Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 01/31/2023
    TIME: 1142
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-0861
    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 N/AVAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: RP states: A third party contractor struck a gasoline resulting in the release of the material. The release is stopped and contained. Gas containment was achieved at 1048 hours.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
StoppedNoNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 9301 Gaston Court
b. CITY:c. COUNTY: d. ZIP:
Unincorporated county area Placer East of Donner Lake
Placer County96161PLACER COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
01/31/20231004 Residence Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoYes
Evacs #: 7 individuals		Unrecoverable
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, EMSA, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-0861 *********

Created by: Warning Center on: 01/31/2023 11:42:40 AM Last Modified by: Warning Center on: 01/31/2023 12:02:03 PM