STRUCTURE
Field Notes TYPE OF OCCUPANCY
ESTIMATED AGE OCCUPANCY TYPE/USE HEIGHT (STORIES)
AGENCY INVESTIGATOR
CASE NUMBER PAGE OF
LENGTH
WIDTH
PROPERTY STATUS
LAST PERSON IN STRUCTURE PRIOR TO FIRE TIME/DATE IN STRUCTURE
[ ] OCCUPIED [ ] UNOCCUPIED [ ] VACANT EXITED VIA WHICH DOOR/EGRESS:
BUILDING CONSTRUCTION
FOUNDATION TYPE MATERIAL EXTERIOR COVERING ROOF [ ] BASEMENT [ ] CRAWLSPACE [ ] SLAB [ ] OTHER: [ ] MASONRY [ ] CONCRETE [ ] STONE [ ] OTHER: [ ] WOOD [ ] BRICK/STONE [ ] VINYL [ ] ASPHALT [ ] METAL [ ] CONCRETE [ ] OTHER: [ ] ASPHALT [ ] WOOD [ ] TILE [ ] METAL [ ] OTHER:
[ ] WOOD FRAME [ ] ORDINARY [ ] FIRE RESISTIVE [ ] NON-COMBUSTIBLE [ ] OTHER: TYPE OF CONSTRUCTION
ALARMS PROTECTION SECURITY
SPRINKLERS [ ] Yes [ ] No SMOKE DETECTORS [ ] Yes [ ] No ALERTED OCCUPANTS? Yes No Location(s): HIDDEN KEYS: [ ] Yes [ ] No SECURITY BARS: Location(s): Windows: [ ] Yes [ ] No Doors: [ ] Yes [ ] No STANDPIPES [ ] Yes [ ] No Hardwired? [ ] Yes [ ] No SECURITY CAMERA(S): [ ] Yes [ ] No Battery? [ ] Yes [ ] No Batteries in place? [ ] Yes [ ] No
CONDITION OF DOORS
LOCKED FORCED ENTRY? [ ] Yes [ ] No REMARKS UNLOCKED (CLOSED) WHO FORCED ENTRY? OPEN
CONDITION OF WINDOWS
SECURE BROKEN BY RESPONDERS? [ ] Yes [ ] No UNLOCKED (CLOSED) LOCATION? OPEN BROKEN
UTILITIES ELECTRIC GAS/FUEL WATER TELEPHONE
OVERHEAD UNDERGROUND [ ] ON [ ] OFF [ ] NONE ENTRY: [ ] ON [ ] OFF [ ] NONE [ ] ON [ ] OFF [ ] NONE [ ] ON [ ] OFF [ ] NONE NATURAL LP OIL ENTRY: PANEL: RATING: METER REMOVED? BY: BREAKERS FUSES PANEL SKETCH? Y N
**ADDTIONAL INFORMATION ON REVERSE**