Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 04/08/2024
    TIME: 1207
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-2072
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Marin Sanitary Service
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. Red Coolant=8 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per reporting party, a truck driver observed fluid leaking from the truck. He stopped the truck and utilized a kit onboard to contain the spill before promptly notifying Marin Sanitary Services for assistance. The release occurred on asphalt within the parking lot and also affected a nearby concrete gutter. Clean up personnel arrived at the scene at 0540 hours and cleared the scene at 0630 hours. Cleanup procedures involved using dry sweeping and utilizing street sweepers. No waterways were affected.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoN/ANo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 111 Marydale Rd
b. CITY:c. COUNTY: d. ZIP:
San Rafael
Marin County94903BAY AREA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
04/08/20240530 Other
Description for Other : Convalescent Hospital		Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Marin County Waste Management Officee. SEC. AGENCY: Marin County Communications Center
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

2
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: 24-2072 *********

Created by: Warning Center on: 04/08/2024 12:07:27 PM Last Modified by: Warning Center on: 04/08/2024 12:38:40 PM