HomeMy WebLinkAbout19-05219_RedactedNFIRS-1 Basic
40060 CA 10 11 2019 Fire Station
1 (FS1)
19-05219 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
519 BRIZZOLARA
Number Prefix Street or Highway Street Type Suffix
San Luis Obispo CA 93401
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
111-Structure Fire
Aid Given Or Received
1 Mutual Aid Received
2 Auto. Aid Received
3 Mutual Aid Given
4 Auto. Aid Given
5 Other Aid Given
None
California
Their FDID Their
State
Their Incident Number
Dates and Times
Alarm 10 11 2019 18:34
Arrival 10 11 2019 18:39
Controlled 10 11 2019 18:41
Last Unit
Cleared
10 11 2019 20:50
Shifts and Alarms
C 1 FZ1
Shift or
Platoon
Alarms District
Special Studies
ID#Value
A
B
C
D
E1 E2
E3
Page 1 of 13
Actions Taken
11-Extinguishment by fire service
personnel
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 6 15
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:$ 1,223.00
Contents:$ 100.00
Pre-Incident Values: Optional None
Property:$ 122,326.00
Contents:$ 100.00
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.
Person/Entity Involved Employee Stand Strong
Local Option Person/Entity Type Business Name (if applicable)Phone Number
MS-Ms.
Mr., Ms., Mrs.First Name MI Last Name Suffix
Number Prefix Street or Highway Street Type Suffix
Post Office Box Apt./Suite/Room City
State Zip Code
F G1 G2
H1
H2
H3 I
J
K1
Page 2 of 13
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 my arrival I reported a 4 unit complex with building C being a one story, single family occupancy with light smoke
showing from side D. Brizzolara IC was established and utilized City Tac 1.
T2 was assigned to investigate and extinguish the fire. T1 was assigned to ventilate and control the utilities. The gas an
electrical were shut off. Prior to the electrical being shut off, it was noted that electrical breaker #1 had been tripped, see
attached photo.
T2 and T1 were able to locate the fire underneath the structure. It was a small fire burning in some cardboard boxes. An 1
3/4" hose line was used to extinguish the fire, preserving the fire scene.
E3, E4, and Cal Fire resources were released.
Prevention 20 performed fire investigation. See his narrative for origin and cause.
I left a voice mail for from Stand Strong, the building owner, to let them know of the fire damage to the building and
that the building was uninhabitable due to the fire melting the sewer pipe and the electrical lines underneath the house.
I left a voice mail for Paula Frojae, from the City of San Luis Obispo Building Department, to let her know that the structure
had been damaged and that the occupants were displaced. I also followed up with an email.
Red Cross arrived on scene and provided assistance to Ms. I also provide a $250.00 S.A.V.E. card from the
California Professional Firefighters.
Authorization
16750 Berryman, Neal Fire Battalion Chief 10/12/2019
Officer In Charge ID Signature Position or Rank Assignment Date
80947 Skove, Shayne Fire Captain 10/12/2019
Member Making Report
ID
Signature Position or Rank Assignment Date
K2
L
M
Page 3 of 13
NFIRS-2 Fire
40060 CA 10 11 2019 Fire Station
1 (FS1)
19-05219 0
FDID State Month Day Year Station Number Exposure
Property Details
B1 1 Not Residential
Estimated number of residential living units in the building
of origin whether or not all units became involved
B2 1 Buildings Not Involved
Number of buildings involved
B3 None Less than 1 acre
Acres burned (outside fires)
On-Site Materials
Or Products
On-Site Materials
Storage Use
Ignition
D1
71-Substructure area or
space, crawl space
Area of Fire Origin
D2 65-Lighter: cigarette, cigar
Heat Source
D3
51-Box, carton, bag, basket,
barrel
Item First Ignited
D4 68-Cardboard
Type of Material First Ignited
Cause of Ignition
1 - Intentional
2 - Unintentional
3 - Failure of Equipment or Heat
Source
4 - Act of Nature
5 - Cause Under Investigation
U - Cause Undetermined After
Investigation
Factors Contributing to Ignition
19-Playing with heat source
Factor Contributing to Ignition
Human Factors Contributing to
Ignition
Check all applicable boxes
None
1 - Asleep
2 - Possibly impaired by alcohol or
drugs
3 - Unattended person
4 - Possibly Mentally Disabled
5 - Physically Disabled
6 - Multiple Persons Involved
7 - Age Was A Factor
Estimated Age of
Person Involved
Male Female
Equipment Involved In Ignition
None
Equipment Involved
Brand
Model
Serial #
Year
Equipment Power Source
Equipment Power Source
Equipment Portability
1 - Portable
2 - Stationary
Portable equipment normally can be moved by one or two
persons.
