HomeMy WebLinkAboutGarcia Incident ReportNFIRS-1 Basic
40060 CA 09 09 2020 Fire Station
4 (FS4)
20-04030 0
FDID State Month Day Year Station Number Exposure
Location Type
Census tract:
Street Address
Intersection
In Front Of
Rear Of
Adjacent To
Directions
US National Grid
1403 GARCIA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
PEREIRA
Cross Street
Incident Type
322-Motor vehicle accident with injuries (not extrication)
Aid Given Or Received
1 Mutual Aid Received
2 Auto. Aid Received
3 Mutual Aid Given
4 Auto. Aid Given
5 Other Aid Given
None
California
Their FDID Their
State
Their Incident Number
Dates and Times
Alarm 09 09 2020 22:34
Arrival 09 09 2020 22:38
Controlled
Last Unit
Cleared
09 10 2020 01:11
Shifts and Alarms
B 1 FZ4
Shift or
Platoon
Alarms District
Special Studies
9244 3 - No, COVID
19 was not a
factor
ID#Value
A
B
C
D
E1 E2
E3
Page 1 of 7
Actions Taken
22-Rescue, remove from harm
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 5 14
EMS 0 0
Other 0 0
Resource counts include aid received
resources.
Estimated Dollar Losses and Values
Losses:Required for all fires if
known. Optional for all
non-fires.
None
Property:$
Contents:$
Pre-Incident Values: Optional None
Property:$
Contents:$
Completed Modules
2 - Fire
3 - Structure Fire
4 - Civilian Fire Cas.
5 - Fire Service Cas.
6 - EMS
7 - HazMat
8 - Wildland Fire
9 - Apparatus
10 - Personnel
11 - Arson
Casualties None
Deaths Injuries
Fire
Service
0 0
Civilian 0 0
Detector
Required for Confined Fires
1 - Detector Alerted Occupants
2 - Detector Did Not Alert Them
3 - Unknown
Hazardous Materials Release
1 - Natural Gas
2 - Propane Gas
3 - Gasoline
4 - Kerosene
5 - Diesel Fuel / Fuel Oil
6 - Household Solvents
7 - Motor Oil
8 - Paint
0 - Other
None
Mixed Use Property
Not Mixed
10 - Assembly Use
20 - Education Use
33 - Medical Use
40 - Residential Use
51 - Row Of Stores
53 - Enclosed Mall
58 - Business and
Residential
59 - Office Use
60 - Industrial Use
63 - Military Use
65 - Farm Use
00 - Other Mixed Use
Property Use None
Structures
131 Church, Place of Worship
161 Restaurant or Cafeteria
162 Bar/Tavern or Nightclub
213 Elementary School, Kindegarten
215 High School, Junior High
241 College, Adult Education
311 Nursing Home
331 Hospital
341 Clinic, Clinic-Type Infirmary
342 Doctor/Dentist Office
361 Prison or Jail, Not Juvenile
419 1- or 2-Family Dwelling
429 MultiFamily Dwelling
439 Rooming/Boarding House
449 Commerical Hotel or Motel
459 Residential, Board and Care
464 Dormitory/Barracks
519 Food and Beverage Sales
539 Household Goods, Sales, Repairs
571 Gas or Service Station
579 Motor Vehicle/Boat Sales/Repairs
599 Business Office
615 Electric-Generating Plant
629 Laboratory/Science Laboratory
700 Manufacturing Plant
819 Livestock/Poultry Storage (Barn)
882 Non-Residential Parking Garage
891 Warehouse
Outside
124 Playground or Park
655 Crops or Orchard
669 Forest (Timberland)
807 Outdoor Storage Area
919 Dump or Sanitary Landfill
931 Open Land or Field
936 Vacant Lot
938 Graded/Cared for Plot of Land
946 Lake, River, Stream
951 Railroad Right-of-Way
960 Other Street
961 Highway/Divided Highway
962 Residential Street/Driveway
981 Construction Site
984 Industrial Plant Yard
Property Use:
Description
Look up and enter a Property Use code and
description only if you have NOT checked a
Property Use box.
