HomeMy WebLinkAboutHAZMAT 88-0176 - 1120 ANDOVER PARK EAST - SPILL (FLAMMABLE LIQUID SPILL) ON 1/29/19881120 ANDOVER PARK
EAST
SPILL (FLAMMABLE
LIQUID SPILL)
HAZMAT # 88-0176
FIBERCHEM
WASHINGTON STATE FIRE INCIDENT REPOR
FIRE DEPT.
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FDID
INCIDENT NO.
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EXP.
0
MO.
- "
DAY
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`
YEAR
c 8
DAY OF WEEK
5 0 Thursday
1-12 Sunday 3 0 Tuesday 6gFriday
2 ❑ Monday 4 ❑ Wednesday 7 ❑ Saturday
IF EQUIPMENT (N.A. IF NOT APPLICABLE)
ALARM TIME ARRIVAL TIME
/ f I z I3 iI y `I J
TIME IN SERVICE
/ I$7 IS
B
C
D
P o
EO SITUATION10.01 0o D
[ i l I
1
1. FIRE, EXPL. 1 1 3. RESCUE 1 L 1 5. SER. CALL , 1 7. FALSE 1 I I
i I I
2. PRESSURE RUPTURE I 1 I 4. HAZ. COND. WI/ 6. GOOD INTENT I I 9. OTHER 1 1 I
ACTION
TAKEN
1 ❑Extinguishment 5 0 Stand by 8 0 Fill in. Move up
2 0 Rescue Only 6 0 Salvage 9 0 Not classified
3 0 Investigation only 7 0 Emerg. Med. 0 0 Undetermined/Not reported
4` Remove Hazard
l
77
MUTUAL AID
1 0 Recd
2 0 Given ,v
XN/A
Al
6FIXED PROPERTY USE (Occupancy)
i 1
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IGNITION FACTOR
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CORRECT ADDRESS (Up to maximum of 21 characters)
/lam ,4.14 L7 v c' u_ .f pit 61.
ZIP CODE
eel/ I c l e
CENSUS TRACT
O t =91®1.2-1,1 Z
11
OCCUPANT NAME (LAST, FIRST, M.I.)
/
r- /fj Gl !/Y1 Tel
TELEPHONE
20 -57.E -0Z7u
ROOM or APT.
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12
OWNER NAME (LAST, P(RST, M.I.)
d N le -t.1 o U✓ 1`4
ADDRESS
TELEPHONE
13 2
METHOD OF ALARM
1 ❑ Telephone direct 4Radio 8 0 Voice signal municipal alarm signal
0 Municipal alarm system 5 Verbal 9 0 Not classified
3 ❑ Private alarm system 6 0 No alarm rec'd. 0 0 Undetermined or not reported,I41-
7 0 Tie -line (911)
CO. INSPECTION
DISTRICT
1
SHIFT f
•
NO. ALARMS 1
`
r /
H
NO. FIRE SERVICE PERSONNEL j
RESPONDED
100 Ia
NO. ENGINES I
RESPONDED
t.
I'D to 1 /
NO. AERIAL APPARATUS I
RESPONDED
!Io1oo
NO. OTHER VEHICLES
RESPONDED
(230 3
20
NUMBER OF INJURIES Complete Form NFIRS 3
1 1 1
FIRE SERVICE
COMPLETE FORM NFIRS 2
OTHER 1 1 1
NUMBER OF FATALITIES
FIRE SERVICE
1
OTHER 1 I
J
K
L
M
N
0
Q
R
COMPLEX
1
MOBILE PROPERTY TYPE (Complete Line S)
I
' I I
AREA OF FIRE ORIGIN
I
EQUIPMENT INVOLVED IN IGNITION (Complete Line T) I
t
it 1
FORM OF HEAT IGNITION
TYPE OF MATERIAL IGNITED
FORM OF MATERIAL IGNITED
IF EQUIPMENT (N.A. IF NOT APPLICABLE)
1
1
1 1
1
I
METHOD OF
INVOLVED
EXTINGUISHMENT 2 0 Make shift aids 5 0 Pre -connect hose/tank only 8 0 Master stream device
0 1 Self extinguished 3 0 Portable extinguisher 6 0 Pre -connect hose/hydrant draft standpipe 9 0 Not classified
4 0 Automatic ext. system 7 0 Hand -laid hose/hydrant draft standpipe 0 0 Undetermined or not reported
LEVEL OF FIRE ORIGIN
40
ESTIMATED DOLLAR LOSS
1 0 Grade level to 9 ft. 6 0 Over 70 feet
i
2 0 10 to 19 feet 7 0 Objects in flight
3 0 20 to 29 feet 8 0 Below ground level
I
4 0 30 to 49 feet 9 0 Not classified above
5 50 to 70 feet 0 Undetermined
1 I 1 1 1 1 1 1 I
NUMBER OF STORIES
1 1 story. 4 5 to 6 stories.
