Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 03/02/2021
TIME: 2324
RECEIVED BY: CONTROL#:
Cal OES - 21-1149
NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Target Food Distribution Center
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. Anhydrous Ammonia=1 Lbs.VAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per Caller-Evaporator 45 control valve had a component failure resulting in the release of the substance into the atmosphere. No waterways impacted, No fire and no other Hazmat reported.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoNo
l. MARITIME VESSEL
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 2245 West Renascence Parkway
b. CITY:c. COUNTY: d. ZIP:
Rialto
San Bernardino County92376SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
03/02/20212027 Merchant/Business Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnrecoverable
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:
i. Cal GEM:
j. RWQCB Unit:

8
k. Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DFG-OSPR, AIR RESOURCES BD, Co/WP, Co/E-Hlth
AA/CUPA; DTSC; RWQCB; US EPA; USFWS; DFG-OSPR; AIR RESOURCES BD; Co/WP; Co/E-Hlth

Photo Attachment:
11. Cal OES Reg.
********* Control No: 21-1149 *********

Created by: Warning Center on: 03/02/2021 11:24:09 PM Last Modified by: Warning Center on: 03/02/2021 11:32:51 PM