Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 09/05/2024
    TIME: 0410
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-5001
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Premium Environmental Services
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. UN 3082 Environmentally Hazardous Substance=5 Gal(s)CHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per reporting party: The driver of tractor trailer noticed a release from the trailer and pulled over to the side of the road. The substance being transported seems to have shifted in transit. Release from the trailer has created a 2ft x 1ft puddle on the shoulder of the road. There is an odor. Driver has not opened trailer doors to keep the release contained. Contractor is en route for cleanup. This has occurred in the City of Homer in San Bernardino.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: I-40 WB exit 120 onto Water Road on the on-ramp
b. CITY:c. COUNTY: d. ZIP:
Unincorporated county area San Bernardino Northern area
San Bernardino County92322MOJAVE DESERT AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
09/05/20240400 Road Other
Description for Other : Load shifted during transit
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
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, AIR RESOURCES BD, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-5001 *********

Created by: Warning Center on: 09/05/2024 04:10:22 AM Last Modified by: Warning Center on: 09/05/2024 04:32:16 AM