Loading...
HomeMy WebLinkAboutPermit Correspondence 2004-11-21 DISTRICT OF INCIDENT: te Fi.allnCident Report COUNTY: 0347: SPRINGFIELD FIRE LIFE SFTY 20: LANE DEPT, RESPONDING: 0347: SPRINGFIELD FIRE LIFE SFTY ALARM DATE: 1112112004 i ALARM TIME: 1 :32:00 I ARRIVAL DATE: 1112112004 TYPE OF SITUATIONS FOUND: 111: Building fire INCIDENTADDRESS: 2212 BEVERLY ST CITYIZIP: SPRINGFIELD, OR 97477 OCCUPANT/COMPANY: DANIEL WALKER , ARRIVAL TIME: 1:36:00 I BACK IN DATE: 11/2112004 IBACK IN TIME: 3:13:00 CENSUS TRACT: 21,02 ZONE: 5 DOB: 6/22/1968 TELEPHONE: (541)747-5869 BUSINESS OWNER: ADDRESS: DOB: TELEPHONE: BUILDING/MOBILE PROPERTY OWNER: DANIEL WALKER ADDRESS: SAA 97477- DOB: 6/22/1968 I TELEPHONE: (541) 747-5869 REPORTED BY: ADDRESS: DOB: TELEPHONE: CAREER FIF: 18 VOLUNTEERF/F: o I ENGINES: 3 I AERIAL APPARATUS: ! OTHER VEHICLES: 5 MUTUAL AID: 2: Received ACTIONS TAKEN: 15: EXTINGUISH 16: VENTILATE 14: SALVAGE & OVERHAUL METHOD OF EXTINGUISHMENT: 6: WATER FROM HYDRANT,DRAFT,STANDPIPE ~:~;~~~ USE: 41: SPECIFIC PROPERTY, UNCLASSIFIED GO TO 097 - 099 MOBILE PROPERTY INVOLVED: 98: NO MOBILE PROPERTY INVOLVED AGENT OF EXTINGUISHMENT: GENERAL , PROPERTY USE: 41, 1 OR 2 FAMILY RESIDENCE ROOM/AREA OF ORIGIN: 47: GARAGElCARPORTNEHICLE STORAGE AREA EQUIPMENT INVOLVED: 9800: NO EQUIPMENT INVOLVED JUVENILE: COUNT: 'I' No 0 IGNIT10N FACTOR: 00: IGNITION FACTOR UNDETERMINED FORM OF HEAT: MATERIAL FIRST IGNITED WAS MADE OF: ITEM FIRST IGNITED: C: FORM OF HEAT OF IGNITION UNKNOWN 00: TYPE OF MATERIAL, UNKNOW 00: FORM OF MATERIAL NOT KNOWN/NOT REF I BUILDING: CONTENTS MOBILE PROPERTY AND CONTENTS: I OTHER: ESTIMATED VALUE $140,349,00 $50,000,00 $0,00 $0,00 ESTIMATED LOSS $20,000,00 $0,00 1 $0,00 DETECTOR TYPE: 1: SMOKE ALARM I DETECTOR POWER SUPPLY: ! 1: BATTERY ONLY I DETECTOR PERFORMANCE: 1: IN ROOM OF ORIGIN, ALERTED OCCU REASON FOR DETECTOR FAILURE: 8: NO ALARM FAILURE SPRINKLER SYSTEM TYPE: # OF HEADS OPENED: SPRINKLER PERFORMANCE: 0: SPRINKLER SYSTEM UNKNOWN/N 0 0: UNKNOWN/NOT REPORTED REASON FOR SPRINKLER FAILURE: 0: REASON FAILURE UNKNOWN/NO FOLLOW-UP INVESTIGATION REQUESTED: Y IF YES, WHO WILL INVESTIGATE: Y: LOCAL FD PERSONNEL OR TEAM NUMBER OF INJURIES FIRE SERVICE: o OTHER: o NUMBER OF FATALITIES FIRE SERVICE: o OTHER: o MEMBER MAKING REPORT: Little, Le/don ADDIT10NAL INFORMATION BY: Gordon, Gilbert TITLE: Captain TITLE: DFM DATE: 11/21/2004 DATE: ~4..\~~