Boyle County Fire Protection District
Fire Incident Report

Please complete the form below and click "Submit"

 

 

 

 
Date
Run Number
Day of the Week
Alarm Time
On-Scene Time
Cleared Time
Dispatch Time
Controlled Time
In Quarters
     
Type of Situation Found
Structure Fire
Brush / Grass Fire
Alarm Drop
Hazmat Incident
Other
Type of Action Taken
Extinguishment
  Gallons of Water Used
Remove Hazard
Investigation Only
Municipal Water Source
Static Water Source
Other
 
Fixed Property Use
Ignition Factor
 
Incident Location
Response District
 
Occupant Name
Telephone
 
Owner's Name
Address Owner's Telephone
 
Method of Alarm from Public
Insurance Company and Contact Person
 
Civilian Injury / Death
Firefighter Injury / Death
Total Number of
Firefighters on Scene
 
Fire Apparatus responding
Engines Tankers Rescue Trucks Brush Trucks Other
 
Fire Cause Determination
Fire Cause Determination Made By
 

Complete the Section Below for All Fires
Property Use / Type
Mobile Property Type
 
Area of Fire Origin
Equipment Involved in Ignition
 
Form of Heat of Ignition
Form & Type of Material First Ignited
 
Method of Extinguishment
Level of Fire of Origin
Estimated Dollar Losses
 

Complete the Section Below for Structure Fires Only
Number of Stories
Above Ground
Number of Stories
Below Ground
Construction Type
 

Fire Suppression
Systems Present

Smoke Detectors Present?

Carbon Monoxide Detectors Present?

Detector
Activated?
 
Extent of Flame Damage
Extent of Smoke Damage
 
Utilities in Service at time of Fire  
Electricity
Water
Natural Gas
Propane
Telephone
Cable
Well /Cistern
Generator
Utilities Disconnected By Fire Operations / Utility Company
 
If Mobile Property or Equipment Invovled in ignition:
Year
Make
Model
Serial number
License number
 
Vehicle Identification number (VIN) and description of Vehicle
 
Officer in Charge
 
Unit number
Member completing report
Date of report
 
Mutual aid given / received / agencies
Unified incident Commander (if applicable)
 
Narrative
 
Personnel Responding Cost
 
Assist Responding Cost