HomeMy WebLinkAboutPRR25263 Manley Responsive DocumentsNFIRS -1 Basic
40060 CA 06 07 2025 Fire Station 1
(FS1)
25-03464 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
280 HIGUERA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
412-Gas leak (natural gas or LPG)
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 07 2025 17:31
Arrival 06 07 2025 17:38
Controlled
Last Unit
Cleared 06 07 2025 17:48
Shifts and Alarms
A NA FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 3 - No,
COVID
19 was
not a
factor
ID#Value
Actions Taken
86-Investigate
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 2 7
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 6
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:
580-General retail, 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
Remarks:
Truck 1 dispatched to local business for a smell of gas outside. Upon our arrival we were met by staff who stated that a new gas
line and meter was installed this last week. The employees have been smelling gas outside ever since. The property was
investigated with the gas detector and gas was detected near the meter. The emergency gas line was called and the gas company
sent out a representative. No gas was detected inside the building.
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Page 2 of 6
Authorization
70995 Pratt, Jason Fire Captain 06/07/2025
Officer In Charge ID Signature Position or Rank Assignment Date
70995 Pratt, Jason Fire Captain 06/07/2025
Member Making Report ID Signature Position or Rank Assignment Date
M
Page 3 of 6
NFIRS -9 Apparatus or Resources
40060 CA 06 07 2025 Fire Station 1
(FS1)
25-03464 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:06/07/2025 17:31
Arrival:
Clear:06/07/2025 17:32
Sent 3 Suppression
EMS
Other
93-Cancelled en route
ID:T1
Type:12-Truck or aerial
Dispatch:06/07/2025 17:33
Arrival:06/07/2025 17:38
Clear:06/07/2025 17:48
Sent 4 Suppression
EMS
Other
86-Investigate
A
Page 4 of 6
NFIRS -10 Personnel
40060 CA 06 07 2025 Fire Station 1
(FS1)
25-03464 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:06/07/2025 17:31
Arrival:
Clear:06/07/2025 17:32
Sent 3 Suppression
EMS
Other
93-Cancelled en route
Personnel ID Name Rank Role Attend Actions Taken
100070 Kaperonis, George Firefighter
73250 Renner, David Captain
92335 Williams, Joseph Engineer
ID:T1
Type:12-Truck or aerial
Dispatch:06/07/2025 17:33
Arrival:06/07/2025 17:38
Clear:06/07/2025 17:48
Sent 4 Suppression
EMS
Other
86-Investigate
Personnel ID Name Rank Role Attend Actions Taken
70995 Pratt, Jason Captain
99162 Kraemer, Luke Firefighter
57382 Larsen, Patrick Engineer
30791 Doolin, Luke Engineer
A
Page 5 of 6
NFIRS -1S Supplemental
40060 CA 06 07 2025 Fire Station 1
(FS1)
25-03464 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
Truck 1 dispatched to local business for a smell of gas outside. Upon our arrival we were met by staff who stated that a
new gas line and meter was installed this last week. The employees have been smelling gas outside ever since. The property was
investigated with the gas detector and gas was detected near the meter. The emergency gas line was called and the gas company
sent out a representative. No gas was detected inside the building.
A
Page 6 of 6
NFIRS -1 Basic
40060 CA 05 02 2025 Fire Station 4
(FS4)
25-02705 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
280 HIGUERA
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
Their FDID Their
State
Their Incident Number
Dates and Times
Alarm 05 02 2025 13:26
Arrival 05 02 2025 13:31
Controlled
Last Unit
Cleared 05 02 2025 14:15
Shifts and Alarms
A FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 4 -
Unknown
ID#Value
Actions Taken
33-Provide advanced life support (ALS)
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 6
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:
500-Mercantile, business,
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
Remarks:
E4 responded code 3 to the dispatched address for a report of a medical emergency. E4 arrived on scene at a retail store and
found one patient on the floor inside in a bathroom. E4 paramedic intern and FTO assessed and treated the patient on scene. Upon
arrival of SLAS the patient was loaded into the ambulance and transported to the hospital with E4 continuing care. Upon arrival at
the hospital patient care was transferred to the hospital. E4 cleared the hospital and returned. See PCR for further patient care
information.
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Page 2 of 6
Authorization
73250 Renner, David Fire Captain 05/02/2025
Officer In Charge ID Signature Position or Rank Assignment Date
73250 Renner, David Fire Captain 05/02/2025
Member Making Report ID Signature Position or Rank Assignment Date
M
Page 3 of 6
NFIRS -9 Apparatus or Resources
40060 CA 05 02 2025 Fire Station 4
(FS4)
25-02705 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:05/02/2025 13:26
Arrival:05/02/2025 13:31
Clear:05/02/2025 14:15
Sent 3 Suppression
EMS
Other
A
Page 4 of 6
NFIRS -10 Personnel
40060 CA 05 02 2025 Fire Station 4
(FS4)
25-02705 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:05/02/2025 13:26
Arrival:05/02/2025 13:31
Clear:05/02/2025 14:15
Sent 3 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
99552 Morrison, Keanu Firefighter
73250 Renner, David Captain
92335 Williams, Joseph Engineer
A
Page 5 of 6
NFIRS -1S Supplemental
40060 CA 05 02 2025 Fire Station 4
(FS4)
25-02705 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
E4 responded code 3 to the dispatched address for a report of a medical emergency. E4 arrived on scene at a retail store
and found one patient on the floor inside in a bathroom. E4 paramedic intern and FTO assessed and treated the patient on scene.
Upon arrival of SLAS the patient was loaded into the ambulance and transported to the hospital with E4 continuing care. Upon
arrival at the hospital patient care was transferred to the hospital. E4 cleared the hospital and returned. See PCR for further patient
care information.
