| 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. |
| Date of Incident: | 2016-10-15 |
| Time of Incident: | 12:00:00 |
| Location of Incident: | Pacheco High School |
| Home Team: | Fuego FC Los Banos |
| Visiting Team: | Patterson United Patterson Deportivo |
| Age Group and Gender: | U17B |
| Team Affiliation of Individual Committing Incident: | Patterson United Patterson Deportivo |
| Incident Summary: | No players listed on game card. |
| Comments: | Please refer this to Jason Drury, the Event Coordinator. |
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