Fire Suppression Factors
A
B C
D E1
E2
E3
F1 F2
F3
G
Page 4 of 13
Mobile Property Involved
1 - Not involved in ignition, but burned
2 - Involved in ignition, but did not burn
3 - Involved in ignition and burned
None
Mobile Property Type and Make
Mobile Property Type
Mobile Property Make
Local Use
Pre-Fire Plan Available
Arson Report Attached
Police Report Attached
Coroner Report Attached
Other Reports Attached
Mobile Property Model Year
State License Plate Number VIN
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
H1 H2
Page 5 of 13
NFIRS-3 Structure Fire
Structure Type
1 - Enclosed Building
2 - Portable/Mobile Structure
3 - Open Structure
4 - Air-Supported Structure
5 - Tent
6 - Open Platform
7 - Underground Structure
8 - Connective Structure
0 - Other
Building Status
1 - Under Construction
2 - In Normal Use
3 - Idle, Not Routinely Used
4 - Under Major Renovation
5 - Vacant and Secured
6 - Vacant and Unsecured
7 - Being Demolished
0 - Other
U - Undetermined
Building Height
1
Number of Stories
At/Above Grade
0
Number of Stories
Below Grade
Main Floor Size
800
Total Square Feet
OR
BY
Length (ft) X Width (ft)
Fire Origin
0 Below Grade
Story of Fire Origin
Fire Spread
Confined to Object of Origin
2 - Confined to Room of Origin
3 - Confined to Floor of Origin
4 - Confined to Building of Origin
5 - Beyond Building of Origin
Number of Stories Damaged By Flame
Number of Stories w/Minor Damage (1-24%)
Number of Stories w/Significant Damage (25-49%)
Number of Stories w/Heavy Damage (50-74%)
Number of Stories w/Extreme Damage (75-100%)
*Count the roof as part of the highest story
Type of Material Contributing
Most to Flame Spread
K1
Item Contributing Most
to Flame Spread
K2
Type of Material
Contributing
Most To Flame Spread
Presence of Detectors
N - None Present
1 - Present
U - Undetermined
Detector Type
1 - Smoke
2 - Heat
3 - Combination of Smoke and Heat
4 - Sprinkler, Water Flow Detection
5 - More Than One Type Present
0 - Other
U - Undetermined
Detector Power Supply
1 - Battery Only
2 - Hardwire Only
3 - Plug-In
4 - Hardwire With Battery
5 - Plug-In With Battery
6 - Mechanical
7 - Multiple Detectors
& Power Supplies
0 - Other
U - Undetermined
Detector Operation
1 - Fire Too Small To
Activate
2 - Operated
3 - Failed To Operate
U - Undetermined
Detector Effectiveness
1 - Alerted Occupants, Occupants Responded
2 - Alerted Occupants, Occupants Failed to Respond
3 - There Were No Occupants
4 - Failed to Alert Occupants
U - Undetermined
Detector Failure Reason
1 - Power Failure, Shutoff, or Disconnect
2 - Improper Installation or Placement
3 - Defective
4 - Lack of Maintenance, Dirty
5 - Battery Missing or Disconnected
6 - Battery Discharged or Dead
0 - Other
U - Undetermined
I1 I2 I3 I4
J1
J2
J3 K
L1
L2
L3
L4
L5
L6
Page 6 of 13
Presence of Automatic Extinguishing
System
N - None Present
1 - Present
2 - Partial System Present
U - Undetermined
Type of Automatic Extinguishing
System
1 - Wet-Pipe Sprinkler
2 - Dry-Pipe Sprinkler
3 - Other Sprinkler System
4 - Dry Chemical System
5 - Foam System
6 - Halogen-Type System
7 - Carbon Dioxide System
0 - Other
U - Undetermined
Required if fire was within designed range
of AES
Operation of Automatic
Extinguishing System
1 - Operated/Effective
2 - Operated/Not Effective
3 - Fire Too Small To Activate
4 - Failed To Operate
0 - Other
U - Undetermined
Required if fire was within
designed range
Number of Sprinkler
Heads Operating
Required if system operated
Reason for Automatic Extinguishing
System Failure
1 - System Shut Off
2 - Not Enough Agent Discharged
3 - Agent Discharged But Did Not Reach Fire
4 - Wrong Type of System