A
Page 6 of 6
NFIRS -1 Basic
40060 CA 01 22 2025 Fire Station 1
(FS1)
25-00550 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
280 HIGUERA
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
Their FDID Their
State
Their Incident Number
Dates and Times
Alarm 01 22 2025 14:28
Arrival 01 22 2025 14:33
Controlled
Last Unit
Cleared 01 22 2025 15:02
Shifts and Alarms
B FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 4 -
Unknown
ID#Value
Actions Taken
33-Provide advanced life support (ALS)
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 1 4
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 5
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:
500-Mercantile, business,
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
Remarks:
See EPCR for call details. T1 cleared the scene without further incident.
Authorization
60045 Lokkart, Eric Fire Captain 01/22/2025
Officer In Charge ID Signature Position or Rank Assignment Date
60045 Lokkart, Eric Fire Captain 01/22/2025
Member Making Report ID Signature Position or Rank Assignment Date
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Page 2 of 5
NFIRS -9 Apparatus or Resources
40060 CA 01 22 2025 Fire Station 1
(FS1)
25-00550 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:01/22/2025 14:28
Arrival:01/22/2025 14:33
Clear:01/22/2025 15:02
Sent 4 Suppression
EMS
Other
A
Page 3 of 5
NFIRS -10 Personnel
40060 CA 01 22 2025 Fire Station 1
(FS1)
25-00550 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:01/22/2025 14:28
Arrival:01/22/2025 14:33
Clear:01/22/2025 15:02
Sent 4 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
70100 Polkow, Matthew Engineer
88690 Vasquez, Mark Firefighter
60045 Lokkart, Eric Captain
90841 Weis, Trevor Engineer
A
Page 4 of 5
NFIRS -1S Supplemental
40060 CA 01 22 2025 Fire Station 1
(FS1)
25-00550 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
See EPCR for call details. T1 cleared the scene without further incident.
A
Page 5 of 5
NFIRS -1 Basic
40060 CA 05 03 2024 Fire Station 1
(FS1)
24-02579 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
280 HIGUERA
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
Their FDID Their
State
Their Incident Number
Dates and Times
Alarm 05 03 2024 15:43
Arrival 05 03 2024 15:46
Controlled
Last Unit
Cleared 05 03 2024 16:06
Shifts and Alarms
B FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 4 -
Unknown
ID#Value
Actions Taken
33-Provide advanced life support (ALS)
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 2 7
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 5
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:
000-Property Use, 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
Remarks:
See EPCR for call details. T1 cleared the scene without further incident.
Authorization
60045 Lokkart, Eric Fire Captain 05/03/2024
Officer In Charge ID Signature Position or Rank Assignment Date
60045 Lokkart, Eric Fire Captain 05/03/2024
Member Making Report ID Signature Position or Rank Assignment Date
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Page 2 of 5
NFIRS -9 Apparatus or Resources
40060 CA 05 03 2024 Fire Station 1
(FS1)
24-02579 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:05/03/2024 15:44
Arrival:05/03/2024 15:53
Clear:05/03/2024 16:06
Sent 4 Suppression
EMS
Other
ID:T2
Type:12-Truck or aerial
Dispatch:05/03/2024 15:43
Arrival:
Clear:
Sent 3 Suppression
EMS
Other
A
Page 3 of 5
NFIRS -10 Personnel
40060 CA 05 03 2024 Fire Station 1
(FS1)
24-02579 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:05/03/2024 15:44
Arrival:05/03/2024 15:53
Clear:05/03/2024 16:06
Sent 4 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
50826 Johnston, Kenneth Firefighter
70100 Polkow, Matthew Engineer
52001 Joy, Cullen Engineer
60045 Lokkart, Eric Captain
ID:T2
Type:12-Truck or aerial
Dispatch:05/03/2024 15:43
Arrival:
Clear:
Sent 3 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
100068 Barkhimer, Jake Engineer
38890 Gonzalez, Steven Captain
99161 Hutslar, Dane Firefighter
A
Page 4 of 5
NFIRS -1S Supplemental
40060 CA 05 03 2024 Fire Station 1
(FS1)
24-02579 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
See EPCR for call details. T1 cleared the scene without further incident.
A
Page 5 of 5
NFIRS -1 Basic
40060 CA 04 05 2024 Fire Station 1
(FS1)
24-02010 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
280 HIGUERA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
553-Public service
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 04 05 2024 13:57
Arrival 04 05 2024 14:15
Controlled
Last Unit
Cleared 04 05 2024 14:15
Shifts and Alarms
C FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 4 -
Unknown
ID#Value
Actions Taken
83-Provide information to public or media
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 0 1
EMS 1 1
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 6
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:
500-Mercantile, business,
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
Remarks:
MCU 1 assited PD with a CTW call on Higuera. At the scene, PD and MCU 1 made contact with the person who was acting erratic
and walking in the creek. They complied with PD's requests and MCU 1 offered services and gave the person food water and
contact info. The person cleared the scene with no medical complaint or resource needs. MCU 1 cleared.
