Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 08/13/2024
    TIME: 1908
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-4577
    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: During an excavation, a third party struck and damaged a 1-inch plastic natural gas service line. There were no fires, injuries, or need for evacuations. Technicians arrived at the scene, isolated the line, and shut off the gas at 11:58 hours. Permanent repairs were completed shortly thereafter without incident.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, Not containedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 7081 North Lake Boulevard
b. CITY:c. COUNTY: d. ZIP:
Tahoe Vista
Placer County96418PLACER COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
08/13/20241149 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:
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: 24-4577 *********

Created by: Warning Center on: 08/13/2024 07:08:01 PM Last Modified by: Warning Center on: 08/13/2024 07:20:44 PM