HomeMy WebLinkAbout35 Casa FR 3NFIRS-1 Basic
40060 CA 08 18 2022 Fire Station
1 (FS1)
22-04647 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
35 CASA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
651-Smoke scare, odor of smoke
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 08 18 2022 13:16
Arrival 08 18 2022 13:18
Controlled
Last Unit
Cleared
08 18 2022 14:18
Shifts and Alarms
B FZ2
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
86-Investigate
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 4 11
EMS 1 2
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:
340-Clinics, doctors offices,
hemodialysis cntr, other
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:
Dispatched to above location for report of smoke in the structure on the second floor. On arrival, T1 met with the RP who
guided us up stairs and showed us that there was very light smoke in the hallway and some of the offices on the A side of the
structure. T1 established Casa IC and then requested T2 respond. T1 and T2 searched the building and on the second floor
and could not find a source in any of the office areas. T1 personnel made access to the roof and found that one of the HVAC
units was cycling off and on. This action was different than any of the other HVAC units on the roof. T1 made contact with the
property manager and the HVAC tech. They were advised and the HVAC tech advised T1 to shut off the unit was cycling
different. The unit was shut off and the hallway and office blown out with our fans. The building was then TOT the RP and
they were going to wait on site for the HVAC. T1 and T2 cleared.
Authorization
62800 MacDonald, John 08/18/2022
Officer In Charge ID Signature Position or Rank Assignment Date
62800 MacDonald, John 08/18/2022
Member Making Report
ID
Signature Position or Rank Assignment Date
L
M
Page 3 of 7
NFIRS-9 Apparatus or Resources
40060 CA 08 18 2022 Fire Station
1 (FS1)
22-04647 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:08/18/2022 13:27
Arrival:08/18/2022 13:31
Clear:
Sent 1 Suppression
EMS
Other
81-Incident command
ID:E4
Type:11-Engine
Dispatch:08/18/2022 13:16
Arrival:
Clear:08/18/2022 13:17
Sent 3 Suppression
EMS
Other
93-Cancelled en route
ID:MCU1
Type:75-BLS unit
Dispatch:08/18/2022 13:29
Arrival:
Clear:08/18/2022 13:56
Sent 2 Suppression
EMS
Other
92-Standby
ID:T1
Type:12-Truck or aerial
Dispatch:08/18/2022 13:17
Arrival:08/18/2022 13:18
Clear:08/18/2022 14:18
Sent 4 Suppression
EMS
Other
86-Investigate
ID:T2
Type:12-Truck or aerial
Dispatch:08/18/2022 13:16
Arrival:08/18/2022 13:30
Clear:
Sent 3 Suppression
EMS
Other
86-Investigate
A
Page 4 of 7
NFIRS-10 Personnel
40060 CA 08 18 2022 Fire Station
1 (FS1)
22-04647 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:BC3
Type:92-Chief officer car
Dispatch:08/18/2022 13:27
Arrival:08/18/2022 13:31
Clear:
Sent 1 Suppression
EMS
Other
81-Incident command
Personnel ID Name Rank Role Attend Actions Taken
80947 Skove, Shayne Battalion
Chief
ID:E4
Type:11-Engine
Dispatch:08/18/2022 13:16
Arrival:
Clear:08/18/2022 13:17
Sent 3 Suppression
EMS
Other
93-Cancelled en route
Personnel ID Name Rank Role Attend Actions Taken
46955 Hoover, Nicholas Captain
90841 Weis, Trevor Engineer
99161 Hutslar, Dane Firefighter
ID:MCU1
Type:75-BLS unit
Dispatch:08/18/2022 13:29
Arrival:
Clear:08/18/2022 13:56
Sent 2 Suppression
EMS
Other
92-Standby
Personnel ID Name Rank Role Attend Actions Taken
99552 Morrison, Keanu 5588014-EMT-B
99719 Smith, Erin 5588014-EMT-B
ID:T1
Type:12-Truck or aerial
Dispatch:08/18/2022 13:17
Arrival:08/18/2022 13:18
Clear:08/18/2022 14:18
Sent 4 Suppression
EMS
Other
86-Investigate
Personnel ID Name Rank Role Attend Actions Taken
62800 MacDonald, John Captain
36520 Gatton, Christopher Engineer
70100 Polkow, Matthew Engineer
99186 McAninch, Scott Firefighter
ID:T2
Type:12-Truck or aerial
Dispatch:08/18/2022 13:16
Arrival:08/18/2022 13:30
Clear:
Sent 3 Suppression
EMS
Other
86-Investigate
Personnel ID Name Rank Role Attend Actions Taken
60045 Lokkart, Eric Captain
92892 Woods, Mitchell Engineer
50826 Johnston, Kenneth Firefighter
Page 6 of 7
NFIRS-1S Supplemental
40060 CA 08 18 2022 Fire Station
1 (FS1)
22-04647 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
Dispatched to above location for report of smoke in the structure on the second floor. On arrival, T1 met with the RP who
guided us up stairs and showed us that there was very light smoke in the hallway and some of the offices on the A side of the
structure. T1 established Casa IC and then requested T2 respond. T1 and T2 searched the building and on the second floor
and could not find a source in any of the office areas. T1 personnel made access to the roof and found that one of the HVAC
units was cycling off and on. This action was different than any of the other HVAC units on the roof. T1 made contact with the
property manager and the HVAC tech. They were advised and the HVAC tech advised T1 to shut off the unit was cycling
different. The unit was shut off and the hallway and office blown out with our fans. The building was then TOT the RP and
they were going to wait on site for the HVAC. T1 and T2 cleared.
Apparatus Narrative for T2:
T2 was originally cancelled and later requested to respond.
A
Page 7 of 7