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Authorization
99343 99343 04/05/2024
Officer In Charge ID Signature Position or Rank Assignment Date
99343 99343 04/05/2024
Member Making Report ID Signature Position or Rank Assignment Date
M
Page 3 of 6
NFIRS -9 Apparatus or Resources
40060 CA 04 05 2024 Fire Station 1
(FS1)
24-02010 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:MCU1
Type:75-BLS unit
Dispatch:04/05/2024 13:57
Arrival:04/05/2024 14:15
Clear:04/05/2024 14:15
Sent 1 Suppression
EMS
Other
A
Page 4 of 6
NFIRS -10 Personnel
40060 CA 04 05 2024 Fire Station 1
(FS1)
24-02010 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:MCU1
Type:75-BLS unit
Dispatch:04/05/2024 13:57
Arrival:04/05/2024 14:15
Clear:04/05/2024 14:15
Sent 1 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
99343 Taffe, Owen 5588014-EMT-B
A
Page 5 of 6
NFIRS -1S Supplemental
40060 CA 04 05 2024 Fire Station 1
(FS1)
24-02010 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
MCU 1 assited PD with a CTW call on Higuera. At the scene, PD and MCU 1 made contact with the person who was acting
erratic and walking in the creek. They complied with PD's requests and MCU 1 offered services and gave the person food water and
contact info. The person cleared the scene with no medical complaint or resource needs. MCU 1 cleared.
A
Page 6 of 6
NFIRS -1 Basic
40060 CA 03 01 2024 Fire Station 3
(FS3)
24-01335 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
280 HIGUERA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
324-Motor vehicle accident with no injuries
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 03 01 2024 17:26
Arrival 03 01 2024 17:33
Controlled
Last Unit
Cleared 03 01 2024 17:40
Shifts and Alarms
A FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 4 -
Unknown
ID#Value
Actions Taken
73-Provide manpower
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 2 7
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 6
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:
963-Street or road in
commercial area
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
Remarks:
High and Higuera for a two vehicle accident (see Police report for accident and vehicle information.). Upon arrival, E-3 assumed
Higuera IC and found two patients being evaluated by SLAS medic 52. Both patients refused care and transport (see SLAS patient
care report) prior to our arrival, E-3 cancelled T-1 and assisted with scene clean up prior to turning over scene to SLOPD. E-3
returned to quarters.
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Authorization
54190 54190 Fire Captain Fire Station 3 03/01/2024
Officer In Charge ID Signature Position or Rank Assignment Date
54190 54190 Fire Captain Fire Station 3 03/01/2024
Member Making Report ID Signature Position or Rank Assignment Date
M
Page 3 of 6
NFIRS -9 Apparatus or Resources
40060 CA 03 01 2024 Fire Station 3
(FS3)
24-01335 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:E3
Type:11-Engine
Dispatch:03/01/2024 17:26
Arrival:03/01/2024 17:33
Clear:03/01/2024 17:40
Sent 3 Suppression
EMS
Other
81-Incident command
ID:T1
Type:12-Truck or aerial
Dispatch:03/01/2024 17:26
Arrival:03/01/2024 17:34
Clear:
Sent 4 Suppression
EMS
Other
92-Standby
A
Page 4 of 6
NFIRS -10 Personnel
40060 CA 03 01 2024 Fire Station 3
(FS3)
24-01335 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:E3
Type:11-Engine
Dispatch:03/01/2024 17:26
Arrival:03/01/2024 17:33
Clear:03/01/2024 17:40
Sent 3 Suppression
EMS
Other
81-Incident command
Personnel ID Name Rank Role Attend Actions Taken
46543 Hicks, Judson Firefighter
54190 King, Michael Captain
99161 Hutslar, Dane Engineer
ID:T1
Type:12-Truck or aerial
Dispatch:03/01/2024 17:26
Arrival:03/01/2024 17:34
Clear:
Sent 4 Suppression
EMS
Other
92-Standby
Personnel ID Name Rank Role Attend Actions Taken
100076 McClanahan, Maren Firefighter
70995 Pratt, Jason Captain
57382 Larsen, Patrick Engineer
99186 McAninch, Scott Engineer
A
Page 5 of 6
NFIRS -1S Supplemental
40060 CA 03 01 2024 Fire Station 3
(FS3)
24-01335 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
High and Higuera for a two vehicle accident (see Police report for accident and vehicle information.). Upon arrival, E-3
assumed Higuera IC and found two patients being evaluated by SLAS medic 52. Both patients refused care and transport (see SLAS
patient care report) prior to our arrival, E-3 cancelled T-1 and assisted with scene clean up prior to turning over scene to SLOPD. E-3
returned to quarters.
A
Page 6 of 6
NFIRS -1 Basic
40060 CA 01 08 2024 Fire Station 4
(FS4)
24-00167 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
280 HIGUERA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
322-Motor vehicle accident with injuries (not extrication)
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 01 08 2024 12:09
Arrival 01 08 2024 12:11
Controlled
Last Unit
Cleared 01 08 2024 12:25
Shifts and Alarms
A FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 3 - No,
COVID
19 was
not a
factor
ID#Value
Actions Taken
33-Provide advanced life support (ALS)
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 2 7
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 6
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:
963-Street or road in
commercial area
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
Remarks:
E-4 and T-1 responded code 3 to a report of a T/C. On arrival E-4 found 3 vehicles involved with 1 minor injury. E-4 canceled T-1. E-4
assessed one pt. See further pt information in the PCR. E-4 completed the assignment and returned.
