HomeMy WebLinkAboutCalle Fire Reports_Calle 11NFIRS-1 Basic
40060 CA 05 26 2020 Fire Station
4 (FS4)
20-02306 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
1433 CALLE JOAQUIN
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
321-Medical Emergency
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
California
Their FDID Their
State
Their Incident Number
Dates and Times
Alarm 05 26 2020 22:04
Arrival 05 26 2020 22:09
Controlled
Last Unit
Cleared
05 26 2020 22:20
Shifts and Alarms
C 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 6
Actions Taken
70-Assistance, other
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 1 3
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 Pt. was sitting in car ETOH and uncooperative; PD assisted getting Pt. on gurney for assessment and transport to
ER by SLAS.
Authorization
88690 Vasquez, Mark Fire Captain 05/27/2020
Officer In Charge ID Signature Position or Rank Assignment Date
88690 Vasquez, Mark Fire Captain 05/27/2020
Member Making Report
ID
Signature Position or Rank Assignment Date
L
M
Page 3 of 6
NFIRS-9 Apparatus or Resources
40060 CA 05 26 2020 Fire Station
4 (FS4)
20-02306 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:E4
Type:11-Engine
Dispatch:05/26/2020 22:04
Arrival:05/26/2020 22:09
Clear:05/26/2020 22:20
Sent 3 Suppression
EMS
Other
A
Page 4 of 6
NFIRS-10 Personnel
40060 CA 05 26 2020 Fire Station
4 (FS4)
20-02306 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:E4
Type:11-Engine
Dispatch:05/26/2020 22:04
Arrival:05/26/2020 22:09
Clear:05/26/2020 22:20
Sent 3 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
88690 Vasquez, Mark Captain
60045 Lokkart, Eric Engineer
92710 Witt, James Firefighter
A
Page 5 of 6
NFIRS-1S Supplemental
40060 CA 05 26 2020 Fire Station
4 (FS4)
20-02306 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
Upon arrival Pt. was sitting in car ETOH and uncooperative; PD assisted getting Pt. on gurney for assessment and transport to
ER by SLAS.
A
Page 6 of 6