| Type of Incident: | Referee |
| Match Number: | 2191 |
| Date of Incident: | 2017-05-06 |
| Time of Incident: | 02:00:00 |
| Location of Incident: | Elbow Creek Elementary |
| Competition: | 2017_SOR_SPRING_ |
| Home Team: | South Valley Chivas 00B |
| Visiting Team: | Fuego FC Los Banos |
| Age Group and Gender: | U17B |
| Team Affiliation of Individual Committing Incident: | South Valley Chivas 00B |
| Incident Summary: | 1 referee appeared for the game. |
| Comments: | This is not a PAD issue. Please address with the Event Coordinator. |
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