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Authorization
44555 Hasch, Nathan Captain 01/08/2024
Officer In Charge ID Signature Position or Rank Assignment Date
44555 Hasch, Nathan Captain 01/08/2024
Member Making Report ID Signature Position or Rank Assignment Date
M
Page 3 of 6
NFIRS -9 Apparatus or Resources
40060 CA 01 08 2024 Fire Station 4
(FS4)
24-00167 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:01/08/2024 12:09
Arrival:01/08/2024 12:11
Clear:01/08/2024 12:25
Sent 3 Suppression
EMS
Other
33-Provide advanced life support (ALS)
ID:T1
Type:12-Truck or aerial
Dispatch:01/08/2024 12:09
Arrival:
Clear:01/08/2024 12:12
Sent 4 Suppression
EMS
Other
93-Cancelled en route
A
Page 4 of 6
NFIRS -10 Personnel
40060 CA 01 08 2024 Fire Station 4
(FS4)
24-00167 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:01/08/2024 12:09
Arrival:01/08/2024 12:11
Clear:01/08/2024 12:25
Sent 3 Suppression
EMS
Other
33-Provide advanced life support (ALS)
Personnel ID Name Rank Role Attend Actions Taken
99552 Morrison, Keanu Firefighter
44555 Hasch, Nathan Captain
66265 Nason, William Engineer
ID:T1
Type:12-Truck or aerial
Dispatch:01/08/2024 12:09
Arrival:
Clear:01/08/2024 12:12
Sent 4 Suppression
EMS
Other
93-Cancelled en route
Personnel ID Name Rank Role Attend Actions Taken
100068 Barkhimer, Jake Firefighter
38890 Gonzalez, Steven Captain
57382 Larsen, Patrick Engineer
99186 McAninch, Scott Engineer
A
Page 5 of 6
NFIRS -1S Supplemental
40060 CA 01 08 2024 Fire Station 4
(FS4)
24-00167 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
E-4 and T-1 responded code 3 to a report of a T/C. On arrival E-4 found 3 vehicles involved with 1 minor injury. E-4 canceled
T-1. E-4 assessed one pt. See further pt information in the PCR. E-4 completed the assignment and returned.
A
Page 6 of 6
NFIRS -1 Basic
40060 CA 12 11 2023 Fire Station 3
(FS3)
23-07469 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
280 HIGUERA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
611-Dispatched and cancelled en route
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 12 11 2023 16:16
Arrival
Controlled
Last Unit
Cleared 12 11 2023 16:23
Shifts and Alarms
B FZ1
Shift
or
Platoon
Alarms District
Special Studies
ID#Value
Actions Taken
93-Cancelled en route
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 2 7
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 5
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
Remarks:
Cancelled in route by SLAS.
Authorization
92710 Witt, James Fire Fighter 12/11/2023
Officer In Charge ID Signature Position or Rank Assignment Date
92710 Witt, James Fire Fighter 12/11/2023
Member Making Report ID Signature Position or Rank Assignment Date
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NFIRS -9 Apparatus or Resources
40060 CA 12 11 2023 Fire Station 3
(FS3)
23-07469 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:E3
Type:11-Engine
Dispatch:12/11/2023 16:17
Arrival:
Clear:12/11/2023 16:23
Sent 3 Suppression
EMS
Other
ID:T1
Type:12-Truck or aerial
Dispatch:12/11/2023 16:16
Arrival:
Clear:
Sent 4 Suppression
EMS
Other
A
Page 3 of 5
NFIRS -10 Personnel
40060 CA 12 11 2023 Fire Station 3
(FS3)
23-07469 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:E3
Type:11-Engine
Dispatch:12/11/2023 16:17
Arrival:
Clear:12/11/2023 16:23
Sent 3 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
100068 Barkhimer, Jake Firefighter
36520 Gatton, Christopher Engineer
92710 Witt, James Captain
ID:T1
Type:12-Truck or aerial
Dispatch:12/11/2023 16:16
Arrival:
Clear:
Sent 4 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
100076 McClanahan, Maren Firefighter
25944 Child, Robert Engineer
60045 Lokkart, Eric Captain
70995 Pratt, Jason Engineer
A
Page 4 of 5
NFIRS -1S Supplemental
40060 CA 12 11 2023 Fire Station 3
(FS3)
23-07469 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
Cancelled in route by SLAS.
A
Page 5 of 5
NFIRS -1 Basic
40060 CA 08 04 2023 Fire Station 1
(FS1)
23-04645 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
280 HIGUERA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
600-Good intent call, 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
Their FDID Their
State
Their Incident Number
Dates and Times
Alarm 08 04 2023 20:38
Arrival 08 04 2023 20:44
Controlled
Last Unit
Cleared 08 04 2023 20:50
Shifts and Alarms
A FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 3 - No,
COVID
19 was
not a
factor
ID#Value
Actions Taken
86-Investigate
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 1 4
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 6
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:
963-Street or road in
commercial area
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
Remarks:
T-1 responded code 2 to a report of a seagull into the power line, brief power outage before returning. On arrival T-1 found a
large bird hanging from the power line, no fire, no immediate hazard. T-1 requested dispatch contact PG&E to have a crew respond
and remove the bird from the line. T-1 completed the assignment and returned.
H1
H2
H3 I
J
K2
L
Page 2 of 6
Authorization
44555 Hasch, Nathan Captain 08/05/2023
Officer In Charge ID Signature Position or Rank Assignment Date
44555 Hasch, Nathan Captain 08/05/2023
Member Making Report ID Signature Position or Rank Assignment Date
M
Page 3 of 6
NFIRS -9 Apparatus or Resources
40060 CA 08 04 2023 Fire Station 1
(FS1)
23-04645 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:08/04/2023 20:38
Arrival:08/04/2023 20:44
Clear:08/04/2023 20:50
Sent 4 Suppression
EMS
Other
A
Page 4 of 6
NFIRS -10 Personnel
40060 CA 08 04 2023 Fire Station 1
(FS1)
23-04645 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:08/04/2023 20:38
Arrival:08/04/2023 20:44
Clear:08/04/2023 20:50
Sent 4 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
44555 Hasch, Nathan Captain
90841 Weis, Trevor Engineer
99164 Sabatino, Jacob Engineer
99162 Kraemer, Luke Firefighter
A
Page 5 of 6
NFIRS -1S Supplemental
40060 CA 08 04 2023 Fire Station 1
(FS1)
23-04645 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
T-1 responded code 2 to a report of a seagull into the power line, brief power outage before returning. On arrival T-1 found
a large bird hanging from the power line, no fire, no immediate hazard. T-1 requested dispatch contact PG&E to have a crew
respond and remove the bird from the line. T-1 completed the assignment and returned.