Owner
Local Option Person/Entity Type Business Name (if applicable)Phone Number
Mr., Ms., Mrs.First Name MI Last Name Suffix
Number Prefix Street or Highway Street Type Suffix
Post Office Box Apt./Suite/Room City
State Zip Code
F G1 G2
H1
H2
H3 I
J
K2
Page 2 of 7
Remarks:
E4 T1 initially dispatched to the report of a possible vehicle accident heard in the area, unconfirmed. Upon arrival, E4
reported a vehicle into a single family residence (1403 Garcia). E4 established Garcia IC and added BC2 to the incident.
FF4 and Pump 4 were assigned to initiate triage and determine the total number of patients. Due to a crowd forming, initial
patient count was difficult to obtain -- once three patients had been identified with the likelihood of more, a level 1 MCI was
declared, two additional ambulances were requested, and a first alarm was requested.
M52 was assigned transportation unit leader and began assessing the patients brought over by FF4 and pump 4.
T1 was assigned structure group upon their arrival, with the initial assignment of assessing the structure's integrity, securing
utilities, and conducting a primary all clear.
E3 was assigned to structure group upon their arrival.
BC2 arrived and assumed IC.
E4 became safety, and established a perimeter.
During the incident, a structure was dispatched and all units with the exception of E4 were reassigned to the second incident.
E4 assumed Garcia IC, worked with a private tow truck to remove the vehicle from the building, and turned the scene over to
the city building official who was working with a contractor to board the building up and shore the unstable areas.
E4 became available without further incident.
Authorization
35110 Fox II, Samuel Battalion Chief 09/10/2020
Officer In Charge ID Signature Position or Rank Assignment Date
46955 Hoover, Nicholas Fire Captain Fire Station 1 09/10/2020
Member Making Report
ID
Signature Position or Rank Assignment Date
L
M
Page 3 of 7
NFIRS-9 Apparatus or Resources
40060 CA 09 09 2020 Fire Station
4 (FS4)
20-04030 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:BC2
Type:92-Chief officer car
Dispatch:09/09/2020 22:38
Arrival:09/09/2020 22:46
Clear:09/10/2020 00:00
Sent 1 Suppression
EMS
Other
81-Incident command
ID:E2
Type:11-Engine
Dispatch:09/09/2020 22:39
Arrival:09/09/2020 22:48
Clear:09/10/2020 00:00
Sent 3 Suppression
EMS
Other
92-Standby
ID:E3
Type:11-Engine
Dispatch:09/09/2020 22:39
Arrival:09/09/2020 22:48
Clear:
Sent 3 Suppression
EMS
Other
92-Standby
ID:E4
Type:11-Engine
Dispatch:09/09/2020 22:34
Arrival:09/09/2020 22:38
Clear:09/10/2020 01:11
Sent 3 Suppression
EMS
Other
22-Rescue, remove from harm
ID:T1
Type:12-Truck or aerial
Dispatch:09/09/2020 22:34
Arrival:09/09/2020 22:41
Clear:09/10/2020 00:34
Sent 4 Suppression
EMS
Other
86-Investigate
A
Page 4 of 7
NFIRS-10 Personnel
40060 CA 09 09 2020 Fire Station
4 (FS4)
20-04030 0
FDID State Month Day Year Station Number Exposure
A
Page 5 of 7
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:BC2
Type:92-Chief officer car
Dispatch:09/09/2020 22:38
Arrival:09/09/2020 22:46
Clear:09/10/2020 00:00
Sent 1 Suppression
EMS
Other
81-Incident command
Personnel ID Name Rank Role Attend Actions Taken
35110 Fox II, Samuel Battalion
Chief
ID:E2
Type:11-Engine
Dispatch:09/09/2020 22:39
Arrival:09/09/2020 22:48
Clear:09/10/2020 00:00
Sent 3 Suppression
EMS
Other
92-Standby
Personnel ID Name Rank Role Attend Actions Taken
50050 Jeckell, Matthew Engineer
88690 Vasquez, Mark Captain
60045 Lokkart, Eric Firefighter
ID:E3
Type:11-Engine
Dispatch:09/09/2020 22:39
Arrival:09/09/2020 22:48
Clear:
Sent 3 Suppression
EMS
Other
92-Standby
Personnel ID Name Rank Role Attend Actions Taken
70995 Pratt, Jason Engineer
57385 Larson, Jody Captain
90841 Weis, Trevor Firefighter
ID:E4
Type:11-Engine
Dispatch:09/09/2020 22:34
Arrival:09/09/2020 22:38
Clear:09/10/2020 01:11
Sent 3 Suppression
EMS
Other
22-Rescue, remove from harm
Personnel ID Name Rank Role Attend Actions Taken
25944 Child, Robert Engineer
14857 Barthel, Dustin Firefighter
