Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 06/06/2023
    TIME: 1305
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-3703
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
CDFW
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. gasoline=8ftx10ft SheenPETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: RP States: A resident saw a vessel dock last night (06/05), this morning the resident reports that the vessel has sunk. There is a 8ftx10ft rainbow sheen. RP does not know the size of the vessel.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Not stopped, Not containedYesClearlakeUnknown
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 13825 Lakeshore Drive
b. CITY:c. COUNTY: d. ZIP:
Clearlake
Lake CountyLAKE COUNTY AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
06/06/20231230 Ship/Harbor/Port Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Sheriff Ofc.
d. ADMIN. AGENCY: Lake County Health Departmente. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5B
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DFW-OSPR, CDPH-D.O., DWP-DO, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-3703 *********

Created by: Warning Center on: 06/06/2023 01:05:42 PM Last Modified by: Warning Center on: 06/06/2023 01:29:16 PM