Governor's Office Emergency Services |
TIME: 1136 |
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Cal OES - 23-5958 NRC - |
| 1. NAME: | 2. AGENCY: | 3. PHONE#: | 4. Ext: | 5. PAG/CELL: |
| private citizen | | | |
| 1. NAME: | 2. AGENCY: | 3. PHONE#: | 4. Ext: | 5. PAG/CELL: |
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| 2. a. SUBSTANCE: | b.QTY:>=< | Amount | Measure | c. TYPE: | d. OTHER: | e. PIPELINE | f. VESSEL >= 300 Tons |
| 1. Phos-check Foam | = | Unknown | Gal(s) | CHEMICAL | No | No | |
| 2. | = | No | No | ||||
| 3. | = | No | No |
| g. DESCRIPTION: | RP states that during the fires in Happy Camp the fire crews sprayed large amounts of retardant foam on the land behind his home and into watersheds. RP stated he had sampling done and came back as the chemical Phos-check foam. 1 injury occurred due to this release. The property is located on the Karuk Tribal Lands, Inaam Cultural area. Impacts to wildlife have been reported. No clean up conducted at this time. . | ||
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| h. STOPPAGE/CONTAINMENT: | i. WATER INVOLVED: | j. WATERWAY: | k. DRINKING WATER IMPACTED |
| Stopped, Not contained | Yes | Five Watersheds | Yes |
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| l. MARITIME VESSEL No | | m. KNOWN IMPACT Drinking Water | |
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| 3. a. INCIDENT LOCATION: Forest Service Road 15 N. 23 | |||
| b. CITY: | c. COUNTY: | d. ZIP: | |
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| Happy Camp | Siskiyou County | 96039 | SISKIYOU COUNTY APCD |
| 4. INCIDENT DESCRIPTION: | |||
| a. DATE: | b. TIME (Military): | c. SITE: | d. REPORTED CAUSE |
| 09/01/2023 | 0800 | Residence | Human Error |
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| e. INJURIES | f. FATALITY | g. EVACUATION | h. CLEANUP BY: |
| Yes Injuries #: 1 | No | No | Unknown |
| 6. NOTIFICATION INFORMATION: | ||
| a. ON SCENE: | b. OTHER ON SCENE: | c. OTHER NOTIFIED: |
| Fire Dept. | Karuk Tribe | |
| d. ADMIN. AGENCY: Siskiyou County Environmental Health | | e. SEC. AGENCY: |
| f. ADDITIONAL COUNTY: | | g. ADMIN. AGENCY: |
| h. NOTIFICATION LIST: | | |
| Cal GEM: | RWQCB Unit: | 1 |
| Cal OES Region: Inland | | |
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| Photo Attachment: | |