HomeMy WebLinkAboutNFIRS Report 2200249NFIRS-1 Basic
27113 MN 07 22 2022 Long Lake
Fire
Department
Station 2 (2)
2200249 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
2815 Casco Point RD-Road
Number Prefix Street or Highway Street Type Suffix
City of Orono MN 55356
Apt./Suite/Room City State Zip Code
Cross Street
Incident Type
143-Grass 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
Their FDID Their
State
Their Incident Number
Dates and Times
Alarm 07 22 2022 02:22
Arrival 07 22 2022 02:32
Controlled 07 22 2022 02:40
Last Unit
Cleared
07 22 2022 03:53
Shifts and Alarms
Orono
Shift or
Platoon
Alarms District
Special Studies
1 No
ID#Value
A
B
C
D
E1 E2
E3
Page 1 of 11
Actions Taken
11-Extinguishment by fire service
personnel
Primary Action Taken
Resources
Apparatus or Personnel Module is used.
Apparatus Personnel
Suppression 4 8
EMS 0 0
Other 2 5
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:$ 0
Contents:$ 20,000.00
Pre-Incident Values: Optional None
Property:$ 0
Contents:$ 20,000.00
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.
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
F G1 G2
H1
H2
H3 I
J
K2
Page 2 of 11
Remarks:
Arrived on scene to a grass fire that spread to a deck and dock. We applied water to extinguish the grass fire and the deck.
After the fire was out we did overhaul to make sure that the fire had not spread.
Authorization
180 Kanive, Ryan Lieutenant Long Lake Fire
Department Station 1
07/22/2022
Officer In Charge ID Signature Position or Rank Assignment Date
180 Kanive, Ryan Lieutenant Long Lake Fire
Department Station 1
07/22/2022
Member Making Report
ID
Signature Position or Rank Assignment Date
L
M
Page 3 of 11
NFIRS-2 Fire
27113 MN 07 22 2022 Long Lake
Fire
Department
Station 2 (2)
2200249 0
FDID State Month Day Year Station Number Exposure
Property Details
B1 Not Residential
Estimated number of residential living units in the building
of origin whether or not all units became involved
B2 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
Area of Fire Origin
D2
Heat Source
D3
Item First Ignited
D4
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
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
Equipment Involved
Brand
Model
Serial #
Year
Equipment Power Source
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 11
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 11
NFIRS-8 Wildland Fire
27113 MN 07 22 2022 Long Lake
Fire
Department
Station 2 (2)
2200249 0
FDID State Month Day Year Station Number Exposure
Alternate Location Specification
North
South
East
West
Township Range
Section
Subsection
Meridian
Area Type
1 - Rural, Farms > 50 Acres
2 - Urban (Heavily Populated)
3 - Rural/Urban or Suburban
4 - Urban-Wildland Interface Area
Wildland Fire Cause
1 - Natural Source
2 - Equipment
3 - Smoking
4 - Open/Outdoor Fire
5 - Debris/Vegetation Burn
6 - Structure (Exposure)
7 - Incendiary
8 - Misuse of Fire
0 - Other
U - Undetermined
Human Factors Contributing
to Ignition
1 - Asleep
2 - Possibly Impared by Alcohol
or Drugs
3 - Unattended Person
4 - Possibly Mental Disabled
5 - Physically Disabled
6 - Multiple Persons Involved
7 - Age Was a Factor
None
Factors Contributing to Ignition
74-Outside/open fire for warming or
cooking
Fire Suppression Factors
Heat Source
83-Flying brand, ember, spark
Mobile Property Type
Equipment Involved In Ignition
Weather Information
NFDRS Weather Station ID Weather Type
Wind Direction Wind Speed
Negative
Air Temperature (F)Relative Humidity (%)
Fuel Moisture (%)Fire Danger Rating
Number of Buildings Ignited
None
Number of Buildings
Threatened
None
Total Acres Burned
0.1
Primary Crops Burned
A
B
C
D1
D2
D3
D4
E
F
G
H I1
I2
I3
I4
Page 6 of 11
Property Management
Owner % Acres
Burned
U - Undetermined
Private
1 - Tax Paying
2 - Non-tax Paying
Public
3 - City, Town, Village,
or Other Locality
4 - County or Parish
5 - State or Province
6 - Federal
7 - Foreign
8 - Military
0 - Other
NFDRS Fuel Model At Origin
Person Responsible For Fire
1 - Identified Person Caused Fire
2 - Unidentified Person Caused Fire
3 - Fire Not Caused By Person
Gender of Person Involved
1 - Male
2 - Female
Age or Date of Birth
OR
Age Date of Birth
Activity of Person Involved
Type of Right-Of-Way
Feet
Horizontal Distance From Right-of-Way
Type of Right-of-Way
