Professional Documents
Culture Documents
Bruder Gas Drill Site Incident Report 09172013
Bruder Gas Drill Site Incident Report 09172013
Bruder Gas Drill Site Incident Report 09172013
WB701
FDID
TX
State
MM 09
DD 17
YYYY 2013
Delete
10
Station
13-0026144
Incident Number
000
Exposure
Change No Activity
Incident Date
*
I20
NFIRS -1 Basic
Location* X
Street address Intersection In front of Rear of Adjacent to Directions
Check this box to Indicate that the address for this incident is provided on the Wildland Fire Module In Section B "Alternative Location Specification". Use only for Wildland fires.
Census Tract
HWY
Street Type Suffix
3701
Number/Milepost Prefix
Street or Highway
ARLINGTON
Apt./Suite/Room City Cross street or directions, as applicable
TX
State
76016
Zip Code
E1
gas or LPG)
E 2 Shift
C
Shift or Platoon
& Alarms
Incident Type
D
1 2 3 4 5 N X
Local Option
Alarm
* *
09 09
17 17
01 10
Alarms District
Arrival
E3
Special Studies
Local Option Special Study ID#
Controlled
Their Incident Number LAST UNIT CLEARED, required except for wildland fires
09
18
2013 01:02:48
Actions Taken * 86
Investigate
G1
X
Resources *
Check this box and skip this section if an Apparatus or Personnel form is used.
G 2 Estimated
LOSSES: Personnel Property Contents
Apparatus Suppression
$ $ $ $
, ,
000 , 000 ,
Optional
000 000
EMS Other
PRE-INCIDENT VALUE:
0004
0010
Property Contents
, ,
000 , 000 ,
000 000
Completed Modules
Fire-2 Structure-3 Civil Fire Cas.-4 Fire Serv. Cas.-5 EMS-6 HazMat-7 Wildland Fire-8 Apparatus-9 Personnel-10 Arson-11
H1* Casualties
Deaths
Fire Service Civilian
None
H3
N 1 2 3 4 5 6 7 8 0
Injuries
1 2 U
X X
I Mixed Use Property Not Mixed NN 10 Assembly use Education use 20 Medical use 33 Residential use 40 51 Row of stores 53 Enclosed mall 58 Bus. & Residential Office use 59 Industrial use 60 63 Military use 65 Farm use 00 Other mixed use
J
131 161 162 213 215 241 311 331 124 655 669 807 919 931
Property Use*
Structures
Church, place of worship Restaurant or cafeteria Bar/Tavern or nightclub Elementary school or kindergarten High school or junior high College, adult education Care facility for the aged Hospital
Outside
Playground or park Crops or orchard Forest (timberland) Outdoor storage area Dump or sanitary landfill Open land or field
341 342 361 419 429 439 449 459 464 519 936 938 946 951 960 961 962
Clinic,clinic type infirmary Doctor/dentist office Prison or jail, not juvenile 1-or 2-family dwelling Multi-family dwelling Rooming/boarding house Commercial hotel or motel Residential, board and care Dormitory/barracks Food and beverage sales Vacant lot Graded/care for plot of land Lake, river, stream Railroad right of way Other street Highway/divided highway Residential street/driveway
539 579 571 599 615 629 700 819 882 891 981 984
Household goods,sales,repairs Motor vehicle/boat sales/repair Gas or service station Business office Electric generating plant Laboratory/science lab Manufacturing plant Livestock/poultry storage(barn) Non-residential parking garage Warehouse Construction site Industrial plant yard
Lookup and enter a Property Use code only if you have NOT checked a Property Use box:
Property Use
982
CITY OF ARLINGTON
WB701
09/17/2013
13-0026144
K1
Person/Entity Involved
Local Option Business name (if applicable) Area Code
Phone Number
Check This Box if same address as incident location. Then skip the three duplicate address lines.
MI
Last Name
Suffix
Number
Prefix
Street or Highway
Street Type
Suffix
Apt./Suite/Room
City
More people involved? Check this box and attach Supplemental Forms (NFIRS-1S) as necessary
K 2 Owner
Local Option
Same as person involved? Then check this box and skip The rest of this section. Business name (if Applicable)
817
Area Code
- 572
- 4928
Phone Number
PHILLIP X
Check this box if same address as incident location. Then skip the three duplicate address lines. Mr.,Ms., Mrs. First Name MI
KABAKOFF
Last Name Suffix
3700
Number Prefix
FORT HUNT
Street or Highway
DR
Street Type Suffix
ARLINGTON
City
TX
State
76016
Zip Code
Remarks
Local Option
On 09/17/2013 at 23:00:09 dispatched To 3700 FORT HUNT DR /3701 W I20 HWY/ARLINGTON, TX 76016. The location is a Oil or gas field. The incident was determined to be a(n) Gas leak (natural gas or LPG). 23:13:01 arrived on scene. The following involvements were noted: Name/Business Name Involvement Type ---------------------------------------------------KABAKOFF, PHILLIP Reporting Party KABAKOFF, BETTY Reporting Party
The following actions were performed on scene: Investigate Units responding were: Unit E10 responded. Unit E9 responded. Unit RESCU9 responded. Unit T9 responded.
Authorization CP
Position or rank
01:02:48 in 173 all units back REICHERT, MARK service. Officer in charge ID Signature
Check Box if same as Officer Member making report ID in charge.
T9
Assignment
09
Month
18
Day Year
2013
173
REICHERT, MARK
Signature
CP
Position or rank
T9
Assignment
09
Month
18
Day Year
2013
CITY OF ARLINGTON
WB701
09/17/2013
13-0026144
WB701
FDID
TX
State
MM 9
DD 17
YYYY 2013
10
Station
13-0026144
Incident Number
000
Exposure
Incident Date
Complete Narrative
Narrative: On 09/17/2013 at 23:00:09 76016. The location is a (natural gas or LPG). 23:13:01 arrived on scene.
dispatched To 3700 FORT HUNT DR /3701 W I20 HWY/ARLINGTON, TX Oil or gas field. The incident was determined to be a(n) Gas leak
The following involvements were noted: Name/Business Name Involvement Type ---------------------------------------------------KABAKOFF, PHILLIP Reporting Party KABAKOFF, BETTY Reporting Party
The following actions were performed on scene: Investigate Units responding were: Unit E10 responded. Unit E9 responded. Unit RESCU9 responded. Unit T9 responded.
01:02:48
CITY OF ARLINGTON
WB701
09/17/2013
13-0026144