Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 09/23/2024
    TIME: 1121
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-5367
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Orange County 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. Sewage =100 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per reporting party, a pumper truck had a collision at the intersection causing 100 gallons of sewage to be released onto the roadway. 50 gallons did make impacts into a storm drain. Clean up is being coordinated by contractors. Fire Dept on scene with road closures at the incident intersection.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesStorm Drain No
l. MARITIME VESSEL
No
m. KNOWN IMPACT
Road Closure
3. a. INCIDENT LOCATION: Fairview Rd // Sunflower Ave
b. CITY:c. COUNTY: d. ZIP:
Costa Mesa
Orange CountySOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
09/23/20240830 Road Collision
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoYes
Fatals #: 1
NoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fire Dept.
d. ADMIN. AGENCY: Orange County Emergency Management Divisione. 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, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-5367 *********

Created by: Warning Center on: 09/23/2024 11:21:45 AM Last Modified by: Warning Center on: 09/23/2024 11:28:08 AM