Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 07/16/2024
    TIME: 1511
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-4070
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Premium Environmental Services
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. Ink, Blue - non regulated=10 Gal(s)CHEMICALNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: While in transit, the trailer of a delivery truck encountered a load shift, resulting in damage to a container carrying the listed substance. This caused the container's contents to spill onto the trailer floor and onto the customer's parking lot. Additionally, an unknown quantity of the substance entered a nearby storm drain, with its ultimate destination unknown. On-site personnel isolated the affected area and contacted an environmental specialist to oversee the cleanup process.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, Not containedYesStorm drainNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
Unknown
3. a. INCIDENT LOCATION: 1750 East Edinger Avenue
b. CITY:c. COUNTY: d. ZIP:
Santa Ana
Orange County92705SOUTH COAST AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
07/16/20241504 Merchant/Business Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoContractor
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
None
d. ADMIN. AGENCY: Santa Ana 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, DFW-OSPR, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-4070 *********

Created by: Warning Center on: 07/16/2024 03:11:39 PM Last Modified by: Warning Center on: 07/16/2024 03:54:55 PM