Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 11/30/2021
TIME: 0919
RECEIVED BY: CONTROL#:
Cal OES - 21-6794
NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Caltrans
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. Fuel - Diesel Type, mixed w motor oil (20 Gal)=100 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: A dual semi truck head on accident caused the release, material flowed onto soil, contractor is handling the containment and clean up.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNo
l. MARITIME VESSEL
m. KNOWN IMPACT
Road Closure
3. a. INCIDENT LOCATION: Highway 395 at MM 5.6
b. CITY:c. COUNTY: d. ZIP:
Hesperia
San Bernardino County92344MOJAVE DESERT AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/30/20210650 Road Collision
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
Yes
Injuries #: 1
NoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Cal Trans, Fire Dept., Sheriff Ofc.
d. ADMIN. AGENCY: San Bernardino County Fire Departmente. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

6B
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, CHP, Co/WP
Photo Attachment:
11. Cal OES Reg.
********* Control No: 21-6794 *********

Created by: Warning Center on: 11/30/2021 09:19:57 AM Last Modified by: Warning Center on: 11/30/2021 09:36:55 AM