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Home My WebLink AboutImage Trend Report - Finalized - 11650 LOVR - Unit G - 9-07-20219/15/21, 11:55 AM Incident 55526 A NFIRS-1 Basic 40060 CA 09 07 2021 Fire Station 4 21-04248J � I� (FS4) FDID State Month Day Year Station Number Exposure B Location Type Street Address Intersection In Front Of 11650 LOS OSOS VALLEY # G Rear OF Adjacent To Number Prefix Street or Highway Directions US National Grid San Luis Obispo Apt./Suite/Room City Cross Street C Incident Type 113-Cooking fire, confined to container D Aid Given Or Received 1 Mutual Aid Received 2 Auto. Aid Received 3 Mutual Aid Given Their FDID Their 4 Auto. Aid Given State 5 Other Aid Given I I None Their Incident Number E1 Dates and Times Alarm 09 07 2021 15:55 Arrival 09 07 2021 1600 Controlled L9 1 07 1 2021 16:01 Last Unit 09 07 2021 16:12 Cleared Census tract: L� Street Type Suffix CA 93401 State Zip Code E2 Shifts and Alarms u u FZ4 Shift or Alarms District Platoon E3 Special Studies 9244 3 - No, COVID 19 was not a factor ID# Value https://www. imagetrendelite.com/Elite/Organizationsanl uisobispo/Agencyksv6mp5vgw/Fi rel ncidentReport/Print/I ncident55526?Basic=true&Fire=true... 1 /12 9/15/21, 11:55 AM Incident 55526 F Actions Taken 12-Salvage & overhaul Primary Action Taken G1 Resources Apparatus or Personnel Module is used. Apparatus Personnel Suppression EMS Other Resource counts include aid received resources. Completed Modules H1 Casualties None 2 - Fire Deaths Injuries 3 -Structure Fire Fire Service o� 04 - Civilian Fire Cas. 5 - Fire Service Cas. Civilian 6-EMS I-1 I-1 7 - HazMat 8 - Wildland Fire 9 - Apparatus H2 10 - Personnel Detector 11 -Arson Required for Confined Fires 1 -Detector Alerted Occupants 2 - Detector Did Not Alert Them 3-Unknown G2 Estimated Dollar Losses and Values Losses: Required for all fires if None known. Optional for all non -fires. Property: $ Contents: $ 1,000.00 Pre -Incident Values: Optional None Property: $ 147,392.00 Contents: $ 110,544.00 H3 I Mixed Use Property Hazardous Materials Release Not Mixed 1 - Natural Gas 10 - Assembly Use 2 - Propane Gas 20 - Education Use 3 - Gasoline 33 - Medical Use 4 - Kerosene 40 - Residential Use 5 - Diesel Fuel / Fuel Oil 51 - Row Of Stores 6 - Household Solvents 53 - Enclosed Mall 7 - Motor Oil 58 - Business and 8 - Paint Residential 0 - Other 59 - Office Use None 60 - Industrial Use 63 - Military Use 65 - Farm Use 00 - Other Mixed Use Property Use None 341 Clinic, Clinic -Type Infirmary 539 Household Goods, Sales, Repairs Structures 342 Doctor/Dentist Office 571 Gas or Service Station 131 Church, Place of Worship 361 Prison or Jail, Not Juvenile 579 Motor Vehicle/Boat Sales/Repairs 161 Restaurant or Cafeteria 419 1- or 2-Family Dwelling 599 Business Office 162 Bar/Tavern or Nightclub 429 MultiFamily Dwelling 615 Electric -Generating Plant 213 Elementary School, Kindegarten 439 Rooming/Boarding House 629 Laboratory/Science Laboratory 215 High School, Junior High 449 Commerical Hotel or Motel 700 Manufacturing Plant 241 College, Adult Education 459 Residential, Board and Care 819 Livestock/Poultry Storage (Barn) 311 Nursing Home 464 Dormitory/Barracks 882 Non -Residential Parking Garage 331 Hospital 519 Food and Beverage Sales 891 