Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 09/15/2023
    TIME: 1358
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-5944
    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: Caller states 3rd party information a release of natural gas was detected in the area. Crews are on site to locate and secure the release.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Not stopped, Not containedNoNoNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
3. a. INCIDENT LOCATION: 6943 North Lake Blvd
b. CITY:c. COUNTY: d. ZIP:
Tahoe Vista
Placer County96148PLACER COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
09/15/20231150 Merchant/Business 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: 23-5944 *********

Created by: Warning Center on: 09/15/2023 01:58:13 PM Last Modified by: Warning Center on: 09/15/2023 02:27:39 PM