Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 12/01/2024
    TIME: 1238
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6697
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Moulton Miguel Water District
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=1,800 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: The reporting party states that there is a broken underground pipe at a sewage lift station, causing an overflow from an 8-inch cleanout onto the pavement and into a storm drain. The release is ongoing but contained. Vacuum trucks are on-site, and the reporting party will conduct the cleanup.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Not stopped, ContainedYesStorm Drain, Salt CreekNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 24881 Camino Del Avion
b. CITY:c. COUNTY: d. ZIP:
Dana Point
Orange County92677SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
12/01/20240900 Residence Broken Pipe
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Orange County Emergency Management Divisione. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

9
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DWP-DO, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-6697 *********

Created by: Warning Center on: 12/01/2024 12:38:47 PM Last Modified by: Warning Center on: 12/01/2024 12:51:37 PM