Warehouse Outside 938 Graded/Cared for Plot of Land Property Use: 124 Playground or Park 946 Lake, River, Stream 655 Crops or Orchard 951 Railroad Right -of -Way 669 Forest (Timberland) 960 Other Street Description 807 Outdoor Storage Area 961 Highway/Divided Highway Look up and enter a Property Use code and 919 Dump or Sanitary Landfill 962 Residential Street/Driveway description only if you have NOT checked a 931 Open Land or Field 981 Construction Site Property Use box. 936 Vacant Lot 984 Industrial Plant Yard https://www. imagetrendelite.com/Elite/Organizationsanl uisobispo/Agencyksv6mp5vgw/Fi rel ncidentReport/Print/I ncident55526?Basic=true&Fire=true... 2/12 9/15/21, 11:55 AM Incident 55526 K1 Person/Entity Involved Occupant 8054710993 Local Option Person/Entity Type Business Name (if applicable) Phone Number Beatriz I I I I Moreno I I Mr., Ms., Mrs. First Name MI Last Name Suffix I II II II I� Number Prefix Street or Highway Street Type Suffix I II II I Post Office Box Apt./Suite/Room City I II I State Zip Code K2 Owner Local Option Person/Entity Type Business Name (if applicable) Phone Number Mr., Ms., Mrs. First Name MI Last Name Suffix I II II II II I Number Prefix Street or Highway Street Type Suffix I II II I Post Office Box Apt./Suite/Room City State Zip Code L Remarks: 1 st alarm responded code 3 to a report of an oven fire. On arrival E-4 found a two story apartment complex with nothing showing, established command and started a 360. E-4 met with the occupant who reported everyone was out, that she had a fire in the oven, used an extinguisher and was unsure if the fire was out. E-4 entered the apartment, found no visible fire in the oven and no extension into the structure. E-4 canceled the incoming units and started overhaul. E-4 removed the stove, secured the gas and electric to the oven. E-4 confirmed no additional fire in the oven. E-4 turned the scene over to resident and management. E-4 advised management the oven should not be used until repaired by a licensed repair technician or replaced. E-4 terminated command and returned to quarters M Authorization 44555 Hasch, Nathan Fire Engineer 09/08/2021 Officer In Charge ID Signature Position or Rank Assignment Date 44555 Hasch, Nathan Fire Engineer 09/08/2021 Member Making Report ID Signature Position or Rank Assignment Date https://www. imagetrendelite.com/Elite/Organizationsanl uisobispo/Agencyksv6mp5vgw/Fi rel ncidentReport/Print/I ncident55526?Basic=true&Fire=true... 3/12 9/15/21, 11:55 AM Incident 55526 NFIRS-2 Fire A 40060 CA 09 07 2021 Fire Station 4 21-04248 j � (FS4) FDID State Month Day Year Station Number B C Property Details On -Site Materials 1131 1 Not Residential Or Products Estimated number of residential living units in the building of origin whether or not all units became involved B2 1 Buildings Not Involved Number of buildings involved B3 1 None Less than 1 acre Acres burned (outside fires) D Ignition D1 Area of Fire Origin D2 Heat Source D3 Item First Ignited D4 Type of Material First Ignited F1 Equipment Involved In Ignition None u Equipment Involved Brand Model I� Serial # Year I� E1 Cause of Ignition 1 - Intentional 2 - Unintentional 3 - Failure of Equipment or Heat Source 4 - Act of Nature 5 - Cause Under Investigation U - Cause