HomeMy WebLinkAboutFire ReportNFIRS -1 Basic
40060 CA 08 10 2025 Fire Station 4
(FS4)
25-04687 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
ROYAL
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
LOVR
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 08 10 2025 10:36
Arrival 08 10 2025 10:40
Controlled
Last Unit
Cleared 08 10 2025 13:26
Shifts and Alarms
C FZ4
Shift
or
Platoon
Alarms District
Special Studies
9244 3 - No,
COVID
19 was
not a
factor
ID#Value
Actions Taken
32-Provide basic life support (BLS)
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 5 12
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
H1
H2
H3 I
J
K2
Page 2 of 6
Remarks:
Units dispatched to MVC with a vehicle into a building. E4 arrived, established Valley IC, and began Pt care. BC4 with BC1 arrived
at scene; BC4 assumed Valley IC and assigned T1 to a primary search inside the affected building. T2 requested code 2 for USAR
shoring evaluation.
3 Pt's involved. 1 Pt (driver of SUV into building) had self-extricated upon arrival. Pt/Driver evaluated by SLAS and willingly signed
AMA. 2 additional Pt's were in the second vehicle on the East side of LOVR with E4 medic assessing both Pt's. 1 Pt willingly signed
AMA, second Pt transport via SLAS. Pt 1 of the second vehicle rode along as translator for EMS.
BC1 contacted City building official for evaluation of occupancy.
Vehicle removed from building by tow truck without incident.
Units assisted residents into their apartments to gather belongings for a possible extended duration of removal from occupancy.
BC4 issued 1 SAVE card for each apartment. Red Cross requested for additional assistance.
Upon arrival of Building Official, BC4 and BC1 with pass on of scene and incident. Confirmed with the building official that power
was shut down to both units involved.
The resident complex manager advised to have the building opening boarded up. Manager noted that a crew was en route to
evaluate and board up.
Residents left in the care of the Red Cross, building TOT SLO City Building Official, Command terminated all units, cleared.
Authorization
34590 Flatos, Alec Fire Captain 08/10/2025
Officer In Charge ID Signature Position or Rank Assignment Date
34590 Flatos, Alec Fire Captain 08/10/2025
Member Making Report ID Signature Position or Rank Assignment Date
L
M
Page 3 of 6
NFIRS -9 Apparatus or Resources
40060 CA 08 10 2025 Fire Station 4
(FS4)
25-04687 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:BC1
Type:92-Chief officer car
Dispatch:08/10/2025 10:36
Arrival:08/10/2025 10:42
Clear:
Sent 1 Suppression
EMS
Other
81-Incident command
ID:BC4
Type:92-Chief officer car
Dispatch:
Arrival:08/10/2025 10:42
Clear:08/10/2025 13:26
Sent 1 Suppression
EMS
Other
81-Incident command
ID:E4
Type:11-Engine
Dispatch:08/10/2025 10:36
Arrival:08/10/2025 10:40
Clear:08/10/2025 12:08
Sent 3 Suppression
EMS
Other
33-Provide advanced life support (ALS)
ID:T1
Type:12-Truck or aerial
Dispatch:08/10/2025 10:36
Arrival:08/10/2025 10:44
Clear:
Sent 4 Suppression
EMS
Other
20-Search & rescue, other
ID:T2
Type:12-Truck or aerial
Dispatch:08/10/2025 10:36
Arrival:08/10/2025 10:46
Clear:08/10/2025 12:03
Sent 3 Suppression
EMS
Other
86-Investigate
A
Page 4 of 6
NFIRS -10 Personnel
40060 CA 08 10 2025 Fire Station 4
(FS4)
25-04687 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:BC1
Type:92-Chief officer
car
Dispatch:08/10/2025 10:36
Arrival:08/10/2025 10:42
Clear:
Sent 1 Suppression
EMS
Other
81-Incident command
Personnel ID Name Rank Role Attend Actions Taken
41550 Hais, Ray Battalion
Chief
ID:BC4
Type:92-Chief officer
car
Dispatch:
Arrival:08/10/2025 10:42
Clear:08/10/2025 13:26
Sent 1 Suppression
EMS
Other
81-Incident command
Personnel ID Name Rank Role Attend Actions Taken
34590 Flatos, Alec Fire
Captain
5588009-Chief Officer 81-Incident command
ID:E4
Type:11-Engine
Dispatch:08/10/2025 10:36
Arrival:08/10/2025 10:40
Clear:08/10/2025 12:08
Sent 3 Suppression
