Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 02/08/2023
    TIME: 1427
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-1045
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Private Citizen
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. Unknown chemical=Unknown UnknownCHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Reporting party states that an unknown person is pouring an unknown chemical into her plants and by the pipes that carries water into the house. The chemical has a strong odor. RP states her sister had a skin reaction causing her skin to turn black and making it hard for her to breathe. She has notified local police department and fire department but nothing has been done.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Unknown if stopped, Unknown if containedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
Unknown
3. a. INCIDENT LOCATION: 9916 Keswick St
b. CITY:c. COUNTY: d. ZIP:
Burbank
Los Angeles County91504SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
02/06/20231000 Residence Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Local Fire Department, Local Police Department
d. ADMIN. AGENCY: Burbank 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: 23-1045 *********

Created by: Warning Center on: 02/08/2023 02:27:18 PM Last Modified by: Warning Center on: 02/08/2023 02:44:22 PM