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Pacific Gas and Electric Company PCB/Oil Spill or Leak Report 1 t� Weather Conditions: ❑ Windy ❑ Lightning ❑ Rain, Moderate Rain, Heavy ElClear nth— X Cloudy Drizzle Snow 623685 (8/94) Distribution Page 2 of 6 ©d .IUL'aT� IMMEDIATE ACTIONS TAKEN TO MIMMIZE HUMAN EXPOSURE, ENVIRONMENTAL IMPACTS AND PROP- ERTY DAMAGE: ❑ Barricades ❑ Absorbents ❑ Dirt berms or Dikes ❑ Cover Storm or Sewer Drains ❑ Other (Describe) PROPERTY OWNER NO FIC TION: d Property Owner's Name O i9r�dh Telephone 9 %& - 6§l `/Address Property Owner Notified? .yes By ❑ No (explain) REPORTING ASSESSMENT Date Time PCB Weight (RQ) calculations (Calculations required for all spills involving 50ppm or greater PCB). Quantity of fluid released (Required for All Spills) gallons PCB Concentration ppm Calculation: Quantity of fluid released gallons x ppm = lbs. PCB or ❑ Calculations not required. 135,000 Federal EPA - (Spills oF41<ids containing 50 ppm or greater PCB Concentrations): ❑ Involves vegetable gardens Involves Surface or Drinking Water o ves Sewers or Sewage Treatment Systems ❑ Involves grazing land ❑ In s special cl e. ire, humans, animals, etc.) ❑ Involves a spill of one (1) pound or mor weight Any or all of the above condidtions must be reported to -the National Response Center (NRC), EPA Region /X, California . OES and the County Environmental Health Services Department. If water is involved, the Regional Water Quality Control Board must also be notified. Other agencies may also need to be notified as circumstances dictate: i.e. Fire Depts., Cal - EPA, Police, Sheriff, CHP, etc. , California Regulated - (Releases or Threaten Releases of Hazardous Materials) ❑ Involves a Relea XI ons or more oil or petroleum products ❑ Involves sensitive as scho and medical facilities ❑ Involves a spill of aini 5 ppm or greater PCB off PG&E property. ❑ Involves wildlife oimals❑ Involves Release oous aterial to water or vegetable gardens ❑ Attracts public andattenti❑ Presents a significao human h th or the environment even if below RQ values Any or all of the above conditions mast be reported to California OES and the County Environmental Health Services Department. The NRC and, the Regional (Yater Quality Control Board must be notified of releases that involve water. Other agencies may also need to be notified as circumstances dictate: i.e. Fire Depts., Cal -EPA, Police, Sheriff, CHP, etc. SPILL CONDITIONS DO NOT MEET ANY OF THE AGENCY NOTIFICATION REQUIREMENTS DESCRIBED ABOVE AND IS NOT REPORTABLE.