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4110 <br /> ` � 1111 <br /> Incident # 2019-00003838 <br /> A I 31M041 !WA I 103 ( L02 { 1 2019 I I 7 I { 00035741 { 000 I Delete NFIRS-10 <br /> FOID '* .State Incident Date * Station Incident Number JL Exposure ['Change Personnel <br /> * <br /> '1pq YC <br /> 6 Apparatus or Dates and Times Midnight is 0000 Sent Number Apparatus Use * Actions Taken <br /> Resources /'�Check if same date as Alarm date on ❑ of * Check ONE box for each List up to 4 actions for <br /> (�the Basic Module(Block El). J( apparatus ton indicate its main each apparatus and <br /> ( Month Day Year Hour/Min People use at the incident, each personnel. <br /> It ID I 31D01 I Dispatch Erl_II II 110026I Sent <br /> Arrival <br /> Si 11 I I 1 {0040 I 0' I 0 I 0 EMS ression { I I { <br /> *TYPe 111 I Clear Si II it 110107 I 0 Other I I LI <br /> Personnel * Name Rank or Attend Action Action Action Action <br /> ID Grade Cl Taken Taken Taken Taken <br /> 0 <br /> 0 <br /> 0 <br /> 0 <br /> 0 <br /> 13 <br /> ❑2 ID I I Dispatch EI II II 1I 0026 Sent I 1 <br /> M6 ❑ Suppression I I I I <br /> Arrival gI I I II 110046 I Q' L 2 Er EMS <br /> *Type 17 6 I Clear ®'LJ L_J I 1 1004 6 1 0 Other I I U <br /> Personnel * Name Rank or Attend Action Action Action Action <br /> ID Grade r� Taken Taken Taken Taken <br /> BA0269 CHRIS WALLACE uu <br /> BA0233 TOM DECKERS E <br /> 0 <br /> 13 <br /> 0 <br /> 0 <br /> 0 ID I M5 I Dispatch En 1 L_1 I 110026 I Sent 0 Suppression I 93 I I I <br /> A L 6 Clear ❑LJ LJ�� OL_i Er L_2i ET EMS U Li <br /> *Typela1 I I II II I 0 Other <br /> Personnel * Name Rank or Attend Action Action Action Action <br /> ID Grade l Taken Taken Taken Taken <br /> BA0240 ERIC BAKER El' <br /> BA0339 KARSTEN STARUP Et <br /> 1 ❑ <br /> I 0 <br /> 1 CI <br /> NFIRS-10 Revisian01/01/04 <br /> � Printed 13:09 03/04/2019 <br />