Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 02/25/2019
    TIME: 1203
    RECEIVED BY:
    CONTROL#:
    Cal OES - 19-1323
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Rio Del
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>1,000 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per the caller storm surge caused the release
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Not stopped, Not containedYesEel RiverNo
m. KNOWN IMPACT
Signs Posted
3. a. INCIDENT LOCATION: Painter St
b. CITY:c. COUNTY: d. ZIP:
Rio Dell
Humboldt County95562NORTH COAST UNIFIED AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
02/25/20190750 Road Other
Description for Other : Act of Nature
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Humboldt County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
DOG Unit:
RWQCB Unit:

1
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DFG-OSPR, CDPH-D.O., LANDS, PARKS & REC, USCG, Co/WP, Co/E-Hlth
AA/CUPA; DTSC; RWQCB; US EPA; USFWS; DFG-OSPR; CDPH-D.O.; LANDS; PARKS & REC; USCG; Co/WP; Co/E-Hlth

Photo Attachment:
11. Cal OES Reg.
********* Control No: 19-1323 *********

Created by: Warning Center on: 02/25/2019 12:03:38 PM Last Modified by: Warning Center on: 02/25/2019 12:09:38 PM