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Home My WebLink About2950 Broad Fire ReportNFIRS-1 Basic 40060 CA 04 23 2022 Fire Station 1 (FS1) 22-02189 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 2950 BROAD Number Prefix Street or Highway Street Type Suffix San Luis Obispo CA 93401 Apt./Suite/Room City State Zip Code Cross Street Incident Type 324-Motor vehicle accident with no injuries 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 23 2022 07:17 Arrival 04 23 2022 07:21 Controlled Last Unit Cleared 04 23 2022 09:22 Shifts and Alarms C FZ3 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 6 Actions Taken 70-Assistance, other Primary Action Taken Resources Apparatus or Personnel Module is used. Apparatus Personnel Suppression 3 9 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 6 Remarks: Upon arrival of TC; T1 found a pickup had struck and sheered off a PGE power pole; T1 confirmed no injuries from occupants; T1 provided isolate and deny entry to hazard area; PGE arrived to secure power pole and took over scene control. Authorization 88690 Vasquez, Mark Fire Captain 04/25/2022 Officer In Charge ID Signature Position or Rank Assignment Date 88690 Vasquez, Mark Fire Captain 04/25/2022 Member Making Report ID Signature Position or Rank Assignment Date L M Page 3 of 6 NFIRS-9 Apparatus or Resources 40060 CA 04 23 2022 Fire Station 1 (FS1) 22-02189 0 FDID State Month Day Year Station Number Exposure B Apparatus/Resource Dates/Times Sent Number of People Apparatus Use Actions Taken ID:BC4 Type:92-Chief officer car Dispatch: Arrival:04/23/2022 07:29 Clear:04/23/2022 07:29 Sent 2 Suppression EMS Other 81-Incident command ID:E3 Type:11-Engine Dispatch:04/23/2022 07:17 Arrival: Clear:04/23/2022 07:21 Sent 3 Suppression EMS Other 93-Cancelled en route ID:T1 Type:12-Truck or aerial Dispatch:04/23/2022 07:17 Arrival:04/23/2022 07:21 Clear:04/23/2022 09:22 Sent 4 Suppression EMS Other 78-Control traffic A Page 4 of 6 NFIRS-10 Personnel 40060 CA 04 23 2022 Fire Station 1 (FS1) 22-02189 0 FDID State Month Day Year Station Number Exposure B Apparatus/Resource Dates/Times Sent Number of People Apparatus Use Actions Taken ID:BC4 Type:92-Chief officer car Dispatch: Arrival:04/23/2022 07:29 Clear:04/23/2022 07:29 Sent 2 Suppression EMS Other 81-Incident command Personnel ID Name Rank Role Attend Actions Taken 16750 Berryman, Neal Battalion Chief 38890 Gonzalez, Steven Battalion Chief ID:E3 Type:11-Engine Dispatch:04/23/2022 07:17 Arrival: Clear:04/23/2022 07:21 Sent 3 Suppression EMS Other 93-Cancelled en route Personnel ID Name Rank Role Attend Actions Taken 54190 King, Michael Captain 70995 Pratt, Jason Engineer 50826 Johnston, Kenneth Firefighter ID:T1 Type:12-Truck or aerial Dispatch:04/23/2022 07:17 Arrival:04/23/2022 07:21 Clear:04/23/2022 09:22 Sent 4 Suppression EMS Other 78-Control traffic Personnel ID Name Rank Role Attend Actions Taken 61580 Mason, Ryan Captain 62800 MacDonald, John Engineer 92335 Williams, Joseph Engineer 99162 Kraemer, Luke Firefighter A Page 5 of 6 NFIRS-1S Supplemental 40060 CA 04 23 2022 Fire Station 1 (FS1) 22-02189 0 FDID State Month Day Year Station Number Exposure Primary Narrative: Upon arrival of TC; T1 found a pickup had struck and sheered off a PGE power pole; T1 confirmed no injuries from occupants; T1 provided isolate and deny entry to hazard area; PGE arrived to secure power pole and took over scene control. 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