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Lawrence-Douglas County Fire Medical DepartmentFire Investigation Job Aid

NOTIFICATION

Date____________ Time ___:___ hours Name______________________ Incident Location __________________________ Arrival on Scene ___:___ Type of Occupancy: Structure Residential Commercial Vehicle

Wildland

AUTHORITY TO ENTER

Exigent Circumstances Consent to Search (non-exigent circumstances): Written Verbal Warrant: Administrative Criminal

DISPATCH INFORMATION

Call Taker ______________________________ Time of Initial Report ___:___ hours

Name(s) of Caller(s) and Contact Information obtained

INCIDENT INFORMATION

Incident Number ___________ Incident Commander ___________________________ First Unit: _____ On Scene __:__ hours Attack Mode

________________ Method of Entry ______________ All Clear __:__ hours Under Control

__:__hours Casualties / Fatalities: Fire____ Civilian ____ Transport

Location Transport Unit(s) Patient Report(s)

Investigation Level: 1 2 3 Notification to: INV1 Fire Marshal Fire Chief

Assisting Investigators: INV1 INV2 INV3 INV4 INV5 INV6 INV7 INV8 Fire Marshal

Assisting Agencies: LPD DGSO KUPD KHP KSFMO KBI ATF FBI

Report Number _____________ Other__________________________________

WEATHER CONDITIONS

Wind Speed_____m.p.h. Wind Direction______ Ambient Temperature ______°F

Wind Chill _______ Relative Humidity____% Sky _______________________

Investigation Use Onlyfm_fire investigation_job aid_10-16-2014


Precipitation Type____________________ Lightning (www.weatherfusion.com)

www.wunderground.com GPS Coordinates: N_______________ E__________________

SCENE SAFETY and INVESTIGATOR BRIEFING

Hazard Assessment and Safety Briefing (Appendix A) Assess for lighting and power needs

Utilities secured Air monitoring complete for CO and HCN Level of PPE determined Investigator assignments made

INTERVIEWS

First Arriving Crew Incident Commander Law Enforcement EMS Treatment Crew(s) Property Owner Occupant(s) Witness(es) Investigator Assigned _________________________________

Condition prior to fire? Last person in area of origin? Hindrances to access / water?

INITIAL OBSERVATIONS

Scene Security (Appendix B) Perimeter Search Housekeeping

Security Cameras: Affected Property Adjacent Property

SCENE DOCUMENTATION – EXTERIOR

360° Walk Around: Property / vehicles involved Property / vehicle exposures

Building Construction Description Exterior Photos: Street View Address Utilities Point(s) of Entry / Ventilation Fire Damage Evidence

Investigator Assigned ________________________________________________________

SCENE DOCUMENTATION – INTERIOR

Building Construction Description and Interior Finish Interior Photos: Electric Service Panel Water Heater Furnace/Air Conditioning

(HVAC) Point(s) of Entry / Ventilation Progression from least to

most Overall / mid-point / close-up

Casualty Field Notes Completed Investigator Assigned _____________________


http://www.wunderground.com/

http://www.weatherfusion.com/


SCENE DOCUMENTATION – ROOM/AREA OF ORIGIN

Level (floor) – Area – Point(s) of Ignition Note ALL potential ignition sources Identify fuel loads Affected structural components Damage

to area Identify first materials ignited Determine ignition sequence and

progression If appliance obtain: manufacturer model number serial number Request: K9 Forensics Crime Lab

Other________________ Casualty Field Notes Completed Investigator Assigned

____________________

SCENE DOCUMENTATION – SKETCH

Site including locations of apparatus, hose lines, hydrants, exposures, etc. Scale drawing of level, area, room, point of origin, furnishings, switches/outlets,

smoke detectors, etc. Dimensions Identify North Identify Sides Identify Evidence

Collection AreasInvestigator Assigned ______________________________________________________

DEMOBILIZATION

Scene cleared of hot spots with thermal imager Banner tape removed

Tools and equipment collected, accounted for, and cleaned Trash picked up Scene secured / released to property owner Photograph of scene at

departure

FOLLOW UP / CRIMINAL INVESTIGATION

Information Collection Research Additional or Follow-up Interviews Lab Reports Utilize Case Preparation Checklist



