Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 08/29/2024
    TIME: 1349
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-4892
    NRC - 1409403
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
NRC
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. Bleach =Unknown UnknownCHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per NRC report: The caller stated that unknown amounts of bleach is being washed Into a storm drain at the location. The cause of the release is an individual washing rugs at the location. Remedial Action: The caller is unaware of actions being taken
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Unknown if stoppedYesStorm drainNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 5327 Jacuzzi St
b. CITY:c. COUNTY: d. ZIP:
Richmond
Contra Costa CountyBAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
08/29/20241200 Waterways Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Contra Costa County Health Services Departmente. 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, DFW-OSPR, DWP-DO, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-4892 *********

Created by: Warning Center on: 08/29/2024 01:49:30 PM Last Modified by: Warning Center on: 08/29/2024 01:55:59 PM