5 - Fire Not In Area Protected
6 - System Components Damaged
7 - Lack of Maintenance
8 - Manual Intervention
0 - Other
U - Undetermined
Required if system failed or not effective
M1
M2
M3
M4
M5
Page 7 of 13
NFIRS-9 Apparatus or Resources
40060 CA 10 11 2019 Fire Station
1 (FS1)
19-05219 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:BC3
Type:92-Chief officer car
Dispatch:10/11/2019 18:34
Arrival:10/11/2019 18:42
Clear:10/11/2019 20:50
Sent 1 Suppression
EMS
Other
81-Incident command
ID:E3
Type:11-Engine
Dispatch:10/11/2019 18:34
Arrival:10/11/2019 18:41
Clear:10/11/2019 18:49
Sent 3 Suppression
EMS
Other
92-Standby
ID:E4
Type:11-Engine
Dispatch:10/11/2019 18:34
Arrival:10/11/2019 18:41
Clear:10/11/2019 18:49
Sent 3 Suppression
EMS
Other
92-Standby
ID:PRV20
Type:00-Other apparatus/resource
Dispatch:10/11/2019 19:12
Arrival:10/11/2019 19:29
Clear:
Sent 1 Suppression
EMS
Other
86-Investigate
ID:T1
Type:12-Truck or aerial
Dispatch:10/11/2019 18:34
Arrival:10/11/2019 18:40
Clear:10/11/2019 19:25
Sent 4 Suppression
EMS
Other
51-Ventilate
ID:T2
Type:12-Truck or aerial
Dispatch:10/11/2019 18:34
Arrival:10/11/2019 18:39
Clear:10/11/2019 20:26
Sent 3 Suppression
EMS
Other
11-Extinguishment by fire service personnel
A
Page 8 of 13
NFIRS-10 Personnel
40060 CA 10 11 2019 Fire Station
1 (FS1)
19-05219 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:BC3
Type:92-Chief officer car
Dispatch:10/11/2019 18:34
Arrival:10/11/2019 18:42
Clear:10/11/2019 20:50
Sent 1 Suppression
EMS
Other
81-Incident command
Personnel ID Name Rank Role Attend Actions Taken
16750 Berryman, Neal Battalion
Chief
ID:E3
Type:11-Engine
Dispatch:10/11/2019 18:34
Arrival:10/11/2019 18:41
Clear:10/11/2019 18:49
Sent 3 Suppression
EMS
Other
92-Standby
Personnel ID Name Rank Role Attend Actions Taken
41600 Hale, Gary Engineer
61000 Marshall, David Captain
90841 Weis, Trevor Firefighter
ID:E4
Type:11-Engine
Dispatch:10/11/2019 18:34
Arrival:10/11/2019 18:41
Clear:10/11/2019 18:49
Sent 3 Suppression
EMS
Other
92-Standby
Personnel ID Name Rank Role Attend Actions Taken
88690 Vasquez, Mark Captain
92710 Witt, James Firefighter
92335 Williams, Joseph Engineer
ID:PRV20
Type:00-Other apparatus/resource
Dispatch:10/11/2019 19:12
Arrival:10/11/2019 19:29
Clear:
Sent 1 Suppression
EMS
Other
86-Investigate
Personnel ID Name Rank Role Attend Actions Taken
Maggio, Rodger Fire
Marshal
ID:T1
Type:12-Truck or aerial
Dispatch:10/11/2019 18:34
Arrival:10/11/2019 18:40
Clear:10/11/2019 19:25
Sent 4 Suppression
EMS
Other
51-Ventilate
Personnel ID Name Rank Role Attend Actions Taken
61580 Mason, Ryan Engineer
14857 Barthel, Dustin Firefighter
38890 Gonzalez, Steven Captain
A
Page 9 of 13
46535 Hicks, Gene Engineer
ID:T2
Type:12-Truck or aerial
Dispatch:10/11/2019 18:34
Arrival:10/11/2019 18:39
Clear:10/11/2019 20:26
Sent 3 Suppression
EMS
Other
11-Extinguishment by fire service personnel
Personnel ID Name Rank Role Attend Actions Taken
70995 Pratt, Jason Engineer
80947 Skove, Shayne Captain
30791 Doolin, Luke Firefighter
Page 10 of 13
NFIRS-1S Supplemental
40060 CA 10 11 2019 Fire Station
1 (FS1)
19-05219 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
Upon my arrival I reported a 4 unit complex with building C being a one story, single family occupancy with light smoke
showing from side D. Brizzolara IC was established and utilized City Tac 1.
T2 was assigned to investigate and extinguish the fire. T1 was assigned to ventilate and control the utilities. The gas an
electrical were shut off. Prior to the electrical being shut off, it was noted that electrical breaker #1 had been tripped, see
attached photo.
