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Home My WebLink AboutPRR23124_RedactedNFIRS-1 Basic 40060 CA 04 28 2023 Fire Station 4 (FS4) 23-02541 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 LOVR Number Prefix Street or Highway Street Type Suffix San Luis Obispo CA 93401 Apt./Suite/Room City State Zip Code MADONNA Cross Street Incident Type 131-Passenger vehicle fire 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 Their FDID Their State Their Incident Number Dates and Times Alarm 04 28 2023 13:08 Arrival 04 28 2023 13:10 Controlled 04 28 2023 13:16 Last Unit Cleared 04 28 2023 13:44 Shifts and Alarms C 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 8 Actions Taken 11-Extinguishment by fire service personnel Primary Action Taken Resources Apparatus or Personnel Module is used. Apparatus Personnel Suppression 3 6 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: 963-Street or road in commercial area 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 8 Remarks: E4 responded to above location for a vehicle fire. On arrival E4 assumed Valley IC and found a 2015 Mini Cooper Countryman with a well involved interior compartment fire. The driver of the vehicle was the only occupant and self extricated and was standing curbside on the corner. The male, stated he was driving when he noticed a fire in the back interior on the passenger side. He was unaware of what could have caused the fire. He stated that he had some rocks and plants in that location. He denied any chemical or volatile substances being transported. E4 personnel stretched a hoseline and utilized water and foam to extinguish the fire. The battery was located and cables were removed to secure the vehicle. E4 requested tow and SLOPD for traffic control. The fire was knocked down and extinguished. A TIC was used to detect any hidden heat or heat sources and none were present. Valley IC was terminated and SLOPD remained on scene until tow arrived and removed vehicle. E4 cleared incident. Authorization 50050 Jeckell, Matthew Fire Captain 04/28/2023 Officer In Charge ID Signature Position or Rank Assignment Date 50050 Jeckell, Matthew Fire Captain 04/28/2023 Member Making Report ID Signature Position or Rank Assignment Date L M Page 3 of 8 NFIRS-2 Fire 40060 CA 04 28 2023 Fire Station 4 (FS4) 23-02541 0 FDID State Month Day Year Station Number Exposure Property Details B1 Not Residential Estimated number of residential living units in the building of origin whether or not all units became involved B2 Buildings Not Involved Number of buildings involved B3 None Less than 1 acre Acres burned (outside fires) On-Site Materials Or Products On-Site Materials Storage Use Ignition D1 80-Vehicle area, other Area of Fire Origin D2 Heat Source D3 Item First Ignited D4 Type of Material First Ignited 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 Factors Contributing to Ignition Undetermined Factor Contributing to Ignition 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 Equipment Involved In Ignition Equipment Involved Brand Model Serial # Year Equipment Power Source Equipment Power Source Equipment Portability 1 - Portable 2 - Stationary Portable equipment normally can be moved by one or two persons. Fire Suppression Factors A B C D E1 E2 E3 F1 F2 F3 G Page 4 of 8 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 Mobile Property Type and Make 11-Automobile, passenger car, ambulance, race car Mobile Property Type OO-Other Make Mobile Property Make Local Use Pre-Fire Plan Available Arson Report Attached Police Report Attached Coroner Report Attached Other Reports Attached Countryman 2015 Mobile Property Model Year Nevada State License Plate Number VIN _________________________ _________________________ _________________________ _________________________ _________________________ _________________________ H1 H2 Page 5 of 8 NFIRS-9 Apparatus or Resources 40060 CA 04 28 2023 Fire Station 4 (FS4) 23-02541 0 FDID State Month Day Year Station Number Exposure B Apparatus/Resource Dates/Times Sent Number of People Apparatus Use Actions Taken ID:BC3 Type:92-Chief officer car Dispatch: Arrival:04/28/2023 13:15 Clear: Sent 1 Suppression EMS Other 92-Standby ID:E4 Type:11-Engine Dispatch:04/28/2023 13:08 Arrival:04/28/2023 13:10 Clear:04/28/2023 13:44 Sent 3 Suppression EMS Other 11-Extinguishment by fire service personnel ID:MR1 Type: 70-Medical & rescue unit, other Dispatch: Arrival: Clear:04/28/2023 13:13 Sent 2 Suppression EMS Other 73-Provide manpower A Page 6 of 8 NFIRS-10 Personnel 40060 CA 04 28 2023 Fire Station 4 (FS4) 23-02541 0 FDID State Month Day Year Station Number Exposure B Apparatus/Resource Dates/Times Sent Number of People Apparatus Use Actions Taken ID:BC3 Type:92-Chief officer car Dispatch: Arrival:04/28/2023 13:15 Clear: Sent 1 Suppression EMS Other 92-Standby Personnel ID Name Rank Role Attend Actions Taken 80947 Skove, Shayne Battalion Chief ID:E4 Type:11-Engine Dispatch:04/28/2023 13:08 Arrival:04/28/2023 13:10 Clear:04/28/2023 13:44 Sent 3 Suppression EMS Other 11-Extinguishment by fire service personnel Personnel ID Name Rank Role Attend Actions Taken 50050 Jeckell, Matthew Captain 74579 Robertson, Travis Engineer 99187 Sensenbach, Mickey Firefighter ID:MR1 Type: 70-Medical & rescue unit, other Dispatch: Arrival: Clear:04/28/2023 13:13 Sent 2 Suppression EMS Other 73-Provide manpower Personnel ID Name Rank Role Attend Actions Taken 100077 Greenelsh, Nathaniel 66265 Nason, William Fire Fighter A Page 7 of 8 NFIRS-1S Supplemental 40060 CA 04 28 2023 Fire Station 4 (FS4) 23-02541 0 FDID State Month Day Year Station Number Exposure Primary Narrative: E4 responded to above location for a vehicle fire. On arrival E4 assumed Valley IC and found a 2015 Mini Cooper Countryman with a well involved interior compartment fire. The driver of the vehicle was the only occupant and self extricated and was standing curbside on the corner. The male, stated he was driving when he noticed a fire in the back interior on the passenger side. He was unaware of what could have caused the fire. He stated that he had some rocks and plants in that location. He denied any chemical or volatile substances being transported. E4 personnel stretched a hoseline and utilized water and foam to extinguish the fire. The battery was located and cables were removed to secure the vehicle. E4 requested tow and SLOPD for traffic control. The fire was knocked down and extinguished. A TIC was used to detect any hidden heat or heat sources and none were present. Valley IC was terminated and SLOPD remained on scene until tow arrived and removed vehicle. E4 cleared incident. A Page 8 of 8