Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 06/04/2024
    TIME: 0732
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-3195
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Shasta County - Department of Public Works
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=850 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: A sewer main blockage resulted in a sewage overflow from a manhole cover. The release flowed onto a residential roadway and into a nearby field. Public Works was notified of the incident and a crew was dispatched. On arrival, the blockage was identified and the sewer main isolated. Technicians cleared the main, stopping the overflow. A cleanup of the impacted surface areas was completed without incident.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: Wagonette Court
b. CITY:c. COUNTY: d. ZIP:
Palo Cedro
Shasta County96073SHASTA COUNTY AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
06/03/20241315 Residence Blockage
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
None
d. ADMIN. AGENCY: Shasta County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5A
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: 24-3195 *********

Created by: Warning Center on: 06/04/2024 07:32:53 AM Last Modified by: Warning Center on: 06/04/2024 07:52:25 AM