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FIRS REPORT - 1800 628 844.

Primary Call Report

A - REPORT HEADER

  • Brigade Advised Date & Time (as per Pager)

  • Pager Details (copy and paste from BART)

  • Location
  • OIC Name:

  • OIC Name If not Officer:

  • Primary Brigade:

  • What type of incident did you attend?

  • Territory

  • Occupant Type

  • What is Property Used For

  • Brigade Action Taken

  • Other

  • First on Scene:

  • OTHER AGENCIES ON SCENE

  • Electricity

  • Water

  • Gas

  • Police

  • Ambulance

  • SES

  • MFB

  • DELWP

  • EPA

  • Govt welfare Agencies

  • Charitable Support Agencies

  • Council

  • Other

  • Enter other details:

INCIDENT SPECIFICS

  • SELECT TYPE OF FIRE/INCIDENT

STRUCTURE FIRE

  • CONSTRUCTION TYPE

  • STRUCTURE TYPE

  • PERCENTAGE INVOLVED ON ARRIVAL %

  • LOW VOLTAGE FUSE REMOVED

  • Removed by:

  • DOMESTIC SMOKE ALARM FITTED

Owner/Occupier Details

  • Title

  • Name

  • Home Phone No.

  • Mob Ph.

  • Owner / Occupier

  • Insurance Details (if known)

  • Were there any exposures?

  • EXPOSURE

EXPOSURE

  • Owners Name:

  • Address:

  • Property use:

  • Estimated Property Loss $

  • Estimated Contents Loss: $

  • Estimated Total Loss: $

  • Type of Non Structure Fire

CAR FIRE

  • Rego:

  • State:

  • Year (if known)

  • Make:

  • Model:

Owner Details (if known)

  • Title

  • Name

  • Address:

  • Home Phone No.

  • Mob Ph.

  • Insurance Details (if known)

  • EXPOSURE

EXPOSURE

  • Owners Name:

  • Address:

  • Property use:

  • Estimated Property Loss $

  • Estimated Contents Loss: $

  • Estimated Total Loss: $

End of section, go to POLICE DETAILS (if applicable)

BIN FIRE

  • Details:

  • Add Photo

Owner Details (if known)

  • Title

  • Name

  • Address:

  • Home Phone No.

  • Mob Ph.

  • Insurance Details (if known)

  • EXPOSURE

EXPOSURE

  • Owners Name:

  • Address:

  • Property use:

  • Estimated Property Loss $

  • Estimated Contents Loss: $

  • Estimated Total Loss: $

End of section, go to POLICE DETAILS (if applicable)

POLE FIRE

  • Pole Number:

  • Power Co. Notified?

  • Did they attend?

End of section, go to POLICE DETAILS (if applicable)

BBQ FIRE

Owner/Occupier Details

  • Title

  • Name

  • Home Phone No.

  • Mob Ph.

  • Owner / Occupier

  • Insurance Details (if known)

Appliance Details

  • BBQ Make:

  • BBQ Model:

  • Fuel type:

  • Were there any exposures damaged?

EXPOSURE

  • Owners Name:

  • Property use:

  • Estimated Property Loss $

  • Estimated Contents Loss: $

  • Estimated Total Loss: $

End of section, go to POLICE DETAILS (if applicable)

OTHER

  • Enter Details:

Owner/Occupier Details

  • Title

  • Name

  • Home Phone No.

  • Mob Ph.

  • Owner / Occupier

  • Insurance Details (if known)

  • Add Photo (optional)

Owner/Occupier Details

  • Title

  • Name

  • Home Phone No.

  • Mob Ph.

  • Owner / Occupier

  • Insurance Details (if known)

GRASS & SCRUB FIRE

  • Vegetation Type

  • Area Burnt (ha)
  • Private:

  • Local Govt:

  • State Park:

  • National Park:

  • Forest/Timber reserve:

  • Flora/Fauna/Nature

  • Defence Dept:

  • Other Public Land:

  • Undetermined:

  • WERE THERE ANY RURAL LOSSES?

  • Sheep:

  • Cattle:

  • Other Livestock:

  • Fencing (km):

  • Hay/Fodder (tonne):

Owner/Occupier Details (If any)

  • Title

  • Name

  • Home Phone No.

  • Mob Ph.

  • Owner / Occupier

  • Insurance Details (if known)

End of section, go to POLICE DETAILS (if applicable)

  • INCIDENT TYPE:

MVA

    Vehicle Details
  • Rego:

  • State:

  • Year (if known)

  • Make:

  • Model:

  • Owner Details (if known)

  • Details of MVA:

  • Add photo (optional)

C - HAZARDOUS MATERIALS

    Chemical
  • Primary Hazard

  • Type of Hazmat Incident

  • Action Taken:

  • Personal Protection Used:

  • Decontamination:

  • Chemical Name/s:

  • UN No.

  • QTY Present:

  • QTY Released:

Owner/Occupier Details (If any)

  • Title

  • Name

  • Home Phone No.

  • Mob Ph.

  • Owner / Occupier

  • Insurance Details (if known)

ANIMAL RESCUE

  • Enter details of incident:

  • Did Animal Rescue Agency Attend:

End of section, go to POLICE DETAILS (if applicable)

LOCK IN/LOCK OUT

  • Enter details of incident:

  • Did RACV Agency Attend:

Owner/Occupier Details (If any)

  • Title

  • Name

  • Home Phone No.

  • Mob Ph.

  • Owner / Occupier

  • Insurance Details (if known)

End of section, go to POLICE DETAILS (if applicable)

OTHER:

  • Enter details of incident:

End of section, go to POLICE DETAILS (if applicable)

B - PROTECTED PREMISES

  • Alarm No.

  • Circuit No.

  • Premises Name

  • Type of Alarm Call:

  • Other:

F - FIRE FIGHTING

  • FIRE FIGHT INFO

  • Hose Lines
  • High Pressure Line (Pumper)

  • 25mm Hose line

  • 38mm Hose Line

  • 64mm Hose Line

  • Other:

  • Major Extinguishing Medium

  • Breathing Apparatus Used

  • BA WEARER
  • Name:

  • No. Of Cylinders

  • Foam Used

  • Percentage Used %

  • Approx Qty used (Ltrs):

  • Percentage Used

  • Approx Qty used (Ltrs):

  • Possible Cause of Fire

  • Ignition Details
  • Where did the fire start

  • Other:

  • What Started the Fire

  • Other:

POLICE DETAILS

  • Number:

  • Name:

  • Station:

  • CIVILIAN CASUALTIES/RESCUES EVACUATIONS

D - CIVILIAN CASUALTIES/ RESCUES EVACUATIONS

  • No. Civilians Injured:

  • No. Civilians Rescued:

  • No. Civilian Fatalities:

  • No. Civilians Evacuated:

  • ADDITIONAL NOTES:

  • Supporting Photo's

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