Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 12/09/2024
    TIME: 2024
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6865
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
City of Vernon Health 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. Coolant=5 Gal(s)CHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: The reporting party states that a vehicle collided with the center medium and curb causing the release of 5 gallons of coolant onto the street impacting a storm drain. The release has been stopped and contained. A contractor will conduct the cleanup.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesStorm DrainNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 3030 S. Atlantic Blvd
b. CITY:c. COUNTY: d. ZIP:
Vernon
Los Angeles County90058SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
12/09/20241915 Road Collision
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Co Health, Police Dept.
d. ADMIN. AGENCY: LACoFD Health Haz-Mate. SEC. AGENCY: City of Vernon CUPA
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, DWP-DO, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-6865 *********

Created by: Warning Center on: 12/09/2024 08:24:40 PM Last Modified by: Warning Center on: 12/09/2024 08:33:52 PM