Fire Incident Field Notes

OWNER

Name: _________________ Date of Birth:_______________ Drivers License:______________Hair: __________ Eyes: __________ Height: ___ft. ___in. Weight: _____ lbs.Address:____________________________ City: ________________________ State:____Telephone: (Home) ___-____-_____ (Cellular) ___-___-_____ (Business) ___-___-_____Insurer: _____________________________ (Policy Number) ________________________

(Agent) _______________________ (Address) _____________________________(Phone Number) ___-___-_____

OCCUPANT

Name: _________________ Date of Birth:_______________ Drivers License:______________Hair: __________ Eyes: __________ Height: ___ft. ___in. Weight: _____ lbs.Temporary Address: ______________________ City: _________________________ State: ___Permanent Address: ______________________ City: _________________________ State: ___Telephone: (Home) ___-____-_____ (Cellular) ___-___-_____ (Business) ___-___-_____Insurer: ____________________________ (Policy Number) ________________________

(Agent) ______________________ (Address) _____________________________(Phone Number) ___-___-_____

INCIDENT DISCOVERED BY

Name: _________________ Date of Birth:_______________ Drivers License:______________Hair: __________ Eyes: __________ Height: ___ft. ___in. Weight: _____ lbs.Address:____________________________ City: ________________________ State:_____Telephone: (Home) ___-____-_____ (Cellular) ___-___-_____ (Business) ___-___-_____

INCIDENT REPORTED BY

Name: _________________ Date of Birth:_______________ Drivers License:______________Hair: __________ Eyes: __________ Height: ___ft. ___in. Weight: _____ lbs.Address:____________________________ City: _______________________ State:_____Telephone: (Home) ___-____-_____ (Cellular) ___-___-_____ (Business) ___-___-_____



Additional Remarks______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Structure Fire Field Notes

TYPE OF OCCUPANCY

Residential 1 or 2 Family Multi Family Commercial Office

Government Church School Restaurant/bar/lounge Industrial Other: _______________

Estimated Age: __________Height (stories): ___________ Length: _______ Width: ________Levels Below Grade: ______ (description) ___________________________________________

PROPERTY STATUS

Occupied at time of fire: Yes No Unoccupied at time of fire: Yes No

Vacant at time of fire: Yes No Under construction / renovationName of last person in structure prior to fire: ________________________________________Time and Date: _________________ Exited via which door / egress point:_________________

PROTECTION SYSTEMS

Automatic Sprinklers: Yes No In-service at time of fire: Yes No

Operative/Activated: number of heads ___ Inoperative: Disabled Tampering Records of Inspection and Maintenance available and provided: Yes

NoAdditional Notes: _______________________________________________________________

Automatic Fire Alarm: Yes No In-service at time of fire: Yes No

Monitored System Local Alarm Manual Pull Stations Multiple Alarm Panels

Operative/Activated: Obtain Alarm Activation Report Operative/Not Activated

Inoperative: Disabled TamperingInvestigation Use Only

fm_fire investigation_job aid_10-16-2014


Records of Inspection and Maintenance available and provided: Yes No

Additional Notes: _______________________________________________________________

Smoke Detectors: Yes No Hardwired Battery Interconnected Batteries in place: Yes No Locations installed: Bedroom(s) Hallway(s) Stairway(s)

Kitchen Mechanical/Utility Room Basement Wall Mount Ceiling

Mount Did smoke detectors activate/sound: Yes NoAdditional Notes: _______________________________________________________________

Security Cameras: Yes No Video available and provided: Yes NoSecurity Bars: Windows Doors Hidden Key(s): Yes No Location(s):________________________________

CONDITION OF DOORS AND WINDOWS

Doors: Locked Unlocked but closed Open Forced Entry By Whom?_____________________________________________

Windows: Secure Unlocked but closed Open Broken Broken by responders Remarks

__________________________________

CONSTRUCTION TYPE AND FEATURES

Non-combustible (Type I) Fire Resistive (Type II) Ordinary (Type III)

Heavy Timber (Type IV) Wood Frame (Type V) Balloon Platform

Pre-fabricated / Modular Mobile Home / Trailer Trusses

ROOF TYPE AND FEATURES

Gable(s) Hip Mansard Gambrel (barn) Shed Flat Lantern Arched Dormers Trusses Solar Array

