Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 01/30/2023
    TIME: 0919
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-0829
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Private Citizen
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=Unknown Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: RP stated that his neighbors septic tank is releasing sewage and is causing an odor and he noticed that he had a dead blue bird in a bird bath on his property and believes that it is related. He stated that he did yard work and now he is extremely ill and states that the cause of it is from the septic tank overflowing.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Not stopped, Not containedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 16619 Estralita Drive
b. CITY:c. COUNTY: d. ZIP:
Sonora
Tuolumne CountyTUOLUMNE COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
01/27/20231030 Residence Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Tuolumne County Environmental Divisione. 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., Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-0829 *********

Created by: Warning Center on: 01/30/2023 09:19:20 AM Last Modified by: Warning Center on: 01/30/2023 09:30:04 AM