Fire Call Report Sheet

An operational sheet for fire stations to document every call: response times, weather conditions, responding personnel, ignition causes, damage, vehicles involved and injuries. It keeps the entire incident file in one place.

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Physical address of the call

Address paged out on Active 911

Date

Call Out Time

On Scene Time

Back in Service Time

Control Date

Control Time

If other, explain

Temperature

Humidity

Wind

Latitude

Longitude

Safety Officer

Officer in Charge

Time

701 - M. Hooper

Responded to the scene Responded to the station On standby Did not respond

Asmundson, Nicole 3480

Responded to the scene Responded to the station On standby Did not respond

Firefighter not on the list but on scene

Cause of ignition (check all that apply)

Human factors contributing to ignition

Person asleep Impaired by alcohol or drugs Unattended equipment Age-related factor Physical disability None

Structure Type

Single-family home Multi-family home Mobile home Commercial building Barn or outbuilding Garage Other

What was the square footage of the structure?

Were there smoke detectors in the structure?

Yes No Unknown

Detector Power Supply

How many smoke detectors were in the structure?

Did the detector alert the occupants of the fire?

Yes No Unknown

Detector Failure Reason

Dead battery Missing battery Disconnected Defective unit Smoke did not reach the detector Unknown

Were there carbon monoxide detectors in the structure?

Yes No Unknown

How many carbon monoxide detectors were in the structure?

How many acres burned

Cause of ignition (check all that apply)

Human factors contributing to ignition

Person asleep Impaired by alcohol or drugs Unattended equipment Age-related factor Physical disability None

How many houses were saved

How many houses were lost

How much water was used by all responding units?

How much foam A was used by all responding units?

How much foam B was used by all responding units?

Resident of the structure

Nombre

Apellido

Address

Dirección

Ciudad

Estado / Provincia

Código postal

Phone Number

Homeowner, if different from resident

Nombre

Apellido

Address

Dirección

Ciudad

Estado / Provincia

Código postal

Phone Number

Vehicle Driver's Name

Nombre

Apellido

Driver's Address

Dirección

Ciudad

Estado / Provincia

Código postal

Driver's Phone Number

Company Name

Company Address

Dirección

Ciudad

Estado / Provincia

Código postal

Company Phone Number

Supervisor's Name

Nombre

Apellido

Supervisor's Phone Number

Vehicle Plate Number

Vehicle VIN Number

Make of the Vehicle

Model of the Vehicle

Year of the Vehicle

Vehicle Unit Number (if any)

Trailer Plate Number

Trailer VIN Number

Make of the Trailer

Model of the Trailer

Year of the Trailer

Trailer Unit Number

Mutual aid given by

Firefighters

Senior firefighter Firefighter Probationary firefighter Volunteer firefighter Junior firefighter

Primary apparent symptom

Activity when injured

Fire suppression Search and rescue Ventilation Salvage and overhaul Driving or responding Training Other

Notes about the injury

Non fire department members who were injured

Primary apparent symptom

Activity when injured

Fire suppression Search and rescue Ventilation Salvage and overhaul Driving or responding Training Other

Notes about the injury

Non fire department members who were injured

Primary apparent symptom

Activity when injured

Fire suppression Search and rescue Ventilation Salvage and overhaul Driving or responding Training Other

Notes about the injury

Non fire department members who were injured

Primary apparent symptom

Activity when injured

Fire suppression Search and rescue Ventilation Salvage and overhaul Driving or responding Training Other

Notes about the injury

Incident report notes - what did you see? Also include anything that was told to you

Report taken by (fire department # or position #)

Name

Nombre

Apellido

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