Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 12/05/2023
    TIME: 1149
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-7465
    NRC - 1385941
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
NRC
1.b. PERSON REPORTING SPILL (If different from above):
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Cura Emergency Services
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Gasoline=10 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per NRC: "CALLER IS REPORTING THE RELEASE OF 10 GALLONS OF GASOLINE FROM A PICK UP TRUCK AT THE ADDRESS LOCATION. THE RELEASED MATERIAL WENT ONTO THE GROUND AND AN UNKNOWN AMOUNT WENT INTO A STORM DRAIN. THE CAUSE OF THE RELEASE IS UNKNOWN AT THIS TIME. CLEANUP HAS BEEN COMPLETED, AND PRESSURE WASHED STORM DRAIN."
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesStorm DrainUnknown
l. MARITIME VESSEL
No
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 3890 Orange St.
b. CITY:c. COUNTY: d. ZIP:
Riverside
Riverside County92501SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
12/04/20231500 Merchant/Business Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
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, DFW-OSPR, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-7465 *********

Created by: Warning Center on: 12/05/2023 11:49:51 AM Last Modified by: Warning Center on: 12/05/2023 11:59:48 AM