Undetermined After Investigation E2 Factors Contributing to Ignition F2 Equipment Power Source u Equipment Power Source F3 Equipment Portability u Exposure E3 Human Factors Contributing to Ignition Check all applicable boxes None 1 - Asleep 2 - Possibly impaired by alcohol or drugs 3 - Unattended person 4 - Possibly Mentally Disabled 5 - Physically Disabled 6 - Multiple Persons Involved 7 - Age Was A Factor Estimated Age of Person Involved Male Female 1 - Portable 2 - Stationary Portable equipment normally can be moved by one or two persons. G Fire Suppression Factors https://www. imagetrendelite.com/Elite/Organizationsanl uisobispo/Agencyksv6mp5vgw/Fi rel ncidentReport/Print/I ncident55526?Basic=true&Fire=true... 4/12 9/15/21, 11:55 AM Incident 55526 H1 Mobile Property Involved 1 - Not involved in ignition, but burned 2 - Involved in ignition, but did not burn 3 - Involved in ignition and burned None H2 Mobile Property Type and Make u Mobile Property Type Mobile Property Make Mobile Property Model Year UI State License Plate Number VIN Local Use Pre -Fire Plan Available Arson Report Attached Police Report Attached Coroner Report Attached Other Reports Attached https://www. imagetrendelite.com/Elite/Organizationsanl uisobispo/Agencyksv6mp5vgw/Fi rel ncidentReport/Print/I ncident55526?Basic=true&Fire=true... 5/12 9/15/21, 11:55 AM 11 Structure Type 1 - Enclosed Building 2 - Portable/Mobile Structure 3 - Open Structure 4 -Air-Supported Structure 5 - Tent 6 - Open Platform 7 - Underground Structure 8 - Connective Structure 0 - Other J1 (Fire Origin u Below Grade Story of Fire Origin J2 Fire Spread Confined to Object of Origin 2 - Confined to Room of Origin 3 - Confined to Floor of Origin 4 - Confined to Building of Origin 5 - Beyond Building of Origin L1 Presence of Detectors N - None Present 1 - Present U - Undetermined L2 Detector Type 1 -Smoke 2 - Heat 3 - Combination of Smoke and Heat 4 - Sprinkler, Water Flow Detection 5 - More Than One Type Present 0 - Other U - Undetermined Incident 55526 NFIRS-3 Structure Fire 12 13 14 Building Status Building Height Main Floor Size 1 - Under Construction U 2 - In Normal Use Number of Stories Total Square Feet 3 - Idle, Not Routinely Used bove Grade OR 4 - Under Major Renovation r 5 - Vacant and Secured Number of Stories 6 -Vacant and Unsecured Below Grade u BY u 7 - Being Demolished Length (ft) X Width (ft) 0 - Other U - Undetermined J3 Number of Stories Damaged By Flame I1 Number of Stories w/Minor Damage (1-24%) Number of Stories w/Significant Damage (25-49%) IUNumber of Stories w/Heavy Damage (50-74%) II 1 Number of Stories w/Extreme Damage (75-100%) *Count the roof as part of the highest story L3 Detector Power Supply 1 -Battery Only 2 - Hardwire Only 3 - Plug -In 4 - Hardwire With Battery 5 - Plug -In With Battery 6 - Mechanical 7 - Multiple Detectors & Power Supplies 0 - Other U - Undetermined L4 Detector Operation 1 - Fire Too Small To Activate 2 - Operated 3 - Failed To Operate U - Undetermined L5 IH Type of Material Contributing Most to Flame Spread K1 U Item Contributing Most to Flame Spread K2 U Type of Material Contributing Most To Flame Spread Detector Effectiveness 1 -Alerted Occupants, Occupants Responded 2 - Alerted Occupants, Occupants Failed to Respond 3 - There Were No Occupants 4 - Failed to Alert Occupants U - Undetermined L6 Detector Failure Reason 1 - Power Failure, Shutoff, or Disconnect 2 - Improper Installation or Placement 3 - Defective 4 - Lack of Maintenance, Dirty 5 - Battery Missing or Disconnected 6 - Battery Discharged or Dead 0 - Other U - Undetermined https://www. imagetrendelite.com/Elite/Organizationsanl uisobispo/Agencyksv6mp5vgw/Fi rel ncidentReport/Print/I ncident55526?Basic=true&Fire=true... 6/12 9/15/21, 11:55 AM Incident 55526 M1 Presence of Automatic Extinguishing System N - None Present 1 - Present 2 - Partial System Present U - Undetermined M2 Type of Automatic Extinguishing System 1 - Wet -Pipe Sprinkler 2 - Dry -Pipe Sprinkler 3 - Other Sprinkler System 4 - Dry Chemical System 5 - Foam System 6 - Halogen -Type System 7 - Carbon Dioxide System 0 - Other U - Undetermined Required if fire was within designed range of AES M3 Operation of Automatic Extinguishing System 1 - Operated/Effective 2 - Operated/Not Effective 3 - Fire Too Small To Activate 4 - Failed To Operate 0 - Other U - Undetermined Required if fire was within designed range M4 Number of Sprinkler Heads Operating u Required if system operated M5 Reason for Automatic Extinguishing System Failure 1 -System Shut Off 2 - Not Enough Agent Discharged 3 - Agent Discharged But Did Not Reach Fire 4 - Wrong Type of System 5 - Fire Not In Area Protected 6 - System Components Damaged 7 - Lack of Maintenance 8 - Manual Intervention 0 - Other U - Undetermined Required if system failed or not effective https://www. imagetrendelite.com/Elite/Organizationsanl uisobispo/Agencyksv6mp5vgw/Fi rel ncidentReport/Print/I ncident55526?Basic=true&Fire=true... 7/12 9/15/21, 11:55 AM Incident 55526 114 im>-7 /yppardLUb yr Kt!bUUrces A 40060 CA 09 07 2021 Fire Station 4 21-04248j � I 0 (FS4) III FDID State Month Day Year Station Number Exposure B Number Apparatus/Resource Dates/Times Sent of People Apparatus Use Actions Taken ID: BC1 Dispatch: 09/07/2021 15:55 Sent 1 Suppression 81-Incident command EMS Type: 92-Chief officer car Arrival: 09/07/2021 16:02 Other Clear: 09/07/2021 16:12 ID: E3 Dispatch: 09/07/2021 15:55 Sent Suppression 93-Cancelled en route 13 EMS Type: 11 Engine Arrival: U U Other Clear: 09/07/2021 16:03 ID: E4 Dispatch: 09/07/2021 15:55 Sent 13 Suppression 12-Salvage & overhaul EMS Type: 11-Engine Arrival: 09/07/2021 16:00 Other Clear: 09/07/2021 16:12 ID: T1 Dispatch: 09/07/2021 i!: Sent Suppression 93-Cancelled en route 14 EMS Type: 12-Truck or aerial Arrival: I I Other Clear: 09/07/2021 16:03 ID: T2 Dispatch: 09/07/2021 n5 Sent 13 Suppression 92 Standby EMS Type: 12-Truck or aerial Arrival: 09/07/2021 16:01 Other Clear: 09/07/2021 16:03 https://www. imagetrendelite.com/Elite/Organizationsanl uisobispo/Agencyksv6mp5vgw/Fi rel ncidentReport/Print/I ncident55526?Basic=true&Fire=true... 8/12 9/15/21, 11:55 AM Incident 55526 NFIRS-10 Personnel 40060 FDID CA 09 07 2021 Fire Station 4 21-04248 j � (FS4) State Month Day Year Station Number u Exposure https://www. imagetrendeIite.com/Elite/0rganizationsanI uisobispo/Agencyksv6mp5vgw/Fi reI ncidentReport/Print/I ncident55526?Basic=true&Fire=true... 9/12 9/15/21, 11:55 AM Incident 55526 B Number Apparatus/Resource Dates/Times Sent of People Apparatus