T2 and T1 were able to locate the fire underneath the structure. It was a small fire burning in some cardboard boxes. An 1
3/4" hose line was used to extinguish the fire, preserving the fire scene.
E3, E4, and Cal Fire resources were released.
Prevention 20 performed fire investigation. See his narrative for origin and cause.
I left a voice mail for from Stand Strong, the building owner, to let them know of the fire damage to the building and
that the building was uninhabitable due to the fire melting the sewer pipe and the electrical lines underneath the house.
I left a voice mail for Paula Frojae, from the City of San Luis Obispo Building Department, to let her know that the structure
had been damaged and that the occupants were displaced. I also followed up with an email.
Red Cross arrived on scene and provided assistance to Ms. I also provide a $250.00 S.A.V.E. card from the
California Professional Firefighters.
Person/Entity Involved Reporting Party
Local Option Person/Entity Type Business Name (if applicable)Phone Number
Mr., Ms., Mrs.First Name MI Last Name Suffix
519 Brizzolara
Number Prefix Street or Highway Street Type Suffix
A City of San Luis Obispo
Post Office Box Apt./Suite/Room City
CA 93401
State Zip Code
A
Page 11 of 13
Person/Entity Involved Occupant
Local Option Person/Entity Type Business Name (if applicable)Phone Number
Mr., Ms., Mrs.First Name MI Last Name Suffix
519 Brizzolara
Number Prefix Street or Highway Street Type Suffix
C City of San Luis Obispo
Post Office Box Apt./Suite/Room City
CA 93401
State Zip Code
Person/Entity Involved Occupant
Local Option Person/Entity Type Business Name (if applicable)Phone Number
Mr., Ms., Mrs.First Name MI Last Name Suffix
519 Brizzolara
Number Prefix Street or Highway Street Type Suffix
C City of San Luis Obispo
Post Office Box Apt./Suite/Room City
CA 93401
State Zip Code
Person/Entity Involved Other SLO City Building Inspector 8054402440
Local Option Person/Entity Type Business Name (if applicable)Phone Number
Paula Frojae
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
Page 12 of 13
Person/Entity Involved Other Red Cross
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
Additional Narrative (#1 of 2 ):
T2 arrived on scene and was assigned to investigate/fire attack. T2 found a multi unit single family dwelling with light smoke
coming from exterior sub floor vents on bravo and delta sides of structure, and light smoke inside structure.
Upon further investigation, a contents/debris fire was found under residence in crawl space access area. T2 personnel
extinguished fire and checked for extension, preserving area of origin.
T2 assisted FM Maggio with investigation efforts.
Additional Narrative (#2 of 2 ):
Fire Origin and Cause Report:
I received a phone call from the San Luis Obispo Fire Dispatch at approximately 7:10 Pm on Friday, October 11, 2019
requesting I respond to a structure fire at 519 Brizzolara Street. I arrived at approximately 7:30 PM and check in with Battalion
Chief Neal BERRYMAN. BERRYMAN led me to a property with two duplex units and showed me a fire area underneath Unit 'C'
in the crawlspace.
The fire origin was an area approximately 6 feet in from an opening on side 'C' of Unit 'C' and approximately 1 foot to the left
of the plastic sewer line, which exhibited charring in this area. In the origin I observed two partially burned books, a small
wooden box with charring on the side facing the origin, and the remnants of a cardboard box (the bottom of the box had not
burned. Food items were and food containers were also found in the origin area. To the left of the origin, a cloth insulated
electrical wire was found with the two conductors shorted out exhibiting a bead at the termination. The breaker panel
showed that breaker #1 had tripped. In addition to the fire under the home, two other small fires were discovered which
consisted of crumpled newspaper in gopher holes.
During the scene examination a mother and her four children approached me. The family lived in Unit at the front of the
property. The children stated that they often "played" in that yard area behind Unit 'C' and that they "dumpster dive" for
recyclables. While they denied setting the fire, one of the boys admitted to have been in the crawl space that afternoon.
Text messages from the resident of Unit 'C' to her boyfriend detail that around 5:30 PM she smelled something burning and
heard children playing in the yard area. In addition, empty plastic milk jugs, partially filled with water were found in the area of
the small fires of burned newspaper and water around the hose spigot was obvious. The mother in Unit 'A' is a smoker and
there was access to a lighter.
It is my opinion based on training and experience that the origin of the fire in the crawlspace was 6 feet in from the opening
on side 'C' the material first ignited was paper and cardboard. Cause is incendiary, juvenile fire setter.
Page 13 of 13