HomeMy WebLinkAbout1825 Monterey_RedactedNFIRS-1 Basic
40060 CA 12 06 2019 Fire Station
2 (FS2)
19-06276 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
1825 MONTEREY
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
CALFIRE
(40080)
California
Their FDID Their
State
Their Incident Number
Dates and Times
Alarm 12 06 2019 10:43
Arrival 12 06 2019 10:49
Controlled 12 06 2019 10:56
Last Unit
Cleared
12 06 2019 11:52
Shifts and Alarms
A 1 FZ2
Shift or
Platoon
Alarms District
Special Studies
ID#Value
A
B
C
D
E1 E2
E3
Page 1 of 10
Actions Taken
11-Extinguishment by fire service
personnel
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 4 11
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:$ 36,783.30
Contents:$ 20,000.00
Pre-Incident Values: Optional None
Property:$ 1,226,610.00
Contents:$ 50,000.00
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 Manager University Inn
Local Option Person/Entity Type Business Name (if applicable)Phone Number
MR-Mr.
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 10
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:
First alarm response to a reported structure fire. Battalion 1 arrived on scene to find an approximate 40 unit 2 story motel
with mild to moderate smoke coming from the laundry room. Monterey IC was established and all units continued code 3.
Truck 2 was assigned fire attack, Engine 4 was assigned 2 out and to back up Truck 2 if needed and Engine 4 captain became
Interior group with Engine 4 and Truck 2 crew assigned.
Upon Truck 1s arrival they were assigned as evacuation group and instructed to evacuate the second and first floor.
Fire was extinguished by Truck 2 and Building was evacuated and confirmed by Truck 1.
Fire Marshal Maggio arrived on scene and conducted his fire investigation. Maggio found the fire to be accidental in nature
and the fire started inside a commercial dryer and spread to the corner of the room.
All units conducted salvage and overhaul and checked for any fire extension, none was found.
James Blattler was PIO for the incident.
An after action briefing was done on scene.
All units were released.
Authorization
41550 Hais, Ray Fire Battalion Chief 12/06/2019
Officer In Charge ID Signature Position or Rank Assignment Date
41550 Hais, Ray Fire Battalion Chief 12/06/2019
Member Making Report
ID
Signature Position or Rank Assignment Date
K2
L
M
Page 3 of 10
NFIRS-2 Fire
40060 CA 12 06 2019 Fire Station
2 (FS2)
19-06276 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
26-Laundry area, wash house
(laundry)
Area of Fire Origin
D2
10-Heat from powered
equipment, other
Heat Source
D3
32-Bedding; blanket, sheet,
comforter
Item First Ignited
D4 50-Natural product, other
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
20-Mechanical failure, malfunction, other
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
811-Clothes dryer
Equipment Involved
Brand
Model
Serial #
Year
Equipment Power Source
10-Electrical, other
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 10
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 10
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
2
Number of Stories
At/Above Grade
0
Number of Stories
Below Grade
Main Floor Size
9000
Total Square Feet
OR
BY
Length (ft) X Width (ft)
Fire Origin
1 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 10
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 10
NFIRS-9 Apparatus or Resources
40060 CA 12 06 2019 Fire Station
2 (FS2)
19-06276 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:12/06/2019 10:43
Arrival:12/06/2019 10:50
Clear:12/06/2019 11:52
Sent 1 Suppression
EMS
Other
81-Incident command
ID:E4
Type:11-Engine
Dispatch:12/06/2019 10:43
Arrival:12/06/2019 10:50
Clear:12/06/2019 11:52
Sent 3 Suppression
EMS
Other
10-Fire control or extinguishment, other
ID:T1
Type:12-Truck or aerial
Dispatch:12/06/2019 10:43
Arrival:12/06/2019 10:49
Clear:
Sent 4 Suppression
EMS
Other
10-Fire control or extinguishment, other
ID:T2
Type:12-Truck or aerial
Dispatch:12/06/2019 10:43
Arrival:12/06/2019 10:54
Clear:12/06/2019 11:52
Sent 3 Suppression
EMS
Other
10-Fire control or extinguishment, other
A
Page 8 of 10
NFIRS-10 Personnel
40060 CA 12 06 2019 Fire Station
2 (FS2)
19-06276 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:12/06/2019 10:43
Arrival:12/06/2019 10:50
Clear:12/06/2019 11:52
Sent 1 Suppression
EMS
Other
81-Incident command
Personnel ID Name Rank Role Attend Actions Taken
41550 Hais, Ray Battalion
Chief
ID:E4
Type:11-Engine
Dispatch:12/06/2019 10:43
Arrival:12/06/2019 10:50
Clear:12/06/2019 11:52
Sent 3 Suppression
EMS
Other
10-Fire control or extinguishment, other
Personnel ID Name Rank Role Attend Actions Taken
41600 Hale, Gary Captain
60045 Lokkart, Eric Engineer
92892 Woods, Mitchell Firefighter
ID:T1
Type:12-Truck or aerial
Dispatch:12/06/2019 10:43
Arrival:12/06/2019 10:49
Clear:
Sent 4 Suppression
EMS
Other
10-Fire control or extinguishment, other
Personnel ID Name Rank Role Attend Actions Taken
59710 Lipson, Matthew Captain
73250 Renner, David Engineer
61580 Mason, Ryan Engineer
52001 Joy, Cullen Firefighter
ID:T2
Type:12-Truck or aerial
Dispatch:12/06/2019 10:43
Arrival:12/06/2019 10:54
Clear:12/06/2019 11:52
Sent 3 Suppression
EMS
Other
10-Fire control or extinguishment, other
Personnel ID Name Rank Role Attend Actions Taken
40667 Gutierrez, Armando Captain
34590 Flatos, Alec Engineer
74579 Robertson, Travis Firefighter
A
Page 9 of 10
NFIRS-1S Supplemental
40060 CA 12 06 2019 Fire Station
2 (FS2)
19-06276 0
FDID State Month Day Year Station Number Exposure
Primary Narrative:
First alarm response to a reported structure fire. Battalion 1 arrived on scene to find an approximate 40 unit 2 story motel
with mild to moderate smoke coming from the laundry room. Monterey IC was established and all units continued code 3.
Truck 2 was assigned fire attack, Engine 4 was assigned 2 out and to back up Truck 2 if needed and Engine 4 captain became
Interior group with Engine 4 and Truck 2 crew assigned.
Upon Truck 1s arrival they were assigned as evacuation group and instructed to evacuate the second and first floor.
Fire was extinguished by Truck 2 and Building was evacuated and confirmed by Truck 1.
Fire Marshal Maggio arrived on scene and conducted his fire investigation. Maggio found the fire to be accidental in nature
and the fire started inside a commercial dryer and spread to the corner of the room.
All units conducted salvage and overhaul and checked for any fire extension, none was found.
James Blattler was PIO for the incident.
An after action briefing was done on scene.
All units were released.
A
Page 10 of 10