Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 11/19/2024
    TIME: 2042
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6490
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Custard Insurance Adjusters
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. Fuel, Diesel=75 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: A freight truck struck road debris while traveling on the listed roadway, causing damage to its saddle tank and releasing 75 gallons of diesel fuel onto the asphalt. There were no injuries or fires, and no road closures were required. A contractor responded and conducted repairs and the cleanup.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: Interstate 210 (Foothill Freeway) - COORDINATES: Latitude: 34.155985 / Longitude: -118.157538
b. CITY:c. COUNTY: d. ZIP:
Pasadena
Los Angeles CountySOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
11/19/20241410 Road Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
None
d. ADMIN. AGENCY: Pasadena Fire Departmente. SEC. AGENCY: LACoFD Health Haz-Mat
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

4
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-6490 *********

Created by: Warning Center on: 11/19/2024 08:42:57 PM Last Modified by: Warning Center on: 11/19/2024 09:15:03 PM