Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 02/04/2023
    TIME: 2352
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-0971
    NRC - 1359289
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:
XXX
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Unk Odor=Unk UnknownVAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: THE CALLER STATED THAT THEY DISCOVERED AN ODOR OF SULFUR AT THE INCIDENT LOCATION. THE SOURCE OF THE ODOR IS UNKNOWN TO THE CALLER.

Building ID: ALBERTSONS
Type of Fixed Object: RETAIL STORE
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Unknown if stoppedNoNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 2291 W MALVERN AVE
b. CITY:c. COUNTY: d. ZIP:
Fullerton
Orange County92833SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
02/05/20230020 Merchant/Business Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Fullerton Fire Departmente. SEC. AGENCY: Orange County Emergency Management Division
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/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-0971 *********

Created by: Warning Center on: 02/04/2023 11:52:28 PM Last Modified by: Warning Center on: 02/04/2023 11:55:29 PM