Fire Behavior
Feet
Elevation
Relative Position on Slope
Aspect
Feet
Flame Length
Chains Per Hour
Rate of Spread
J K
L1
L2
L3
L4
M
N
Page 7 of 11
NFIRS-9 Apparatus or Resources
27113 MN 07 22 2022 Long Lake
Fire
Department
Station 2 (2)
2200249 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:CMD2
Type:92-Chief officer car
Dispatch:07/22/2022 02:22
Arrival:07/22/2022 02:36
Clear:07/22/2022 03:53
Sent 1 Suppression
EMS
Other
81-Incident command
ID:E11
Type:11-Engine
Dispatch:07/22/2022 02:22
Arrival:07/22/2022 02:46
Clear:07/22/2022 03:53
Sent 4 Suppression
EMS
Other
10-Fire control or extinguishment,
other
ID:E22
Type:11-Engine
Dispatch:07/22/2022 02:22
Arrival:07/22/2022 02:32
Clear:07/22/2022 03:53
Sent 3 Suppression
EMS
Other
ID:STAT
Type:
00-
Station/Resource
Dispatch:07/22/2022 02:22
Arrival:
Clear:07/22/2022 03:53
Sent 2 Suppression
EMS
Other
ID:U11
Type:16-Brush truck
Dispatch:07/22/2022 02:22
Arrival:07/22/2022 02:40
Clear:07/22/2022 03:53
Sent 3 Suppression
EMS
Other
10-Fire control or extinguishment,
other
ID:U21
Type:16-Brush truck
Dispatch:07/22/2022 02:22
Arrival:07/22/2022 02:32
Clear:07/22/2022 03:53
Sent 3 Suppression
EMS
Other
A
Page 8 of 11
NFIRS-10 Personnel
27113 MN 07 22 2022 Long Lake
Fire
Department
Station 2 (2)
2200249 0
FDID State Month Day Year Station Number Exposure
B
Apparatus/Resource Dates/Times Sent
Number
of People Apparatus Use Actions Taken
ID:CMD2
Type:
92-Chief officer
car
Dispatch:07/22/2022 02:22
Arrival:07/22/2022 02:36
Clear:07/22/2022 03:53
Sent 1 Suppression
EMS
Other
81-Incident command
Personnel ID Name Rank Role Attend Actions Taken
180 Kanive, Ryan Lieutenant 5588005-IC
81-Incident command
ID:E11
Type:11-Engine
Dispatch:07/22/2022 02:22
Arrival:07/22/2022 02:46
Clear:07/22/2022 03:53
Sent 4 Suppression
EMS
Other
10-Fire control or
extinguishment, other
Personnel ID Name Rank Role Attend Actions Taken
49 Goman, David "D.J."Senior Captain 5588001-Driver
10-Fire control or
extinguishment, other
154 Cotton, Patrick Firefighter 5588003-Crew
10-Fire control or
extinguishment, other
9023 Johnsrud, Michael Probationary
Firefighter
5588003-Crew
10-Fire control or
extinguishment, other
1888 Loosbrock, Richard Firefighter 5588002-Officer
10-Fire control or
extinguishment, other
ID:E22
Type:11-Engine
Dispatch:07/22/2022 02:22
Arrival:07/22/2022 02:32
Clear:07/22/2022 03:53
Sent 3 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
196 Palmer, Erik Firefighter 5588001-Driver
5064 Rioux, Shawn Firefighter 5588002-Officer
9993 Hinker, Justin Probationary
Firefighter
5588003-Crew
ID:STAT
Type:
00-
Station/Resource
Dispatch:07/22/2022 02:22
Arrival:
Clear:07/22/2022 03:53
Sent 2 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
93 Farley, Cole Deputy Chief
of Training
5588008-Standby
212 Spinks, Scott Fire Captain 5588008-Standby
ID:U11 Dispatch:07/22/2022 02:22 Sent 3 Suppression
A
Page 9 of 11
Type:16-Brush truck Arrival:07/22/2022 02:40
Clear:07/22/2022 03:53
EMS
Other
10-Fire control or
extinguishment, other
Personnel ID Name Rank Role Attend Actions Taken
50 Aldrich, Thomas Firefighter 5588001-Driver
10-Fire control or
extinguishment, other
223 Paszkiewicz, John Fire Captain 5588002-Officer
10-Fire control or
extinguishment, other
222 Smiley, Matthew Firefighter 5588003-Crew
10-Fire control or
extinguishment, other
ID:U21
Type:16-Brush truck
Dispatch:07/22/2022 02:22
Arrival:07/22/2022 02:32
Clear:07/22/2022 03:53
Sent 3 Suppression
EMS
Other
Personnel ID Name Rank Role Attend Actions Taken
153 Adams, Christopher Battalion
Chief
5588002-Officer
177 Gonsior, Ryan Deputy Chief
of
Administration
5588001-Driver
5490 Hayden, Adam Probationary
Firefighter
5588003-Crew
Page 10 of 11
NFIRS-1S Supplemental
27113 MN 07 22 2022 Long Lake
Fire
Department
Station 2 (2)
2200249 0
FDID State Month Day Year Station Number Exposure
Supplemental Special Studies
Local Option
1 1 No 2 3 No 3 4 Yes 4 5 No
Special
Study ID#
Special Study
Value
Special
Study ID#
Special Study
Value
Special
Study ID#
Special Study
Value
Special
Study ID#
Special Study
Value
5 6 No 6 7 No 7 9244 3 - No, COVID 19
was not a factor
8
Special
Study ID#
Special Study
Value
Special
Study ID#
Special Study
Value
Special
Study ID#
Special Study
Value
Special
Study ID#
Special Study
Value
A
E3
Page 11 of 11