Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 08/11/2022
TIME: 0838
RECEIVED BY: CONTROL#:
Cal OES - 22-4597
NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
City of Santa Monica Water Resources
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 - Raw Type=50 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: A lateral line blockage caused the release, material flowed onto concrete and asphalt, RP handled the containment and clean up.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNo
l. MARITIME VESSEL
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 2439 Wilshire Blvd
b. CITY:c. COUNTY: d. ZIP:
Santa Monica
Los Angeles County90403SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
08/11/20220930 Residence Blockage
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
LA Co PH
d. ADMIN. AGENCY: City of Santa Monicae. SEC. AGENCY: LACoFD Health Haz-Mat
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

4
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS
Photo Attachment:
11. Cal OES Reg.
********* Control No: 22-4597 *********

Created by: Warning Center on: 08/11/2022 08:38:21 AM Last Modified by: Warning Center on: 08/11/2022 08:43:41 AM