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Home My WebLink AboutFire Report_RedactedNFIRS-1 Basic 40060 CA 01 26 2020 Fire Station 3 (FS3) 20-00474 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 1135 IRIS Number Prefix Street or Highway Street Type Suffix San Luis Obispo CA 93401 Apt./Suite/Room City State Zip Code Cross Street Incident Type 100-Fire, other 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 01 26 2020 20:11 Arrival 01 26 2020 20:16 Controlled 01 26 2020 20:16 Last Unit Cleared 01 26 2020 20:34 Shifts and Alarms C 1 FZ3 Shift or Platoon Alarms District Special Studies ID#Value A B C D E1 E2 E3 Page 1 of 9 Actions Taken 86-Investigate 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 9 Remarks: Authorization 54190 54190 Fire Captain 01/27/2020 Officer In Charge ID Signature Position or Rank Assignment Date 54190 54190 Fire Captain 01/27/2020 Member Making Report ID Signature Position or Rank Assignment Date L M Page 3 of 9 NFIRS-2 Fire 40060 CA 01 26 2020 Fire Station 3 (FS3) 20-00474 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 Ignition D1 55-Duct: hvac, cable, exhaust, heating, or AC Area of Fire Origin D2 12-Radiated or conducted heat from operating equipment Heat Source D3 34-Wearing apparel not on a person Item First Ignited D4 71-Fabric, fiber, cotton, blends, rayon, wool 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 12-Heat source too close to combustibles. 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 9 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 9 NFIRS-9 Apparatus or Resources 40060 CA 01 26 2020 Fire Station 3 (FS3) 20-00474 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:01/26/2020 20:11 Arrival:01/26/2020 20:18 Clear:01/26/2020 20:27 Sent 1 Suppression EMS Other 73-Provide manpower ID:E3 Type:11-Engine Dispatch:01/26/2020 20:11 Arrival:01/26/2020 20:16 Clear:01/26/2020 20:34 Sent 3 Suppression EMS Other 81-Incident command ID:E4 Type:11-Engine Dispatch:01/26/2020 20:11 Arrival: Clear:01/26/2020 20:19 Sent 3 Suppression EMS Other 93-Cancelled en route ID:T1 Type:12-Truck or aerial Dispatch:01/26/2020 20:11 Arrival: Clear:01/26/2020 20:18 Sent 4 Suppression EMS Other 93-Cancelled en route ID:T2 Type:12-Truck or aerial Dispatch:01/26/2020 20:11 Arrival: Clear:01/26/2020 20:19 Sent 3 Suppression EMS Other 93-Cancelled en route A Page 6 of 9 NFIRS-10 Personnel 40060 CA 01 26 2020 Fire Station 3 (FS3) 20-00474 0 FDID State Month Day Year Station Number Exposure A Page 7 of 9 B Apparatus/Resource Dates/Times Sent Number of People Apparatus Use Actions Taken ID:BC3 Type:92-Chief officer car Dispatch:01/26/2020 20:11 Arrival:01/26/2020 20:18 Clear:01/26/2020 20:27 Sent 1 Suppression EMS Other 73-Provide manpower Personnel ID Name Rank Role Attend Actions Taken 16750 Berryman, Neal Battalion Chief ID:E3 Type:11-Engine Dispatch:01/26/2020 20:11 Arrival:01/26/2020 20:16 Clear:01/26/2020 20:34 Sent 3 Suppression EMS Other 81-Incident command Personnel ID Name Rank Role Attend Actions Taken 54190 King, Michael Captain 14857 Barthel, Dustin Firefighter 44306 Harris, Michael Engineer ID:E4 Type:11-Engine Dispatch:01/26/2020 20:11 Arrival: Clear:01/26/2020 20:19 Sent 3 Suppression EMS Other 93-Cancelled en route Personnel ID Name Rank Role Attend Actions Taken 88690 Vasquez, Mark Captain 92710 Witt, James Firefighter 92335 Williams, Joseph Engineer ID:T1 Type:12-Truck or aerial Dispatch:01/26/2020 20:11 Arrival: Clear:01/26/2020 20:18 Sent 4 Suppression EMS Other 93-Cancelled en route Personnel ID Name Rank Role Attend Actions Taken 70995 Pratt, Jason Engineer 61580 Mason, Ryan Engineer 38890 Gonzalez, Steven Captain 30791 Doolin, Luke Firefighter ID:T2 Type:12-Truck or aerial Dispatch:01/26/2020 20:11 Arrival: Clear:01/26/2020 20:19 Sent 3 Suppression EMS Other 93-Cancelled en route Personnel ID Name Rank Role Attend Actions Taken 92310 Williams, Nathan Engineer 90841 Weis, Trevor Firefighter 80947 Skove, Shayne Captain Page 8 of 9 NFIRS-1S Supplemental 40060 CA 01 26 2020 Fire Station 3 (FS3) 20-00474 0 FDID State Month Day Year Station Number Exposure Primary Narrative: A Page 9 of 9