Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 07/24/2024
    TIME: 0757
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-4198
    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 contractor struck and damaged a 1/2 inch plastic natural gas service line. The local fire department and Southwest Gas responded to the scene. No fires or injuries occurred and no evacuations were necessary. The line was isolated and the release was stopped without incident. Permanent repairs will be conducted during the daylight hours of 07/24/2024.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, Not containedNoNoneNo
l. MARITIME VESSEL
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 4971 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
07/23/20242213 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:
US EPA, USFWS, AIR RESOURCES BD, EB PARKS, EMSA, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-4198 *********

Created by: Warning Center on: 07/24/2024 07:57:29 AM Last Modified by: Warning Center on: 07/24/2024 08:23:37 AM