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HomeMy WebLinkAbout19-05532_RedactedNFIRS-1 Basic 40060 CA 10 27 2019 Fire Station 4 (FS4) 19-05532 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 1530 FROOM RNCH-Ranch Number Prefix Street or Highway Street Type Suffix San Luis Obispo CA 93401 Apt./Suite/Room City State Zip Code Cross Street Incident Type 111-Structure 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 CALFIRE (40080) California Their FDID Their State Their Incident Number Dates and Times Alarm 10 27 2019 05:10 Arrival 10 27 2019 05:15 Controlled 10 27 2019 05:20 Last Unit Cleared 10 27 2019 07:26 Shifts and Alarms B 1 FZ4 Shift or Platoon Alarms District Special Studies ID#Value A B C D E1 E2 E3 Page 1 of 12 Actions Taken 11-Extinguishment by fire service personnel Primary Action Taken Resources Apparatus or Personnel Module is used. Apparatus Personnel Suppression 6 15 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:$ 61,634.00 Contents:$ 92,450.00 Pre-Incident Values: Optional None Property:$ 6,163,350.00 Contents:$ 4,622,513.00 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: 559-Recreational, hobby, home repair sales, pet store 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 12 Remarks: BC2 C3 with 1st alarm assignment to reports of commercial structure fire in local pet store, BC2 arrived at scene to find E4 on scene of a large single story warehouse style commercial structure with moderate amount of smoke showing inside the structure, E4 had established Valley IC, was establishing a water supply and setting up for fire attack on side A alpha, BC2 completed 360 which was unremarkable, BC2 assumed Valley IC and made contact with employee who stated no occupants inside, E4 was assigned as Fire Attack and made entry on side A once two out was at scn, T1 assigned Roof Division, E3 assigned to work for Fire Attack group, Cal Fire BC assigned Safety, E21 assigned RIC and utilities, Fire Attack Group was given the objective of locating and extinguishing the fire and giving and all clear on a primary search, they advised that fire had been located in A/D corner and was extinguished with a water can, water supply established but not utilized, Fire Attack requested horizontal vent, T2 assigned Vent Group, T1 reported that the roof was sound and had light to moderate smoke coming from HVAC discharge, Fire Attack reported all clear on a primary search, ventilation in progress with good results, E4 reassigned as Interior group and given T2, T2 assigned to complete a secondary search of the structure, Interior reported an all clear on the secondary and except for a large number of pets inside store in fixed cages, all appeared well and uninjured, with smoke removed and I... Full primary narrative can be found in NFIRS 1S - Supplemental Authorization 35110 Fox II, Samuel Battalion Chief 10/27/2019 Officer In Charge ID Signature Position or Rank Assignment Date 46955 Hoover, Nicholas Fire Captain Fire Station 1 10/27/2019 Member Making Report ID Signature Position or Rank Assignment Date L M Page 3 of 12 NFIRS-2 Fire 40060 CA 10 27 2019 Fire Station 4 (FS4) 19-05532 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 136-Pets 1 - Bulk Storage or warehousing 2 - Processing or manufacturing 3 - Packaged goods for sale 4 - Repair or service U - Undetermined On-site material (1) Ignition D1 60-Equipment or service area, other Area of Fire Origin D2 10-Heat from powered equipment, other Heat Source D3 99-Multiple items first ignited Item First Ignited D4 41-Plastic 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 30-Electrical failure, malfunction, other 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 12 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 Mobile Property Type Mobile Property Make Local Use Pre-Fire Plan Available Arson Report Attached Police Report Attached Coroner Report Attached Other Reports Attached Mobile Property Model Year State License Plate Number VIN _________________________ _________________________ _________________________ _________________________ _________________________ _________________________ H1 H2 Page 5 of 12 NFIRS-3 Structure Fire 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 Building Status 1 - Under Construction 2 - In Normal Use 3 - Idle, Not Routinely Used 4 - Under Major Renovation 5 - Vacant and Secured 6 - Vacant and Unsecured 7 - Being Demolished 0 - Other U - Undetermined Building Height 1 Number of Stories At/Above Grade 0 Number of Stories Below Grade Main Floor Size 42500 Total Square Feet OR BY Length (ft) X Width (ft) Fire Origin 1 Below Grade Story of Fire Origin 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 Number of Stories Damaged By Flame Number of Stories w/Minor Damage (1-24%) Number of Stories w/Significant Damage (25-49%) Number of Stories w/Heavy Damage (50-74%) Number of Stories w/Extreme Damage (75-100%) *Count the roof as part of the highest story Type of Material Contributing Most to Flame Spread K1 Item Contributing Most to Flame Spread K2 Type of Material Contributing Most To Flame Spread Presence of Detectors N - None Present 1 - Present U - Undetermined 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 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 Detector Operation 1 - Fire Too Small To Activate 2 - Operated 3 - Failed To Operate U - Undetermined 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 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 I1 I2 I3 I4 J1 J2 J3 K L1 L2 L3 L4 L5 L6 Page 6 of 12 Presence of Automatic Extinguishing System N - None Present 1 - Present 2 - Partial System Present U - Undetermined 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 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 Number of Sprinkler Heads Operating 1 Required if system operated 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 M1 M2 M3 M4 M5 Page 7 of 12 NFIRS-9 Apparatus or Resources 40060 CA 10 27 2019 Fire Station 4 (FS4) 19-05532 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:10/27/2019 05:10 Arrival:10/27/2019 05:19 Clear:10/27/2019 07:26 Sent 1 Suppression EMS Other 81-Incident command ID:E3 Type:11-Engine Dispatch:10/27/2019 05:10 Arrival:10/27/2019 05:22 Clear: Sent 3 Suppression EMS Other 21-Search ID:E4 Type:11-Engine Dispatch:10/27/2019 05:10 Arrival:10/27/2019 05:15 Clear:10/27/2019 07:26 Sent 3 Suppression EMS Other 11-Extinguishment by fire service personnel 12-Salvage & overhaul 66-Remove water ID:PRV20 Type: 00-Other apparatus/resource Dispatch:10/27/2019 05:32 Arrival:10/27/2019 05:48 Clear: Sent 1 Suppression EMS Other 86-Investigate ID:T1 Type:12-Truck or aerial Dispatch:10/27/2019 05:10 Arrival:10/27/2019 05:19 Clear:10/27/2019 07:26 Sent 4 Suppression EMS Other 51-Ventilate 66-Remove water ID:T2 Type:12-Truck or aerial Dispatch:10/27/2019 05:10 Arrival:10/27/2019 05:20 Clear:10/27/2019 07:26 Sent 3 Suppression EMS Other 51-Ventilate 66-Remove water A Page 8 of 12 NFIRS-10 Personnel 40060 CA 10 27 2019 Fire Station 4 (FS4) 19-05532 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:10/27/2019 05:10 Arrival:10/27/2019 05:19 Clear:10/27/2019 07:26 Sent 1 Suppression EMS Other 81-Incident command Personnel ID Name Rank Role Attend Actions Taken 35110 Fox II, Samuel Battalion Chief ID:E3 Type:11-Engine Dispatch:10/27/2019 05:10 Arrival:10/27/2019 05:22 Clear: Sent 3 Suppression EMS Other 21-Search Personnel ID Name Rank Role Attend Actions Taken 73110 Reiss, Devin Captain 54183 King, John Engineer 30791 Doolin, Luke Firefighter ID:E4 Type:11-Engine Dispatch:10/27/2019 05:10 Arrival:10/27/2019 05:15 Clear:10/27/2019 07:26 Sent 3 Suppression EMS Other 11-Extinguishment by fire service personnel 12-Salvage & overhaul 66-Remove water Personnel ID Name Rank Role Attend Actions Taken 25944 Child, Robert Engineer 74579 Robertson, Travis Firefighter 46955 Hoover, Nicholas Captain ID:PRV20 Type: 00-Other apparatus/resource Dispatch:10/27/2019 05:32 Arrival:10/27/2019 05:48 Clear: Sent 1 Suppression EMS Other 86-Investigate Personnel ID Name Rank Role Attend Actions Taken 603733 Maggio, Rodger Fire Marshal 86-Investigate ID:T1 Type:12-Truck or aerial Dispatch:10/27/2019 05:10 Arrival:10/27/2019 05:19 Clear:10/27/2019 07:26 Sent 4 Suppression EMS Other 51-Ventilate 66-Remove water Personnel ID Name Rank Role Attend Actions Taken 50826 Johnston, Kenneth Firefighter 36520 Gatton, Christopher Engineer A Page 9 of 12 50050 Jeckell, Matthew Engineer 14845 Barrett, Richard Captain ID:T2 Type:12-Truck or aerial Dispatch:10/27/2019 05:10 Arrival:10/27/2019 05:20 Clear:10/27/2019 07:26 Sent 3 Suppression EMS Other 51-Ventilate 66-Remove water Personnel ID Name Rank Role Attend Actions Taken 92892 Woods, Mitchell Firefighter 70100 Polkow, Matthew Engineer 44555 Hasch, Nathan Captain Page 10 of 12 NFIRS-1S Supplemental 40060 CA 10 27 2019 Fire Station 4 (FS4) 19-05532 0 FDID State Month Day Year Station Number Exposure Primary Narrative: BC2 C3 with 1st alarm assignment to reports of commercial structure fire in local pet store, BC2 arrived at scene to find E4 on scene of a large single story warehouse style commercial structure with moderate amount of smoke showing inside the structure, E4 had established Valley IC, was establishing a water supply and setting up for fire attack on side A alpha, BC2 completed 360 which was unremarkable, BC2 assumed Valley IC and made contact with employee who stated no occupants inside, E4 was assigned as Fire Attack and made entry on side A once two out was at scn, T1 assigned Roof Division, E3 assigned to work for Fire Attack group, Cal Fire BC assigned Safety, E21 assigned RIC and utilities, Fire Attack Group was given the objective of locating and extinguishing