| Type of Incident: | Other — Do not use if a team, player, coach, or spectator is involved. Use only if the incident cannot be classified as any other Type of Incident above. |
| Match Number: | 2813 |
| Date of Incident: | 2023-10-01 |
| Time of Incident: | 19:30:00 |
| Location of Incident: | William jessup fields, rocklin |
| Competition: | 2023 NorCal State Cup |
| Home Team: | referee |
| Visiting Team: | 2009 B |
| Age Group and Gender: | U15B |
| Team Affiliation of Individual Committing Incident: | referee |
| Incident Summary: | Response to send-off report 10349. |
| Comments: | No action taken. |
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