Laserfiche WebLink
� naic rcn� f / alall;F z o I <br /> � �i...�/ �5 1�1 1 i. I V Q` :i V . I octer¢ 7❑ On <br /> � � <br /> CU:AaLETE FOF ALL INCto�ry75 <br /> r�cinc��rr�u�.�acx 37PP FfCLD INCIDENT REPORT <br /> s o `1_L� ' � `�' ��' FD•2CC <br /> 1 2 7 7 8 9 . <br /> AUCILIA2T I.'ILICEYf TTCE iYfE OF ACTIOfl TAREfl PflOFERfY flAME ppi, ryp,� <br /> TdIP! <br /> (CHEGN) � � � P � � <br /> 17 ❑ It U � <br /> CO:IdEt7 lOV.710A%d70aES5 CI�Y Si�TE ZIP CCOE �. <br /> � _'L_f 4 I i I 1 i I 4- I C��T'I �f I I I I i I I I I I�_ _ <br /> u a3 �V��[.;i' Itip, .. f <br /> cj.7.4.( <br /> CO5!�1W'�ITY t:P S7P.OIVISION �OUqiY PAflCFL t1U11B:R OR LC!ISUS TFACT OISTxICT GUT OF <br /> � f ,� IUP.IS'�IG , <br /> �^•��.I'IL.�i(S%! TCM:1 <br /> 7/ 15 t5 I7 ( FLN) :d <br /> C011PLF% ` FIXEO PROPF9iY USE <br /> � 0A 4 � 09 4 ( � <br /> 50 51 .2 <br /> PP.OPERiY PEPRESEtITnTIVE:NFfAE T[LE7HOfVE ADOPE52(SiREEf,CITY,ST�1TF, ZIP CO�E) <br /> C. :�N� � 1=.��76iLY'r'.I$l'S �53" CJI�7 � �I1 � G�4 � J.E., L'cCLL-Vifc C;�A <br /> o[t1,Yttr*-t1A!nE TFIEPHONE pELATIOHSHIi PROPEP,�Y MANRGENEf1T <br /> �L..V CA <br /> 1A��i �'. CYA.vOA�_ S�n�t cee ss � co ! <br /> COMPLETE IF FIRE <br /> IEVEI OF ORIGIfi pREA OF 041CI�1 <br /> 5 1 �q I Cl icnB — <br /> ' z 'o J iz �3 <br /> EQUIP!dEtli IBYOlVEO IR IGflITIOY FOR.'A OF HEAT OF IG1llTI0fl , ' <br /> ��' [[[!!! / <br /> ' KB4�: �� I760 I�� <br /> � IS I6 17 19 <br /> IF C�UIP�'EtIT ItIYOLVED 111 IGIIITI011 YC.4F 1.1ANE tlODEL SERIAL 110. VOLTAGE(IF ANYJ <br /> TYPE OF 1.1ATiR1AL IG'11iED FOR��I OF�1pTEflIAI IC.'lITEO <br /> � � � �I <br /> {� I(CA �`• � YCB µ.i: <br /> f�l I9 20 � l 22' <br /> ACT OR Ob�ISSIOA—OP.IGIfl OF FIRE COOE VIOlATI0N1 I <br /> �� 1 � CHECN IF VIOLATION <br /> NOA 25 , <br /> 2i 23 <br /> !dAl:l AVEfVES OF FIP.E SPNEAU I <br /> LA <br /> ,5 ... <br /> TYPE OF'dATCP.IAL 1.tO5T qESPOH51BlE FOR FlCE SPfiEFO FONIA OG M1t.1TEflIAL MOST NESPOnSIBtE FOR FIHE SPflEAD j <br /> InA � �rg 1� <br /> 28 23 7'J 3l <br /> ACT OB 07dISS10'1 :AOST RESPOHSIBLE FO�i FIRE SPxEAO LCOE VIOlATIO�II <br /> lCA 1 O CNECB IF VIOLATION <br /> 32 37 31 <br /> COh1ALETEIF M091LE PROPERTY <br /> ,.� %'CdltE PeOYERIT USE LICRISE '10. STATE ! <br /> v 5 4 � � <br /> � z oc <br /> ia u it �s z�if <br /> 6�nNE ht00EL YLiF YEIiI[LE 10.fl0. <br /> COMPIETE IF LO55 If�VOLVED � �. � �' - ' � <br /> 5 5 ,\QUAL VAWE ACTVAL LOSS � 5 6 IlISufiEO VpLUE INSUPEU lOSS <br /> 1 2 1 2 <br /> � SiRUCIU±E 'a I I I I I <br /> _ u le zs io n ia zs <br /> cor�rens I I I I I I I <br /> i6 77 31 al 36 ]) 71 q <br /> CISONA4CE C0.':.PAIIY ::FM1I( I � <br /> IIOTE:PGSIIIO�IS J-S OF ULiI CABD fAU: �RIII �HE INCIDENi A110 :iUPPlEIdqlllAl t1UL:9ENS. <br /> _—' . e <br /> l��e� <br />