Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 05/11/2024
    TIME: 0926
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-2711
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Riverside City Fire Department
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. Carbon Dioxide=N/A N/AVAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: The reporting party states a McDonald's restaurant carbon dioxide tank had a mechanical failure causing the release of carbon dioxide. The Riverside City Fire Department responded and stopped the release. There are no unmet needs.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
StoppedNoNoneNo
l. MARITIME VESSEL
No
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 5225 Arlington Ave
b. CITY:c. COUNTY: d. ZIP:
Riverside
Riverside County92504SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
05/11/20240556 Merchant/Business Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnrecoverable
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fire Dept.Riverside County Environmental Health
d. ADMIN. AGENCY: City of Riverside Fire Marshale. SEC. AGENCY: Riverside County Environmental Health
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

8
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, AIR RESOURCES BD, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-2711 *********

Created by: Warning Center on: 05/11/2024 09:26:56 AM Last Modified by: Warning Center on: 05/11/2024 09:36:23 AM