Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 02/07/2023
    TIME: 1215
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-1013
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Ventura County Public Works Water and Sanitation Department
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. Sewage=Estimated 2,400 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Reporting party states that there was a main line blockage that caused a manhole to overflow. The overflow started approximately at 0800 hours and RP was notified at 1015 hours. The overflow has been stopped and contained. RP recovered what was in the storm drain but was unable to recover what made its way into Arroyo Simi.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesStorm Drain, Arroyo SimiNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 4767 South Moorpark Ave
b. CITY:c. COUNTY: d. ZIP:
Moorpark
Ventura County93021VENTURA COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
02/07/20231015 Residence Blockage
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnrecoverable
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Ventura County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

4
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DFW-OSPR, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-1013 *********

Created by: Warning Center on: 02/07/2023 12:15:15 PM Last Modified by: Warning Center on: 02/07/2023 12:26:10 PM