A
Page 6 of 6
NFIRS -1 Basic
40060 CA 06 18 2023 Fire Station 1
(FS1)
23-03651 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
280 HIGUERA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
611-Dispatched and cancelled en route
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 18 2023 14:19
Arrival
Controlled
Last Unit
Cleared 06 18 2023 14:25
Shifts and Alarms
A FZ1
Shift
or
Platoon
Alarms District
Special Studies
ID#Value
Actions Taken
93-Cancelled en route
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 1 2
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 5
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
Remarks:
Dispatched, cancelled en route.
Authorization
99163 Martin, Ted 06/19/2023
Officer In Charge ID Signature Position or Rank Assignment Date
99163 Martin, Ted 06/19/2023
Member Making Report ID Signature Position or Rank Assignment Date
H1
H2
H3 I
J
K2
L
M
Page 2 of 5
NFIRS -9 Apparatus or Resources
40060 CA 06 18 2023 Fire Station 1
(FS1)
23-03651 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:MR1
Type:70-Medical & rescue unit, other
Dispatch:06/18/2023 14:20
Arrival:
Clear:06/18/2023 14:25
Sent 2 Suppression
EMS
Other
A
Page 3 of 5
NFIRS -10 Personnel
40060 CA 06 18 2023 Fire Station 1
(FS1)
23-03651 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:MR1
Type:70-Medical & rescue unit, other
Dispatch:06/18/2023 14:20
Arrival:
Clear:06/18/2023 14:25
Sent 2 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
99162 Kraemer, Luke AR
99163 Martin, Ted AR
A
Page 4 of 5
NFIRS -1S Supplemental
40060 CA 06 18 2023 Fire Station 1
(FS1)
23-03651 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
Dispatched, cancelled en route.
A
Page 5 of 5
NFIRS -1 Basic
40060 CA 05 10 2023 Fire Station 1
(FS1)
23-02814 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
280 HIGUERA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
561-Unauthorized burning
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 05 10 2023 20:15
Arrival 05 10 2023 20:21
Controlled 05 10 2023 20:23
Last Unit
Cleared 05 10 2023 20:26
Shifts and Alarms
C FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 3 - No,
COVID
19 was
not a
factor
ID#Value
Actions Taken
86-Investigate
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 1 5
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 6
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
Remarks:
T1 responded to smoke seen and smelled in the area of the creek behind the business. T1 found a transient encampment with
illegal warming/ cooking fire. Fire was extinguished by a transient at the scene. T1 cleared.
H1
H2
H3 I
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Page 2 of 6
Authorization
34590 Flatos, Alec Fire Captain 05/11/2023
Officer In Charge ID Signature Position or Rank Assignment Date
34590 Flatos, Alec Fire Captain 05/11/2023
Member Making Report ID Signature Position or Rank Assignment Date
M
Page 3 of 6
NFIRS -9 Apparatus or Resources
40060 CA 05 10 2023 Fire Station 1
(FS1)
23-02814 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:05/10/2023 20:15
Arrival:05/10/2023 20:21
Clear:05/10/2023 20:26
Sent 5 Suppression
EMS
Other
A
Page 4 of 6
NFIRS -10 Personnel
40060 CA 05 10 2023 Fire Station 1
(FS1)
23-02814 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:05/10/2023 20:15
Arrival:05/10/2023 20:21
Clear:05/10/2023 20:26
Sent 5 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
100069 DeLeuw, Casey .FF
25944 Child, Robert Engineer
34590 Flatos, Alec Captain
90841 Weis, Trevor Engineer
99187 Sensenbach, Mickey Firefighter
A
Page 5 of 6
NFIRS -1S Supplemental
40060 CA 05 10 2023 Fire Station 1
(FS1)
23-02814 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
T1 responded to smoke seen and smelled in the area of the creek behind the business. T1 found a transient encampment
with illegal warming/ cooking fire. Fire was extinguished by a transient at the scene. T1 cleared.
A
Page 6 of 6
NFIRS -1 Basic
40060 CA 04 10 2023 Fire Station 1
(FS1)
23-02183 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
280 HIGUERA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
522-Water or steam leak
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 04 10 2023 16:50
Arrival 04 10 2023 16:54
Controlled
Last Unit
Cleared 04 10 2023 17:12
Shifts and Alarms
C FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 4 -
Unknown
ID#Value
Actions Taken
64-Shut down system
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 1 4
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 6
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:
965-Vehicle parking area
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
Remarks:
T1 responded to a deliver cargo truck that had backed into a fire hydrant. Hydrant was still upright and untacked however a small
leak from base of hydrant. Truck rear side step was caught on hydrant, T1 crew removed the step from the truck and the
operator/driver of the vehicle was able to pull away from the hydrant with no further damage. T1 FF turned water valve off with
water shut off key tool. T1 contacted via cell phone city water department stand by (Chris), and informed him of situation, per water
stand by T1 cleared scene. `No other damage was found.
