Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 06/17/2024
    TIME: 0618
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-3441
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Southwest Gas
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. Gas, Natural=Unknown N/AVAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: A third party struck and damaged a 1/2 inch plastic natural gas service line. The local fire department responded to the site and was assisted by Southwest Gas. The gas line was shut off, stopping the release. No fires or injuries were reported and no evacuations were necessary. Gas technicians are in the process of conducting permanent repairs.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 3775 North Lake Boulevard
b. CITY:c. COUNTY: d. ZIP:
Carnelian Bay
Placer County96140PLACER COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
06/17/20240304 Residence Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
None
d. ADMIN. AGENCY: Placer County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

6A
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: 24-3441 *********

Created by: Warning Center on: 06/17/2024 06:18:11 AM Last Modified by: Warning Center on: 06/17/2024 06:30:37 AM