HomeMy WebLinkAbout77 Casa FR 4NFIRS-1 Basic
40060 CA 06 05 2023 Fire Station
2 (FS2)
23-03375 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
77 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
814-Lightning strike (no 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 06 05 2023 22:30
Arrival 06 05 2023 22:36
Controlled
Last Unit
Cleared
06 05 2023 23:05
Shifts and Alarms
A 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
87-Investigate fire out on arrival
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 5 14
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 7
Remarks:
T2 responded with first alarm for unknown fire at 35 Casa, SVH complex. Upon arrival SVH staff noted location to be behind
the hospital. Witness noted lightening striking power pole with fire. T2 established Casa Command. Units level 1 staged. Upon
accessing power pole with BC3, T2 noted no fire and no power lines on the ground. Other units released. PGE contacted for
pole evaluation and tripped pole breakers. SVH running on generator power. Command terminated with no hazards found.
Property TOT engineering staff. T2 cleared.
Authorization
34590 Flatos, Alec Fire Captain 06/06/2023
Officer In Charge ID Signature Position or Rank Assignment Date
34590 Flatos, Alec Fire Captain 06/06/2023
Member Making Report
ID
Signature Position or Rank Assignment Date
L
M
Page 3 of 7
NFIRS-9 Apparatus or Resources
40060 CA 06 05 2023 Fire Station
2 (FS2)
23-03375 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:06/05/2023 22:30
Arrival:06/05/2023 22:36
Clear:
Sent 1 Suppression
EMS
Other
87-Investigate fire out on arrival
ID:E3
Type:11-Engine
Dispatch:06/05/2023 22:30
Arrival:06/05/2023 22:39
Clear:06/05/2023 22:40
Sent 3 Suppression
EMS
Other
92-Standby
ID:E4
Type:11-Engine
Dispatch:06/05/2023 22:30
Arrival:06/05/2023 22:39
Clear:06/05/2023 22:40
Sent 3 Suppression
EMS
Other
92-Standby
ID:T1
Type:12-Truck or aerial
Dispatch:06/05/2023 22:30
Arrival:06/05/2023 22:37
Clear:06/05/2023 22:42
Sent 4 Suppression
EMS
Other
90-Fill-in, standby, other
ID:T2
Type:12-Truck or aerial
Dispatch:06/05/2023 22:30
Arrival:06/05/2023 22:36
Clear:06/05/2023 23:05
Sent 3 Suppression
EMS
Other
81-Incident command
87-Investigate fire out on arrival
A
Page 4 of 7
NFIRS-10 Personnel
40060 CA 06 05 2023 Fire Station
2 (FS2)
23-03375 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:06/05/2023 22:30
Arrival:06/05/2023 22:36
Clear:
Sent 1 Suppression
EMS
Other
87-Investigate fire out on arrival
Personnel ID Name Rank Role Attend Actions Taken
80947 Skove, Shayne Battalion
Chief
ID:E3
Type:11-Engine
Dispatch:06/05/2023 22:30
Arrival:06/05/2023 22:39
Clear:06/05/2023 22:40
Sent 3 Suppression
EMS
Other
92-Standby
Personnel ID Name Rank Role Attend Actions Taken
54190 King, Michael Captain
54183 King, John Engineer
30791 Doolin, Luke Firefighter
ID:E4
Type:11-Engine
Dispatch:06/05/2023 22:30
Arrival:06/05/2023 22:39
Clear:06/05/2023 22:40
Sent 3 Suppression
EMS
Other
92-Standby
Personnel ID Name Rank Role Attend Actions Taken
73250 Renner, David Captain
100080 Davis, Jaden Firefighter
66265 Nason, William Engineer
ID:T1
Type:12-Truck or aerial
Dispatch:06/05/2023 22:30
Arrival:06/05/2023 22:37
Clear:06/05/2023 22:42
Sent 4 Suppression
EMS
Other
90-Fill-in, standby, other
Personnel ID Name Rank Role Attend Actions Taken
99552 Morrison, Keanu Firefighter
70995 Pratt, Jason Captain
57382 Larsen, Patrick Engineer
92335 Williams, Joseph Engineer
ID:T2
Type:12-Truck or aerial
Dispatch:06/05/2023 22:30
Arrival:06/05/2023 22:36
Clear:06/05/2023 23:05
Sent 3 Suppression
EMS
Other
81-Incident command
87-Investigate fire out on arrival
Personnel ID Name Rank Role Attend Actions Taken
100070 Kaperonis, George Firefighter
34590 Flatos, Alec Captain
99186 McAninch, Scott Engineer
Page 6 of 7
NFIRS-1S Supplemental
40060 CA 06 05 2023 Fire Station
2 (FS2)
23-03375 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
T2 responded with first alarm for unknown fire at 35 Casa, SVH complex. Upon arrival SVH staff noted location to be behind
the hospital. Witness noted lightening striking power pole with fire. T2 established Casa Command. Units level 1 staged. Upon
accessing power pole with BC3, T2 noted no fire and no power lines on the ground. Other units released. PGE contacted for
pole evaluation and tripped pole breakers. SVH running on generator power. Command terminated with no hazards found.
Property TOT engineering staff. T2 cleared.
A
Page 7 of 7