Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 11/28/2022
TIME: 0902		RECEIVED BY: CONTROL#:
Cal OES - 22-6969
NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Private Resident
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. Spray paint fumes=Unknown Lbs.VAPORNoNo
2. Automotive oils =Unknown Gal(s)PETROLEUMNoNo
3. = NoNo
g. DESCRIPTION: Caller states a resident is working on vehicles in his garage and is releasing a mixture of oils and vapors onto the ground and atmosphere. Caller states he's observed the resident wash the oil down his driveway. Unknown if release is stopped and unknown if its contained.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Unknown if stopped, Unknown if containedUnknownStorm drain No
l. MARITIME VESSEL
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 3006 Tournament Dr
b. CITY:c. COUNTY: d. ZIP:
Palmdale
Los Angeles County93551ANTELOPE VALLEY AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/28/20220800 Residence Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Code Enforcement
d. ADMIN. AGENCY: LACoFD Health Haz-Mate. 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, DFW-OSPR, AIR RESOURCES BD, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 22-6969 *********

Created by: Warning Center on: 11/28/2022 09:02:49 AM Last Modified by: Warning Center on: 11/28/2022 09:15:44 AM