H1
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Page 2 of 6
Authorization
14845 Barrett, Richard Fire Engineer 04/10/2023
Officer In Charge ID Signature Position or Rank Assignment Date
14845 Barrett, Richard Fire Engineer 04/10/2023
Member Making Report ID Signature Position or Rank Assignment Date
M
Page 3 of 6
NFIRS -9 Apparatus or Resources
40060 CA 04 10 2023 Fire Station 1
(FS1)
23-02183 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:04/10/2023 16:50
Arrival:04/10/2023 16:54
Clear:04/10/2023 17:12
Sent 4 Suppression
EMS
Other
A
Page 4 of 6
NFIRS -10 Personnel
40060 CA 04 10 2023 Fire Station 1
(FS1)
23-02183 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:04/10/2023 16:50
Arrival:04/10/2023 16:54
Clear:04/10/2023 17:12
Sent 4 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
14845 Barrett, Richard Captain
61580 Mason, Ryan Engineer
99161 Hutslar, Dane Engineer
99164 Sabatino, Jacob Firefighter
A
Page 5 of 6
NFIRS -1S Supplemental
40060 CA 04 10 2023 Fire Station 1
(FS1)
23-02183 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
T1 responded to a deliver cargo truck that had backed into a fire hydrant. Hydrant was still upright and untacked however a
small leak from base of hydrant. Truck rear side step was caught on hydrant, T1 crew removed the step from the truck and the
operator/driver of the vehicle was able to pull away from the hydrant with no further damage. T1 FF turned water valve off with
water shut off key tool. T1 contacted via cell phone city water department stand by (Chris), and informed him of situation, per water
stand by T1 cleared scene. `No other damage was found.
A
Page 6 of 6
NFIRS -1 Basic
40060 CA 05 22 2022 Fire Station 1
(FS1)
22-02848 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
280 HIGUERA
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
Their FDID Their
State
Their Incident Number
Dates and Times
Alarm 05 22 2022 14:59
Arrival 05 22 2022 15:03
Controlled
Last Unit
Cleared 05 22 2022 15:11
Shifts and Alarms
C FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 3 - No,
COVID
19 was
not a
factor
ID#Value
Actions Taken
92-Standby
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 1 4
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 5
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:
500-Mercantile, business,
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
Remarks:
Upon arrival T1 assisted loading Pt. for transport.
Authorization
88690 Vasquez, Mark Fire Captain 05/25/2022
Officer In Charge ID Signature Position or Rank Assignment Date
88690 Vasquez, Mark Fire Captain 05/25/2022
Member Making Report ID Signature Position or Rank Assignment Date
H1
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Page 2 of 5
NFIRS -9 Apparatus or Resources
40060 CA 05 22 2022 Fire Station 1
(FS1)
22-02848 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:05/22/2022 15:00
Arrival:05/22/2022 15:03
Clear:05/22/2022 15:11
Sent 4 Suppression
EMS
Other
A
Page 3 of 5
NFIRS -10 Personnel
40060 CA 05 22 2022 Fire Station 1
(FS1)
22-02848 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:05/22/2022 15:00
Arrival:05/22/2022 15:03
Clear:05/22/2022 15:11
Sent 4 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
61580 Mason, Ryan Engineer
36520 Gatton, Christopher Engineer
88690 Vasquez, Mark Captain
99164 Sabatino, Jacob Firefighter
A
Page 4 of 5
NFIRS -1S Supplemental
40060 CA 05 22 2022 Fire Station 1
(FS1)
22-02848 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
Upon arrival T1 assisted loading Pt. for transport.
A
Page 5 of 5
NFIRS -1 Basic
40060 CA 11 20 2021 Fire Station 1
(FS1)
21-05777 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
280 HIGUERA
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
Their FDID Their
State
Their Incident Number
Dates and Times
Alarm 11 20 2021 17:00
Arrival 11 20 2021 17:06
Controlled
Last Unit
Cleared 11 20 2021 17:38
Shifts and Alarms
B FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 3 - No,
COVID
19 was
not a
factor
ID#Value
Actions Taken
33-Provide advanced life support (ALS)
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 3 8
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 6
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:
900-Outside or special
property, 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
Remarks:
Dispatched to above location for report of person in the creek area possibly 1144 per 911 caller. On arrival, T1 made access down
the open space area to the creek. E4 advised to relocate to an area off N101 to find better access. E4 Paramedic made access to
the pt. first. The pt. was found face down in the creek area approximately 25 feet down an embankment adjacent to a homeless
camp. E4 paramedic Doolin confirmed the pt. was 1144 and turned the scene over to SLOPD who was already at scene. . E4 was
released by T1. T1 stood by while SLOPD secured the area. T1 was released by SLOPD. See EPCR for further info on the pt.
H1
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Authorization
62800 MacDonald, John 11/21/2021
Officer In Charge ID Signature Position or Rank Assignment Date
62800 MacDonald, John 11/21/2021
Member Making Report ID Signature Position or Rank Assignment Date
M
Page 3 of 6
NFIRS -9 Apparatus or Resources
40060 CA 11 20 2021 Fire Station 1
(FS1)
21-05777 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:11/20/2021 17:00
Arrival:11/20/2021 17:06
Clear:
Sent 1 Suppression
EMS
Other
92-Standby
ID:E4
Type:11-Engine
Dispatch:11/20/2021 17:00
Arrival:11/20/2021 17:06
Clear:11/20/2021 17:22
Sent 3 Suppression
EMS
Other
92-Standby
ID:T1
Type:12-Truck or aerial
Dispatch:11/20/2021 17:00
Arrival:11/20/2021 17:06
Clear:11/20/2021 17:38
Sent 4 Suppression
EMS
Other
33-Provide advanced life support (ALS)
A
Page 4 of 6
NFIRS -10 Personnel
40060 CA 11 20 2021 Fire Station 1
(FS1)
21-05777 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:11/20/2021 17:00
Arrival:11/20/2021 17:06
Clear:
Sent 1 Suppression
EMS
Other
92-Standby
Personnel ID Name Rank Role Attend Actions Taken
35110 Fox II, Samuel Battalion
Chief
ID:E4
Type:11-Engine
Dispatch:11/20/2021 17:00
Arrival:11/20/2021 17:06
Clear:11/20/2021 17:22
Sent 3 Suppression
EMS
Other
92-Standby
Personnel ID Name Rank Role Attend Actions Taken
59710 Lipson, Matthew Captain
57382 Larsen, Patrick Engineer
30791 Doolin, Luke Firefighter
ID:T1
Type:12-Truck or aerial
Dispatch:11/20/2021 17:00
Arrival:11/20/2021 17:06
Clear:11/20/2021 17:38
Sent 4 Suppression
EMS
Other
33-Provide advanced life support (ALS)
Personnel ID Name Rank Role Attend Actions Taken
62800 MacDonald, John Captain
70100 Polkow, Matthew Engineer
50826 Johnston, Kenneth Engineer
92710 Witt, James Firefighter
A
Page 5 of 6
NFIRS -1S Supplemental
40060 CA 11 20 2021 Fire Station 1
(FS1)
21-05777 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
Dispatched to above location for report of person in the creek area possibly 1144 per 911 caller. On arrival, T1 made access
down the open space area to the creek. E4 advised to relocate to an area off N101 to find better access. E4 Paramedic made access
to the pt. first. The pt. was found face down in the creek area approximately 25 feet down an embankment adjacent to a homeless
camp. E4 paramedic Doolin confirmed the pt. was 1144 and turned the scene over to SLOPD who was already at scene. . E4 was
released by T1. T1 stood by while SLOPD secured the area. T1 was released by SLOPD. See EPCR for further info on the pt.
