Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 05/23/2023
    TIME: 1456
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-3400
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Riverside Department of Environmental Health
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. Propane=Unknown UnknownVAPORNoNo
2. Acetylene=Unknown UnknownVAPORNoNo
3. Unknown Oil=Unknown Gal(s)PETROLEUMNoNo
g. DESCRIPTION: A residential structural fire resulted in the release of the above substances; the unknown oil did not leave the property, and no waterways were impacted. Riverside Environmental Health is conducting a clean-up.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 10537 56th St
b. CITY:c. COUNTY: d. ZIP:
Jurupa valley
Riverside County92509SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
05/23/20231000 Residence Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoResponsible Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Co Health, Fire Dept.
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, AIR RESOURCES BD, CDPH-D.O., Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-3400 *********

Created by: Warning Center on: 05/23/2023 02:56:37 PM Last Modified by: Warning Center on: 05/23/2023 03:24:27 PM