESSEL
|  | m. KNOWN IMPACT
Unknown |  |
 |  |  |  |
3. a. INCIDENT LOCATION: 9574 Rice Street |
b. CITY: | c. COUNTY: | d. ZIP: |  |
 |  |  |  |
Upper Lake
| Lake County | Unknown | LAKE COUNTY AQMD |
4. INCIDENT DESCRIPTION: |
a. DATE: | b. TIME (Military): | c. SITE: | d. REPORTED CAUSE |
05/16/2024 | 1200 | Residence | Human Error |
 |  |  |
 |  |  |  |
e. INJURIES | f. FATALITY | g. EVACUATION | h. CLEANUP BY: |
No | No | No | Unknown |
6. NOTIFICATION INFORMATION: |
a. ON SCENE: | b. OTHER ON SCENE: | c. OTHER NOTIFIED: |
| | |
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