A
Page 6 of 6
NFIRS -1 Basic
40060 CA 11 04 2021 Fire Station 3
(FS3)
21-05435 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
280 HIGUERA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
622-No incident found on arrival at dispatch address
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 11 04 2021 14:41
Arrival 11 04 2021 14:44
Controlled
Last Unit
Cleared 11 04 2021 14:46
Shifts and Alarms
C FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 3 - No,
COVID
19 was
not a
factor
ID#Value
Actions Taken
92-Standby
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 5
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
Remarks:
Upon arrival no emergency found; E3 cancelled.
Authorization
88690 Vasquez, Mark Fire Captain 11/05/2021
Officer In Charge ID Signature Position or Rank Assignment Date
88690 Vasquez, Mark Fire Captain 11/05/2021
Member Making Report ID Signature Position or Rank Assignment Date
H1
H2
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Page 2 of 5
NFIRS -9 Apparatus or Resources
40060 CA 11 04 2021 Fire Station 3
(FS3)
21-05435 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:E3
Type:11-Engine
Dispatch:11/04/2021 14:42
Arrival:11/04/2021 14:44
Clear:11/04/2021 14:46
Sent 3 Suppression
EMS
Other
A
Page 3 of 5
NFIRS -10 Personnel
40060 CA 11 04 2021 Fire Station 3
(FS3)
21-05435 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:E3
Type:11-Engine
Dispatch:11/04/2021 14:42
Arrival:11/04/2021 14:44
Clear:11/04/2021 14:46
Sent 3 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
88690 Vasquez, Mark Captain
92310 Williams, Nathan Engineer
30791 Doolin, Luke Firefighter
A
Page 4 of 5
NFIRS -1S Supplemental
40060 CA 11 04 2021 Fire Station 3
(FS3)
21-05435 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
Upon arrival no emergency found; E3 cancelled.
A
Page 5 of 5
NFIRS -1 Basic
40060 CA 12 06 2020 Fire Station 1
(FS1)
20-05488 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
280 HIGUERA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
611-Dispatched and cancelled en route
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 12 06 2020 12:17
Arrival
Controlled
Last Unit
Cleared 12 06 2020 12:23
Shifts and Alarms
A FZ1
Shift
or
Platoon
Alarms District
Special Studies
ID#Value
Actions Taken
93-Cancelled en route
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 1 4
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 5
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
Remarks:
Cancelled by SLAS
Authorization
59710 59710 Fire Captain 12/06/2020
Officer In Charge ID Signature Position or Rank Assignment Date
59710 59710 Fire Captain 12/06/2020
Member Making Report ID Signature Position or Rank Assignment Date
H1
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NFIRS -9 Apparatus or Resources
40060 CA 12 06 2020 Fire Station 1
(FS1)
20-05488 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:12/06/2020 12:17
Arrival:12/06/2020 12:22
Clear:12/06/2020 12:23
Sent 4 Suppression
EMS
Other
A
Page 3 of 5
NFIRS -10 Personnel
40060 CA 12 06 2020 Fire Station 1
(FS1)
20-05488 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:12/06/2020 12:17
Arrival:12/06/2020 12:22
Clear:12/06/2020 12:23
Sent 4 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
50826 Johnston, Kenneth Firefighter
73250 Renner, David Engineer
59710 Lipson, Matthew Captain
14845 Barrett, Richard Engineer
A
Page 4 of 5
NFIRS -1S Supplemental
40060 CA 12 06 2020 Fire Station 1
(FS1)
20-05488 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
Cancelled by SLAS
A
Page 5 of 5
NFIRS -1 Basic
40060 CA 11 24 2020 Fire Station 3
(FS3)
20-05268 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
280 HIGUERA
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 11 24 2020 13:08
Arrival 11 24 2020 13:12
Controlled
Last Unit
Cleared 11 24 2020 13:25
Shifts and Alarms
A FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 4 -
Unknown
ID#Value
Actions Taken
33-Provide advanced life support (ALS)
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 6
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:
500-Mercantile, business,
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
Remarks:
280 Higuera for a female who fell and had complaint of shoulder pain. E-3 personnel provided patient assessment and patient
care (see EMS report). The patient was transported to SVRMC by SLAS medic 52, E-3 returned to quarters.
