Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 04/14/2021
TIME: 1039
RECEIVED BY: CONTROL#:
Cal OES - 21-1967
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 contractor performing a leak survey struck a 1" plastic residential sercice line witrh a punch bar causoing the release, mayterial vented through soil into the atmosphere, approximately 6 subjects were evacuated and hve not been allowed to return, 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: 18581 Lilac St
b. CITY:c. COUNTY: d. ZIP:
Hesperia
San Bernardino County92345MOJAVE DESERT AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
04/14/20210940-1022 Residence Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoYes
Evacs #: 6
N/A
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fire Dept.
d. ADMIN. AGENCY: San Bernardino County Fire Departmente. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
i. Cal GEM:
j. RWQCB Unit:

6B
k. Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, AIR RESOURCES BD
Photo Attachment:
11. Cal OES Reg.
********* Control No: 21-1967 *********

Created by: Warning Center on: 04/14/2021 10:39:22 AM Last Modified by: Warning Center on: 04/14/2021 10:45:15 AM