the fire and giving and all clear on a primary search, they advised that fire had been located in A/D corner and was extinguished with a water can, water supply established but not utilized, Fire Attack requested horizontal vent, T2 assigned Vent Group, T1 reported that the roof was sound and had light to moderate smoke coming from HVAC discharge, Fire Attack reported all clear on a primary search, ventilation in progress with good results, E4 reassigned as Interior group and given T2, T2 assigned to complete a secondary search of the structure, Interior reported an all clear on the secondary and except for a large number of pets inside store in fixed cages, all appeared well and uninjured, with smoke removed and IDLH mitigated Interior Grp recommended to shelter them in place, E3 reassigned as Exposure Group with the objective of checking the Delta exposure for fire extension and water damage, Store manager at scn advised to contact store's veterinarian to evaluate the animals, RIC disbanded upon determination of non-IDLH, E21 released and assigned Code 11 at FS1 with Patrol 1, Exposure grp made access to Delta exposure and reported minimal water damage and no fire extension, E3 released and available for City coverage, Interior reported ventilation, overhaul, and water removal complete, T2 and T1 released, Manager and property owner at scn, building t/o to them, advised of need for alarm company tech to come replace the sprinkler head and restore the system, and of need for disaster recovery company to respond, command terminated, E4 and BC2 available at scn. Additional Narrative (#1 of 3 ): E3 staged on Side C/D. Given the assignment from IC to assist Interior Group. Made entry through Side A and assisted with secondary search and verification pets were secure and shelter in place was best option. Reassigned by IC to Exposure Group. Side D of Fire Occupancy was World Market. Staff arrived and access made. Mild water intrusion from sprinkler in fire area. Staff said they would mop and vacuum water. Damage appeared to be under $200. Power also restored to World Market. E3 cleared scene by IC for Code 11. Additional Narrative (#2 of 3 ): Fire Origin and Cause Report Rodger Maggio, Fire Marshal On Sunday, October 27, 2019 at approximately 5:30 AM I received a call from San Luis Obispo Fire Dispatch requesting that I respond to a structure fire at 1530 Froom Ranch (PetSmart). I arrived at scene at approximately 5:45 AM and observed an approximate 50,000 square foot, Type III constructed retail pet store with light smoke on the interior and fire suppression personnel ventilating the building with fans. The fire was controlled by an automatic fire sprinkler system and easily extinguished by fire personnel. After assuring the gas levels made it safe to enter, I went in through the front doors on side 'A' and was directed to a room in the A/D corner of the building. This section of the building housed fish aquariums and other aquatic animals. The room where the fire origin was located was for storage of supplies to the support the aquariums and chilling and water filtration systems. Upon entering the room I observed a distinct 'V' burn pattern in the A/D corner of the room. In that area I found the remains of the water chilling system, which consisted of electric motors, pumps, a radiator for heat exchange, filter system and transformer. Above the unit I observed a duplex electrical outlet with an electrical cord plugged into it. The outlet showed signs of severe heat damage. Around the chiller unit I observed a plastic cart with supplies on it that was melted pointing to an origin of the chiller. I also observed the remain of the electrical motor in the debris. I is my opinion that this fire originated in the chiller unit, due to possible overheating. Cause is accidental. A Page 11 of 12 Additional Narrative (#3 of 3 ): E4 dispatched code 3 to the report of a first alarm commercial structure fire. Upon arrival, E4 reported moderate smoke in the building with no flames seen, negative working incident, and requested all units to switch to tactical for an assignment, E4 established Valley IC. The front door was open PTA by an employee at the scene. Pump 4 began initiating a water supply, FF4 and E4 proceeded to the front door with a water can. Upon arrival and transfer of command to BC2, FF4 and E4 made entry with two out established. FF4 and E4 located the fire in the A/D corner and extinguished a small water pump/cooling system with the water can. E4 had been assigned fire attack by IC, and requested horizontal ventilation of the structure, fire attack also reported fire knocked down and controlled. Fire attack transitioned into interior division and assisted with smoke removal and water evacuation. E4 was released by Valley IC after building cleared of smoke, and water removed. Page 12 of 12