ROOF MATERIALS



Asphalt / Composition Shingles Slate Terracotta / Clay Built up

Rubber Membrane Shake Metal Fiberglass Skylights

Other _____________________________________________________________________

EXTERIOR WALL CONSTRUCTION

T1-11 Stucco Brick / Stone Brick/Stone Veneer Wood Shake Asbestos Tile Metal Vinyl Aluminum Lap Glass / Full length windows

Other ______________________________________________________________________

INTERIOR WALL AND CEILING CONSTRUCTION

Wood / Metal Lath and Plaster Concrete block/stone/brick Drywall/plasterboard

Hardwood Wood Paneling Tile / Tile board Exposed joist/truss Wallpaper Fiberglass insulation Blown insulation

Insulation board Grid / Drop ceiling

INTERIOR FLOOR CONSTRUCTION

Finished floors Hardwood Ceramic tile Vinyl / Linoleum Carpet Marble / Granite Asphalt tile Other

________________ Unfinished floors Plywood / particle board Wood

platform Concrete Other ____________________________________________________

INTERIOR USE OF SPACE

Commercial Storefront Commercial Office(s) Warehouse / Industrial use Bedroom(s) ________ Bathroom(s)_______ Living Room Dining Room Kitchen / Eat-in Family Room Laundry / Utility Room Finished Attic Integral Garage Enclosed Porch

FOUNDATION / BASEMENT CONSTRUCTION



No basement / foundation Concrete Slab Finished / Partially Finished

Concrete block walls Poured Walls Dirt floor Poured floor Wood platform / wood floor Stone / brick / tile covering Carpet Exposed wood / steel trusses Exposed wood joists Drywall ceiling Grid / drop ceiling Other

________________________________________

UTILITY DISTRIBUTION

Electrical Panel Documentation form completed Photographic documentation completed

All Utilities Active No Electric Service No Gas Service No Water Service

120v/240v single phase service 240v+ multi-phase service Common/Shared Electric

Breaker-type electrical panel Push button breaker panel Fuse-type panel Multiple Electrical panels Romex / sheathed wiring

Knob and Tube Other ______________________________________________________________________

NG Forced Air Furnace Boiler Heat System Steam Heat System Oil Furnace Electric Heat Common / Shared Gas

and Heat Other ______________________________________________________________________

NG Water Heater Electric Water Heater Common / Shared Hot Water

Other ______________________________________________________________________

Exterior Examination Side A B C DGas MeterElectric Meter Base / Service DropMultiple Electric / Gas Meters

Forced Entry into this SideSecured EntrancesUnsecured Entrances

Open PorchEnclosed PorchNo Porch

Garage Entrance near Side A/B Corner



Garage Entrance near Side A/D CornerGarage Entrance - Lower Level

Main Entrance to First FloorMain Entrance near A/B CornerMain Entrance near A/D CornerMultiple Entrances on this Side

All windows on all levels broken/removed/damagedFirst floor windows broken/removed/damagedSecond floor windows broken/removed/damagedUpper level windows broken/removed/damaged

Smoke stains above/around all doors and windows on all levelsSmoke stains above/around first floor windows/doorsSmoke stains above/around second floor windows/doorsSmoke stains above/around upper level windows/doors

Partial collapse of this side of the structureTotal collapse of this side of the structureHeavy fire damage to exterior walls, windows, doorways, etc. all levelsHeavy fire damage to exterior walls, windows, etc. at upper levelsHeavy fire damage to exterior walls, windows, etc. at lower levelsModerate fire damage to exterior walls, windows, doorways, etc. all levelsModerate fire damage to exterior walls, windows, etc. at upper levelsModerate fire damage to exterior walls, windows, etc. at lower levelsMild fire damage to exterior walls, windows, doorways, etc. all levelsMild fire damage to exterior walls, windows, etc. at upper levelsMild fire damage to exterior walls, windows, etc. at lower levels

No fire damage to this side of structure

Interior Examination Level B 1 2 3 Other

Forced entry into this levelSecured entrance(s)Unsecured entrance(s)

Main entrance into this levelMultiple entrances on this levelGarage entrance on this levelEntrance into Kitchen on this levelStairway leading to basementStairway leading to second / upper floor



Open floor planLiving room on this levelDining room on this levelKitchen / Eat-in Kitchen on this levelOffice / Den on this levelBathroom on this levelEnclosed porch or sun porchOne bedroom on this levelTwo bedrooms on this levelMultiple bedrooms on this levelUtility / Laundry room on this levelBreaker / Fuse Panel on this levelFurnace / Boiler on this levelFireplace(s) on this level