H1
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Page 2 of 6
Authorization
54190 54190 Fire Captain 11/25/2020
Officer In Charge ID Signature Position or Rank Assignment Date
54190 54190 Fire Captain 11/25/2020
Member Making Report ID Signature Position or Rank Assignment Date
M
Page 3 of 6
NFIRS -9 Apparatus or Resources
40060 CA 11 24 2020 Fire Station 3
(FS3)
20-05268 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:E3
Type:11-Engine
Dispatch:11/24/2020 13:08
Arrival:11/24/2020 13:12
Clear:11/24/2020 13:25
Sent 3 Suppression
EMS
Other
A
Page 4 of 6
NFIRS -10 Personnel
40060 CA 11 24 2020 Fire Station 3
(FS3)
20-05268 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:E3
Type:11-Engine
Dispatch:11/24/2020 13:08
Arrival:11/24/2020 13:12
Clear:11/24/2020 13:25
Sent 3 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
54190 King, Michael Captain
54183 King, John Engineer
66265 Nason, William Firefighter
A
Page 5 of 6
NFIRS -1S Supplemental
40060 CA 11 24 2020 Fire Station 3
(FS3)
20-05268 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
280 Higuera for a female who fell and had complaint of shoulder pain. E-3 personnel provided patient assessment and
patient care (see EMS report). The patient was transported to SVRMC by SLAS medic 52, E-3 returned to quarters.
A
Page 6 of 6
NFIRS -1 Basic
40060 CA 11 14 2020 Fire Station 1
(FS1)
20-05121 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
280 HIGUERA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
IncidentType_MedicalAssistAssistEMSCrew
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 11 14 2020 18:16
Arrival 11 14 2020 18:21
Controlled
Last Unit
Cleared 11 14 2020 18:48
Shifts and Alarms
B FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 4 -
Unknown
ID#Value
Actions Taken
34-Transport person
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 1 4
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 6
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
Remarks:
600' up trail head to transient campsite where female was found. Assist with extrication from tent to gurney. Assist SLAS with
pushing gurney to ambulance. See SLAS PCR for care and treatment.
H1
H2
H3 I
J
K2
L
Page 2 of 6
Authorization
38890 Gonzalez, Steven Fire Captain 11/16/2020
Officer In Charge ID Signature Position or Rank Assignment Date
38890 Gonzalez, Steven Fire Captain 11/16/2020
Member Making Report ID Signature Position or Rank Assignment Date
M
Page 3 of 6
NFIRS -9 Apparatus or Resources
40060 CA 11 14 2020 Fire Station 1
(FS1)
20-05121 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:11/14/2020 18:16
Arrival:11/14/2020 18:21
Clear:11/14/2020 18:48
Sent 4 Suppression
EMS
Other
A
Page 4 of 6
NFIRS -10 Personnel
40060 CA 11 14 2020 Fire Station 1
(FS1)
20-05121 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:11/14/2020 18:16
Arrival:11/14/2020 18:21
Clear:11/14/2020 18:48
Sent 4 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
38890 Gonzalez, Steven Captain
36520 Gatton, Christopher Engineer
25944 Child, Robert Engineer
92710 Witt, James Firefighter
A
Page 5 of 6
NFIRS -1S Supplemental
40060 CA 11 14 2020 Fire Station 1
(FS1)
20-05121 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
600' up trail head to transient campsite where female was found. Assist with extrication from tent to gurney. Assist SLAS
with pushing gurney to ambulance. See SLAS PCR for care and treatment.
A
Page 6 of 6
NFIRS -1 Basic
40060 CA 07 30 2020 Fire Station 1
(FS1)
20-03348 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
280 HIGUERA
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 07 30 2020 13:33
Arrival 07 30 2020 13:38
Controlled
Last Unit
Cleared 07 30 2020 14:12
Shifts and Alarms
C FZ1
Shift
or
Platoon
Alarms District
Special Studies
9244 4 -
Unknown
ID#Value
Actions Taken
33-Provide advanced life support (ALS)
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 1 4
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:$
A
B
C
D
E1 E2
E3
F G1 G2
Page 1 of 6
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
Remarks:
Male found at transient camp approx. 500' behind Madonna property. Access via Bianchi bridge. Large camp area where RP
reported male unconscious but breathing. See ePCR for findings, assessment and treatment. Paramedic follow up to local ER.
H1
H2
H3 I
J
K2
L
Page 2 of 6
Authorization
38890 Gonzalez, Steven Fire Captain 07/31/2020
Officer In Charge ID Signature Position or Rank Assignment Date
61580 61580 07/31/2020
Member Making Report ID Signature Position or Rank Assignment Date
M
Page 3 of 6
NFIRS -9 Apparatus or Resources
40060 CA 07 30 2020 Fire Station 1
(FS1)
20-03348 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:07/30/2020 13:33
Arrival:07/30/2020 13:38
Clear:07/30/2020 14:12
Sent 4 Suppression
EMS
Other
A
Page 4 of 6
NFIRS -10 Personnel
40060 CA 07 30 2020 Fire Station 1
(FS1)
20-03348 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:T1
Type:12-Truck or aerial
Dispatch:07/30/2020 13:33
Arrival:07/30/2020 13:38
Clear:07/30/2020 14:12
Sent 4 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
38890 Gonzalez, Steven Captain
61580 Mason, Ryan Engineer
70100 Polkow, Matthew Engineer
57382 Larsen, Patrick Firefighter
A
Page 5 of 6
NFIRS -1S Supplemental
40060 CA 07 30 2020 Fire Station 1
(FS1)
20-03348 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
Male found at transient camp approx. 500' behind Madonna property. Access via Bianchi bridge. Large camp area where
RP reported male unconscious but breathing. See ePCR for findings, assessment and treatment. Paramedic follow up to local ER.
A
Page 6 of 6