Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 06/04/2024
    TIME: 1314
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-3210
    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. Natural Gas=Unknown UnknownVAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: The reporting party states there was a leak on a residential half-inch service line. The release of natural gas started at 1029 hours and was controlled by 1225 hours. The reporting party states the residential half-inch service line is in the process of being repaired.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
StoppedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 7310 3rd Ave
b. CITY:c. COUNTY: d. ZIP:
Tahoma
Placer County96142PLACER COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
06/04/20241029 Residence Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnrecoverable
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
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: 24-3210 *********

Created by: Warning Center on: 06/04/2024 01:14:39 PM Last Modified by: Warning Center on: 06/04/2024 01:22:59 PM