Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 10/04/2024
    TIME: 0825
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-5624
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
City of Vernon
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. Sodium Hypochlorite (12.5% Strength) =200 Gal(s)CHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per the Reporting Party : On one of the Cities water wells the chemical feed pump hose separated due to unknown mechanical issue. The material impacted surface around the well and went into a storm drain; it is unknown where the storm drain leads. The release as been stopped. A contractor is in route for clean up. The City of Vernon Health Department has also been notified.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, Not containedYesstorm drainNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
Unknown
3. a. INCIDENT LOCATION: 2900 50th Street
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
10/04/20240630 Other
Description for Other : City Water Well 		Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
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, CDPH-D.O., DWP-DO, DPR, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-5624 *********

Created by: Warning Center on: 10/04/2024 08:25:35 AM Last Modified by: Warning Center on: 10/04/2024 08:36:19 AM