Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 09/30/2024
    TIME: 1735
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-5542
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Emergency Response and Training Solutions (ERTS)
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. Paint=1 Gal(s)CHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per the reporting party, on 09/25/2024 at approximately 0500 in the morning, at a Fedex ground facility, a 1 gallon can of paint fell from a portable conveyer belt onto a concrete surface at a FedEx Ground facility. No waterways were impacted. FedEx Ground personnel will be cleaning the spill. The paint has dried to the surface since the incident occurred.

***NOTE: This spill report was resent 10/1/24 due to corrected City/County.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoN/ANo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 1070 San Mateo Avenue
b. CITY:c. COUNTY: d. ZIP:
South San Francisco
San Mateo County94080BAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
09/25/20240500 Other
Description for Other : FedEx Ground Facility		Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoResponsible Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: San Mateo County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

2
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-5542 *********

Created by: Warning Center on: 09/30/2024 05:35:30 PM Last Modified by: Warning Center on: 10/01/2024 07:57:57 AM