Use Actions Taken ID: BC1 Dispatch: 09/07/2021 15:55 Sent Suppression 81-Incident command EMS Type: 92-Chief officer car Arrival: 09/07/2021 16:02 Other Clear: 09/07/2021 16:12 Personnel ID Name Rank Role Attend Actions Taken 41550 Hais, Ray Battalion U Chief ID: E3 Dispatch: 09/07/2021 15:55 Sent 3� Suppression 93-Cancelled en route EMS Type: 11 Engine Arrival: U Other Clear: 09/07/2021 16:03 Personnel ID Name Rank Role Attend Actions Taken 50050 Jeckell, Matthew Captain U 54183 King, John Engineer U 66265 Nason, William Firefighter U ID: E4 Dispatch: 09/07/2021 15:55 Sent Suppression 12-Salvage & overhaul I__I EMS Type: 11 Engine Arrival: 09/07/2021 16:00 Other Clear: 09/07/2021 16:12 Personnel ID Name Rank Role Attend Actions Taken 44555 Hasch, Nathan Captain U 92310 Williams, Nathan Engineer U 90841 Weis, Trevor Firefighter U ID: T1 Dispatch: 09/07/2021 15:55 Sent 4� Suppression 93-Cancelled en route EMS Type: 12-Truck or aerial Arrival: U I Other Clear: 09/07/2021 16:03 Personnel ID Name Rank Role Attend Actions Taken 59710 Lipson, Matthew Captain U 73250 Renner, David Engineer U 14845 Barrett, Richard Engineer U 50826 Johnston, Kenneth Firefighter U ID: T2 Dispatch: 09/07/2021 15:55 Sent u Suppression 9z standby EMS Type: 12-Truck or aerial Arrival: 09/07/2021 16:01 Other Clear: 09/07/2021 16:03 Personnel ID Name Rank Role Attend Actions Taken https://www. imagetrendelite.com/Elite/Organizationsanl uisobispo/Agencyksv6mp5vgw/Fi rel ncidentReport/Print/I ncident55526?Basic=true&Fire=true... 10/12 9/15/21, 11:55 AM Incident 55526 40667 Gutierrez, Armando Captain U 34590 Flatos, Alec Engineer U 52001 Joy, Cullen Firefighter U https://www. imagetrendelite.com/Elite/Organizationsanl uisobispo/Agencyksv6mp5vgw/Fi rel ncidentReport/Print/I ncident55526?Basic=true&Fire=true... 11 /12 9/15/21, 11:55 AM Incident 55526 114 1MZ- 1> Zuul7temerlGdl A 40060 CA 09 07 2021 Fire Station 4 21-04248 j � (FS4) FDID State Month Day Year Station Number Primary Narrative: u Exposure 1 st alarm responded code 3 to a report of an oven fire. On arrival E-4 found a two story apartment complex with nothing showing, established command and started a 360. E-4 met with the occupant who reported everyone was out, that she had a fire in the oven, used an extinguisher and was unsure if the fire was out. E-4 entered the apartment, found no visible fire in the oven and no extension into the structure. E-4 canceled the incoming units and started overhaul. E-4 removed the stove, secured the gas and electric to the oven. E-4 confirmed no additional fire in the oven. E-4 turned the scene over to resident and management. E-4 advised management the oven should not be used until repaired by a licensed repair technician or replaced. E-4 terminated command and returned to quarters Person/Entity Involved Maintenance HASLO 8055505661 Local Option Person/Entity Type Business Name (if applicable) Phone Number Michael L Damico Mr., Ms., Mrs. First Name MI Last Name Suffix I II II II II I Number Prefix Street or Highway Street Type Suffix I II II I Post Office Box Apt./Suite/Room City I II I State Zip Code https://www. imagetrendelite.com/Elite/Organizationsanl uisobispo/Agencyksv6mp5vgw/Fi rel ncidentReport/Print/I ncident55526?Basic=true&Fire=true... 12/12