Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 04/05/2024
    TIME: 2056
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-2042
    NRC - 1395721
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
National Response 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. Phenol=Unknown UnknownCHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per NRC report, "Caller is reporting the discovery of phenol in the home. Caller stated the material was placed there intentionally by the suspected responsible party. Caller stated this material is causing older persons in the home to get sick."
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
None
3. a. INCIDENT LOCATION: 220 Mar Vista Drive - Space 69
b. CITY:c. COUNTY: d. ZIP:
Aptos
Santa Cruz CountyMONTEREY BAY UNIFIED APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
04/05/20240400 Residence 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: Santa Cruz County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

3
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, AIR RESOURCES BD, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-2042 *********

Created by: Warning Center on: 04/05/2024 08:56:54 PM Last Modified by: Warning Center on: 04/05/2024 09:03:06 PM