Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/01/2024
    TIME: 0802
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6158
    NRC - 1415294
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
NRC
1.b. PERSON REPORTING SPILL (If different from above):
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Private Citizen
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Unknown Material=N/A N/ACHEMICAL, UNSPECIFIEDNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per the NRC Report: "Caller is reporting that the Suspected Responsible Party is discharging unknown chemicals onto the asphalt in front of their property. Caller is reporting that this issue has happened multiple times." Remedial Actions: "Reporting Party contacted the Riverside Sheriffs Office"
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Unknown if stopped, Unknown if containedNoN/ANo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
Unknown
3. a. INCIDENT LOCATION: 267 Momento Ave
b. CITY:c. COUNTY: d. ZIP:
Perris
Riverside County92571SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
10/23/20240824 Other
Description for Other : Waste Disposal Company		Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Riverside County Sheriff, NRC
d. ADMIN. AGENCY: Riverside County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

8
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, CDPH-D.O., DPR, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-6158 *********

Created by: Warning Center on: 11/01/2024 08:02:12 AM Last Modified by: Warning Center on: 11/01/2024 08:12:34 AM