46955 Hoover, Nicholas Captain
ID:T1
Type:12-Truck or aerial
Dispatch:09/09/2020 22:34
Arrival:09/09/2020 22:41
Clear:09/10/2020 00:34
Sent 4 Suppression
EMS
Other
86-Investigate
Personnel ID Name Rank Role Attend Actions Taken
62800 MacDonald, John Captain
36520 Gatton, Christopher Engineer
92892 Woods, Mitchell Firefighter
70100 Polkow, Matthew Engineer
Page 6 of 7
NFIRS-1S Supplemental
40060 CA 09 09 2020 Fire Station
4 (FS4)
20-04030 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
E4 T1 initially dispatched to the report of a possible vehicle accident heard in the area, unconfirmed. Upon arrival, E4
reported a vehicle into a single family residence (1403 Garcia). E4 established Garcia IC and added BC2 to the incident.
FF4 and Pump 4 were assigned to initiate triage and determine the total number of patients. Due to a crowd forming, initial
patient count was difficult to obtain -- once three patients had been identified with the likelihood of more, a level 1 MCI was
declared, two additional ambulances were requested, and a first alarm was requested.
M52 was assigned transportation unit leader and began assessing the patients brought over by FF4 and pump 4.
T1 was assigned structure group upon their arrival, with the initial assignment of assessing the structure's integrity, securing
utilities, and conducting a primary all clear.
E3 was assigned to structure group upon their arrival.
BC2 arrived and assumed IC.
E4 became safety, and established a perimeter.
During the incident, a structure was dispatched and all units with the exception of E4 were reassigned to the second incident.
E4 assumed Garcia IC, worked with a private tow truck to remove the vehicle from the building, and turned the scene over to
the city building official who was working with a contractor to board the building up and shore the unstable areas.
E4 became available without further incident.
Additional Narrative (#1 of 3 ):
BC2 arrived at scn to find Engine 4 in command of an auto into a structure with four patients, level I MCI had been declared
and a first alarm with two additional ambulances requested, upon arrival BC2 met with E4 for a face to face pass on and
assumed Garcia IC, E4 and first ambulance at scene had triaged and treated all patients, Ambulance staging established on
Garcia near LOVR, total of four patients which included three green tags and one yellow, yellow tag patient was transported
to SVED, the remaining patients signed AMA, staged ambulance released, T1 had been assigned Rescue Group with the
objective of assessing structural stability and stabilization, E3 assigned to work for Rescue Group, and E2 responded to FS1 to
obtain Rescue I and the USAR trailer for shoring material, E4 Captain assigned as Safety, E3 Captain developed site access
plan for tow truck, all patients transported or signed AMA, MCI terminated, IC requested tow, property management
notification, and building department rep to determine structural stability, IC made contact with San Luis Property
Management Rep ( advised on need for building stabilization and board up due to liability and risk of bystanders
entering the structure after the incident, scene turned over to Engine 4 Captain, BC2 responded to reports of a structure fire
with all available units.
Additional Narrative (#2 of 3 ):
E2 responded to vehicle into a structure; upon arrival E2 was tasked with acquiring Rescue 1 from station 1. E2 returned from
station 1 with Rescue 1 for reinforcing the structure. E2 was released from the incident and responded to a structure fire.
Additional Narrative (#3 of 3 ):
E-3 arrived and initially was assigned to Rescue Group. Upon face to face communication with Rescue Group Supervisor it was
determined that E-3 personnel were not needed for that task. E-3 stood by for personnel if needed. E-3 remained available
on scene for further emergency calls for service. Captain 3 developed site access plan for tow vehicle as it arrived on scene.
E-3 cleared post without incident.
A
Page 7 of 7