EMS
Other
33-Provide advanced life
support (ALS)
Personnel ID Name Rank Role Attend Actions Taken
99552 Morrison, Keanu Firefighter
25944 Child, Robert Captain
92335 Williams, Joseph Engineer
ID:T1
Type:12-Truck or
aerial
Dispatch:08/10/2025 10:36
Arrival:08/10/2025 10:44
Clear:
Sent 4 Suppression
EMS
Other
20-Search & rescue, other
Personnel ID Name Rank Role Attend Actions Taken
70995 Pratt, Jason Captain
70100 Polkow, Matthew Engineer
34590 Flatos, Alec Firefighter
90841 Weis, Trevor Engineer
ID:T2
Type:12-Truck or
aerial
Dispatch:08/10/2025 10:36
Arrival:08/10/2025 10:46
Clear:08/10/2025 12:03
Sent 3 Suppression
EMS
Other
86-Investigate
Personnel ID Name Rank Role Attend Actions Taken
74579 Robertson, Travis Engineer
44555 Hasch, Nathan Captain
109137 Saunders, Cole Firefighter
A
Page 5 of 6
NFIRS -1S Supplemental
40060 CA 08 10 2025 Fire Station 4
(FS4)
25-04687 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
Units dispatched to MVC with a vehicle into a building. E4 arrived, established Valley IC, and began Pt care. BC4 with BC1
arrived at scene; BC4 assumed Valley IC and assigned T1 to a primary search inside the affected building. T2 requested code 2 for
USAR shoring evaluation.
3 Pt's involved. 1 Pt (driver of SUV into building) had self-extricated upon arrival. Pt/Driver evaluated by SLAS and willingly signed
AMA. 2 additional Pt's were in the second vehicle on the East side of LOVR with E4 medic assessing both Pt's. 1 Pt willingly signed
AMA, second Pt transport via SLAS. Pt 1 of the second vehicle rode along as translator for EMS.
BC1 contacted City building official for evaluation of occupancy.
Vehicle removed from building by tow truck without incident.
Units assisted residents into their apartments to gather belongings for a possible extended duration of removal from occupancy.
BC4 issued 1 SAVE card for each apartment. Red Cross requested for additional assistance.
Upon arrival of Building Official, BC4 and BC1 with pass on of scene and incident. Confirmed with the building official that power
was shut down to both units involved.
The resident complex manager advised to have the building opening boarded up. Manager noted that a crew was en route to
evaluate and board up.
Residents left in the care of the Red Cross, building TOT SLO City Building Official, Command terminated all units, cleared.
Additional Narrative (#1 of 3):
Upon Truck 1 arrival, Truck 1 crew was assigned to utility lock out and interior primary search.
Truck 1 crew shut down water and completed an all clear for primary search.
Truck 1 crew flagged and denied entry to effected area.
Truck 1 was released by Valley IC.
Truck 1 cleared, available.
Additional Narrative (#2 of 3):
E4 responded for vehicle collision with reports of multiple vehicles involved. E4 arrived on scene and established command
and provided scene size up. E4 relieved from IC by Batt4. E4 provided medical for two occupants of sedan in the roadway, 1 patient
transported with SLAS, see ePCR for medical details. E4 assisted occupants of effected vehicle into structure with personal
property removal. E4 released by IC, available at scene.
Additional Narrative (#3 of 3):
On arrival T-2 was assigned to evaluate the building and determine if shoring was needed. T-2 made entry into the structure
and found T-1 completing the primary search. T-2 pulled some ceiling in the effected room noting the compromised wall was load
bearing, the structure was not resting on the vehicle and DIV 2 did not appear to be sagging. T-2 advised the IC with no life safety
concern in the structure, T-2 recommended removing the vehicle and reevaluating the need for shoring once the vehicle was
removed. T-2 observed no movement of the structure while the vehicle was being removed. T-2 discussed with the IC that the
building was static and shoring/repair of the damaged wall could be handled by the owners contractor. T-2 was released.
A
Page 6 of 6