Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 05/19/2019
TIME: 1924
RECEIVED BY: CONTROL#:
Cal OES - 19-3240
NRC - 1246169
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
PG&E
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. Unknown PCB Mineral Oil=7 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = YesNo
g. DESCRIPTION: Caller states a pole mounted transformer fell to the ground due to a rotten pole resulting in the release of 7 gallons of unknown PCB mineral oil onto pavement in an alley and an unknown amount flowed into a storm drain. There are no emergency services needed. PG&E and a contractor are handling the clean up.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesStorm DrainNo
l. KNOWN IMPACTNone
3. a. INCIDENT LOCATION: 3469 Story Rd
b. CITY:c. COUNTY: d. ZIP:
San Jose
Santa Clara CountyBAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
05/19/20191600 Residence Other
Description for Other : Rotten Pole
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
NRC
d. ADMIN. AGENCY: Santa Clara County Department of Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
DOG Unit:
i. RWQCB Unit:
2
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DFG-OSPR, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
********* Control No: 19-3240 *********

Created by: Warning Center on: 05/19/2019 07:24:15 PM Last Modified by: Warning Center on: 05/19/2019 07:32:47 PM