2 0 2 story. 5 0 7 to 12 stories.
3 0 3 to 4 stories. 6 0 13 to 24 stories.
7 0 25 to 49 stories.
8 0 50 stories or more.
0 0 Number of Stories undetermined or not reported.
CONSTRUCTION TYPE
1 0 Fire resistive
2 0 Heavy timber
3 0 Protected noncombustible
4 0 Unprotected noncombustible
5 0 Protected ordinary
6 0 Unprotected ordinary
7 0 Protected wood frame
8 0 Unprotected wood frame
9 0 Not classified above
0 0 Undetermined or not
reported
EXTENT OF DAMAGE
Flame
1 Confined to the object of origin 1 0
2 Confined to part of room or area of origin 2 0
3 Confined to room of origin 3 0
4 Confined to the fire -rated comp. of origin 4 0
5 Confined to floor of origin 5 0
6 Confined to structure o1 origin 6 0
7 Extended beyond structure of origin 7 0
0 Undetermined/not reported 0 0
9 No damage o1 this type (N/A)
Smoke
1 ❑
2 ❑
3
4
5
7 ❑
0
9
P
DETECTOR PERFORMANCE
1 0 Det. in room or space of fire origin-oper.
2 0 Det. not in rm. or space of fire origin-oper.
3 0 Det in rm. or space of origin -not oper.
4 0 Det. not in rm. or space of origin -not oper.
5 0 Det. not in rm. or space of fire origin
but fire too small to oper.
8 0 No detectors present
9 0 Not classified
0 0 Undetermined or not reported
SPRINKLER PERFORMANCE
1 0 Equipment operated
2 0 Equipment should have operated—did not
3 0 Equipment present, fire too small to oper.
8 0 No equipment present (N/A)
9 0 Not classified
0 0 Undetermined or not reported
TYPE OF MATERIAL GENERATING MOST SMOKE
IF SMOKE SPREAD
BEYOND ROOM
OF ORIGIN
FORM OF MATERIAL GENERATING MOST SMOKE
1
AVENUE OF SMOKE TRAVEL
1 0 Air handling duct 4 0 Stairwell
2 0 Corridor 5 0 Opening in construction
3 0 Elevator shaft 6 0 Utility opening in wall
7 0 Utility opening in floor
8 0 No avenue of smoke travel
9 0 Not classified
0 0 Undetermined or not reported
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0
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30
IF MOBILE PROPERTY
(N.A. IF NOT APPLICABLE)
YEAR
MAKE
MODEL
SERIAL NO.
LICENSE NO.
IF EQUIPMENT (N.A. IF NOT APPLICABLE)
YEAR
MAKE
MODEL
SERIAL NO.
INVOLVED
40
IN IGNITION tti/
0
OFFICER IN CHARGE
112A4/4„(p s' ;/gA.J- -. ' S(
INS -913- 3
MEMBER MAKING REPORT
L r
DATE
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'K')ENT# 1683
01/29/88 14:43:03 FRI JAN 29,1988
0 APE/STRANDER TUKWILA
DISPATCHED AS: NON—STRICT RUN# : 5120
RP: NAP BOX# . 0
PHONE: FDZ#
RCD BY TIME: 1447:01
D I SP
BY .
ON—LOC ON -LOC RETURN RETURN IN—GTR OUTBTR IN GTR
APPR. DISP. RESPOND OS IS IS OS IS IS OS
E51 !1443:02 ! !I443:10
RUN CARD COMMENTS: SHEP IMMED 322-03330 MEDI4/5
APPARATUS:
P. = A5i E51 E52 A53 A24
= ESI E52 E1.3 E53 E76 E42 E241 EIB E71
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