Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 09/13/2023
    TIME: 1300
    RECEIVED BY:
    CONTROL#:
    Cal OES - 23-5884
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
SW Gas Corp
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. Fuel - Natural Gas Type=Unk Lbs.VAPORNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: A residential stub was struck by a third party operating an excavator which caused the release, material vented directly onto the atmosphere, RP handled the containment and no clean up required.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNo
l. MARITIME VESSEL
m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 6662 Wildwood Rd
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
09/13/20230935-0937 Residence Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoN/A
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
Photo Attachment:
11. Cal OES Reg.
********* Control No: 23-5884 *********

Created by: Warning Center on: 09/13/2023 01:00:13 PM Last Modified by: Warning Center on: 09/13/2023 01:06:56 PM