| Type of Incident: | Injury |
| Match Number: | 1658 |
| Date of Incident: | 2022-10-16 |
| Time of Incident: | 03:40:00 |
| Location of Incident: | Livermore Park, Folsom CA |
| Competition: | 2022_SOR_NCSC_ |
| Home Team: | Folsom Lake Surf Premier '04/05B I |
| Visiting Team: | Sierra Surf 05B |
| Age Group and Gender: | U19B |
| Team Affiliation of Individual Committing Incident: | Sierra Surf 05B |
| Incident Summary: | Injury Report. |
| Comments: | Injury Report - no action taken. |
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