Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 04/17/2024
    TIME: 1043
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-2259
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
McDonalds LA
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. Carbon Dioxide =Unknown UnknownVAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: per reporting party, around 0355 hours employees noticed the alarm went off for carbon dioxide. They evacuated the building and called the Fire Department. They found no release about 30 minutes later and it was ok to go back inside. The alarm vendor, Coca Cola is on scene, checking the issue with the alarm. No waterways were impacted..
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 11920 Wilshire Blvd
b. CITY:c. COUNTY: d. ZIP:
Wilshire-La Brea
Los Angeles County90025SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
04/17/20240355 Merchant/Business Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoYes
Evacs #: 3		N/A
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fire Dept.
d. ADMIN. AGENCY: LACoFD Health Haz-Mate. 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, AIR RESOURCES BD, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-2259 *********

Created by: Warning Center on: 04/17/2024 10:43:11 AM Last Modified by: Warning Center on: 04/17/2024 10:59:19 AM