Laserfiche WebLink
STATE OF CALIFORNIA <br />PESTICIDE EPISODE INVESTI ION REPORT <br />PR-ENF-127 (EST/ 10/91)(REV. SJC 1/96) <br />NT OF PESTICIDE REGULATION <br />ESTICIDE ENFORCEMENT BRANCH <br />Pagel of 2 <br />RECEIVED BY <br />DR. VISITED <br />RECEIVED FROM <br />ACTIVITY OF PERSON EXPOSED/INVOLVED <br />REPRESENTING <br />DATE(rIME RECEIVED <br />SON] <br />San Joaquin Co. Ag. Com. <br />Jim Shattuck <br />ENGINEERING CONTROLS <br />CDPR <br />Serious n Exposed Only <br />8/21/15/8:43 AM <br />DFA <br />TYPE OF EPISODE <br />❑ HUMAN EFFECTS # <br />® ENVIRONMENTAL EFFECTS <br />PRIORITY INVESTIGATION <br />DFG <br />❑ PROPERTY LOSS $ <br />❑ OTHER <br />WORKDAYS LOST <br />❑ YES # ® NO <br />DHS <br />I.D. NO. <br />COUNTY OF OCCURRENCE <br />DATE OF OCCURRENCE <br />15-4899 <br />TIME <br />DIR <br />>SJ9THER <br />15-33 <br />San Joaquin I <br />Mo 8 DAY 21 YR 2015 <br />PHONE <br />12:02 AM <br />EPA <br />EPISODE LOCATION CAC <br />BNSF Stockton Mormon Rail Yard track 139.OTHEREWIRUN <br />PERWISERVICES <br />INJURED/COMPLAINANT INFORMATION <br />COMPLAINT SIGNED <br />DR. VISITED <br />EXTENT OF INJURY/ILLNESS. <br />ACTIVITY OF PERSON EXPOSED/INVOLVED <br />❑ YES [:]NO ® N/A <br />❑ YES [_1 NO ® N/A <br />❑ Fatal 1:1 Symptoms , <br />INHALATION <br />❑ Mixer/Loader ❑ Field Worker* ❑ Other* <br />ENGINEERING CONTROLS <br />❑ Safety Glasses <br />Serious n Exposed Only <br />❑ Dust Mask <br />Applicator Public* *Explain <br />NAME <br />❑ Goggles <br />❑ Chem. Resistant Gloves <br />AGE <br />SEX <br />a r s i6.0E 9CO A Erol <br />WORKDAYS LOST <br />Jim Shattuck <br />❑ Full Face Respirator <br />❑ Chem. Resistant Boots <br />N/A <br />M <br />15-4899 <br />0 <br />ADDRESS <br />❑ Other <br />CITY <br />ZIP <br />PHONE <br />10011 Street <br />None <br />Sacramento <br />95812-2815 <br />916-445-4729 <br />MEDICAL FACILITY NAME <br />❑ TREATMENT PROVIDED <br />HOSPITALIZED <br />DATE/TIME ADMITTED <br />DATE/TIME DISCHARGED <br />N/A <br />ElOBSERVATION ONLY <br />❑ YES ® NO <br />N/A <br />N/A <br />PHYSICIAN <br />ADDRESS <br />��+ py <br />R C., i 'fc�� <br />ONE <br />N/A <br />ice.... <br />SIGNS/SYMPTOMS EXPERIENCED <br />None reported A U r 2 6 2015 <br />EMPLOYERI ADDRESS AUR COMM. -S T OC 7E <br />CDPR IVI�Vi lJ <br />PROTECTIVE MEASURES USED <br />PHONE <br />LICENSE/PERMIT NO. <br />NIA <br />RECOMMENDATION MADE <br />10YES # ® NO <br />EYES <br />HANDS <br />INHALATION <br />OTHER <br />ENGINEERING CONTROLS <br />❑ Safety Glasses <br />❑ Cloth/Leather Gloves <br />❑ Dust Mask <br />® Work Clothes <br />❑ Closed System <br />❑ Goggles <br />❑ Chem. Resistant Gloves <br />❑ 1/2 Face Respirator <br />❑ Chem. Resistant Clothes <br />❑ Enclosed Cab <br />❑ Faceshield <br />❑ Other <br />❑ Full Face Respirator <br />❑ Chem. Resistant Boots <br />❑ Enc. Cab w/Air Purification <br />❑ Eye/Sun Glasses <br />® None <br />❑ SCBA <br />❑ Head Covering <br />❑ Other <br />® None <br />E None <br />❑ Other <br />None <br />DESCRIPTION OF DAMAGE AMOUNT/VALUE <br />Leakage of Metam Sodium from a rail car. N/A <br />OWNER ADDRESS PHONE <br />BNSF 720 South B St. Stockton CA 95206 209-460-6393 <br />ALLEGED RESPONDENT(S) PCA F1 DEALER n PILOT n GROWER ❑ AGENCY n OTHER* 5R <br />NAME <br />BNSF --7209-460-6369 <br />PHONE <br />LICENSE/PERMIT NO. <br />NIA <br />RECOMMENDATION MADE <br />10YES # ® NO <br />ADDRESS <br />720 South B St. <br />EMPLOYER'S NAME <br />Same <br />PHONE <br />CITY <br />Stockton <br />STATE <br />CA <br />ZIP <br />95206 <br />EMPLOYER'S ADDRESS <br />Same <br />EXPLAIN* <br />Leakage of Metam Sodium from a rail car <br />CITY <br />STATE <br />ZIP <br />PESTICIDE NAME/MANUFACTURER EPA REGISTRATION NUMBER CATEGORY <br />DOSE/DILUTION/VOLUME <br />TREATMENT DATE COMMODITY/SITE TREATEI <br />Secta on 42/Nova Source 61842-6 <br />I <br />N/A <br />N/A N/A <br />EQUIPMENT/MAKE/MODEL/DESCRIPTION <br />Rail Car Number UTLX 200074 <br />Summarize the episode including a detailed description of evidence taken (Use Pesticide Episode Investigation Supplemental Report if Additional Space is Needed) <br />On August 21, 2015 at 8:43 AM Jim Shattuck of CDPR informed the San Joaquin County Agricultural Commissioner's Office through email of a Hazardous <br />Materials Spill Report (OES Control #:15-4899). Assistant Commissioner (AC) Kamal Bagri instructed me, Senior Agricultural Biologist Robert Pelletier, to <br />contact the Environmental Health Department to offer our departments assistance. AC Bagri provided a contact name of Muniappa Naidu, Lead Senior <br />Registered Environmental Health Specialist (EHS). <br />AC Bagri then sent me a copy of Mr. Shattuck's email. The email stated a rail car (UTLX 200074) located in the Stockton Rail Yard on track 139 <br />leaked approximately 5 gallons of Metam Sodium. "DESCRIPTION: A railyard mechanic observed a release of approximately 5 gallons of Metam Sodium <br />coming from the top of a single tank car (UTLX 200074). The release was contained to the soil below the tank car and was identified as a slow drip from the <br />tank car to the ground. The release is on-going. The location of the tank car is within the Stockton Railyard on track # 139, mile post marker 1119.5. BNSF <br />environmental and hazardous materials personnel are en -route to the scene." <br />REPORT PREPARED BY (NDATE PREPARED REPORT REVIEWED/APPROVED BY (NAME/TITLE) DATE APPROVED <br />Robert Pelletier/SAB 8/26/2015 Barbara Huecksteadt/DAC W 8/26/2015 <br />