Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 12/09/2024
    TIME: 1627
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6858
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
CHP - Ventura Comm 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. Diesel Fuel =75 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per the Reporting Party: A passenger vehicle (Ford SUV) and a semi tractor were involved in vehicle accident causing one of the semi trucks saddle fuel tanks to rupture releasing the material onto the roadway and the soil on right hand shoulder. No waterways were affected. The release is stopped and contained to the right hand shoulder. Ventura County Road Department is in route to handle clean up. The driver of the passenger vehicle sustained minor injuries and was transported to the hospital. The Fire Department also responded to the scene.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoN/ANo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
3. a. INCIDENT LOCATION: Old Telegraph Road just north of Highway 126
b. CITY:c. COUNTY: d. ZIP:
Fillmore
Ventura County93015 VENTURA COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
12/09/20241541 Road Collision
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
Yes
Injuries #: 1		NoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
CHP, Fire Dept.
d. ADMIN. AGENCY: Ventura County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

4
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, CHP, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-6858 *********

Created by: Warning Center on: 12/09/2024 04:27:22 PM Last Modified by: Warning Center on: 12/09/2024 04:39:40 PM