Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 01/17/2019
TIME: 1938
RECEIVED BY: CONTROL#:
Cal OES - 19-0431
NRC -
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. Mineral Oil ( Non-PCB)=103 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: RP states that 103 gallons of mineral Oil ( Non-PCB) was released onto the asphalt and onto the road due to a vehicle struck the pole. The release has been stopped and contained, the County applied an absorbent on the impacted area.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNo
l. KNOWN IMPACTNone
3. a. INCIDENT LOCATION: 9385 Orravile Quincy Hwy
b. CITY:c. COUNTY: d. ZIP:
Berry Creek
Butte County95916BUTTE COUNTY AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
01/17/20191800 Road Collision
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnrecoverable
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Co HealthEnvironmental Health
d. ADMIN. AGENCY: Butte County Health Departmente. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
DOG Unit:
RWQCB Unit:
5A
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, Co/Hlth, Co/E-Hlth
Photo Attachment:
********* Control No: 19-0431 *********

Created by: Warning Center on: 01/17/2019 07:38:21 PM Last Modified by: Warning Center on: 01/17/2019 07:48:39 PM