All rooms completely furnished on this levelExcessive content / furnishings on this levelRooms partially furnishings on this levelNo content / furnishings on this levelRooms under construction / renovation on this levelEvidence of homeless activity on this level

Normal housekeepingPoor housekeeping

Heavy smoke stains to all walls, ceilings, and content in all rooms on this levelModerate smoke stains to all walls, ceilings, and content in all rooms on this levelLight smoke stains to all walls, ceilings, and content in all rooms on this level

Interior Examination (continued) Level B 1 2 3 Other

Heavy heat damage to all walls, ceiling, and content in all rooms on this levelModerate heat damage to all walls, ceiling, and content in all rooms on this levelLight heat damage to all walls, ceiling, and content in all rooms on this level

Heavy fire damage to all walls, ceiling, and content in all rooms on this levelModerate fire damage to all walls, ceiling, and content in all rooms on this levelLight fire damage to all walls, ceiling, and content in all rooms on this level

Heaviest

Heaviest

Heaviest



Smoke Heat FireLiving room contentsDining room contentsKitchen contentsFamily room contentsBedroom contentsBathroom contentsRooms situated near the front of the structureRooms situated near the middle of the structureRooms situated near the rear of the structureIntegral garage contentsOther

Level B 1 2 3 Other

Partial collapse of upper level(s) onto this level of the structurePartial collapse of this level into the lower level(s) of the structureTotal collapse of upper level(s) onto this level of the structureTotal collapse of this level into the lower level(s) of the structure

Water damage to this level of the structureOverhaul damage to this level of the structure

No fire damage to this level of the structure


Lawrence-Douglas County Fire Medical DepartmentFire Investigation Job AidFurnishings Locator Sheet 1

(Items may be placed on grid of Sheet 4)

Room Living Room Dining Room Kitchen Bathroom Bedroom Den / Office Laundry Room Utility Room

Furniture - Seating Couch Loveseat Sectional Chair Recliner Ottoman Lift Chair Desk Chair Wooden Metal Synthetic Leather Other __________________________________

Furniture – Tables Coffee End Dining Kitchen

Occasional Folding Wood Metal Glass Other __________

Furniture – Bedroom Twin Bed Double Bed Queen King Bunk Futon Crib Day Bed Other

______________________

Storage – Dining China Closet Hutch Buffet Other ______________________

Storage – Bedroom Dresser Night Stand Chest of Drawers: ______ (number of

drawers) Cedar Chest Armoire Wardrobe Other ______________________

Storage – Media Entertainment Center Armoire TV Stand Bookshelves Computer Desk Desk Other __________________________________

Appliances / Electronics Stove/Oven: Manufacturer____________ Model____________ Serial Number

___________Gas Electric

Refrigerator: Manufacturer____________ Model____________ Serial Number ___________Freezer: Manufacturer____________ Model____________ Serial Number ___________Dishwasher: Manufacturer____________ Model____________ Serial Number ___________Microwave: Manufacturer____________ Model____________ Serial Number ___________Toaster/Oven: Manufacturer____________ Model____________ Serial Number ___________



Coffee Maker: Manufacturer____________ Model____________ Serial Number ___________Washer: Manufacturer____________ Model____________ Serial Number ___________Dryer: Manufacturer____________ Model____________ Serial Number ___________

Gas Electric Iron: Manufacturer____________ Model____________ Serial Number ___________

Furnishings Locator Sheet 2

Appliances / Electronics (continued)Television: Manufacturer____________ Model____________ Serial Number ___________DVD/DVR/VCR: Manufacturer____________ Model____________ Serial Number ___________Cable Box: Manufacturer____________ Model____________ Serial Number ___________Stereo / Radio: Manufacturer____________ Model____________ Serial Number ___________Telephone: Manufacturer____________ Model____________ Serial Number ___________Computer: Manufacturer____________ Model____________ Serial Number ___________Router: Manufacturer____________ Model____________ Serial Number ___________

Wall Covering Plaster Drywall Paint Wallpaper Paneling Brick / Stone Tile Other __________________________________

Floor Covering Ceramic Tile Vinyl Linoleum Laminate Wood Carpet Area Rug Other __________________________________

Doors Interior Exterior Screen Open Closed Forced

Windows Casement Double Hung Jalousie Open Closed Forced

Window Covering Blinds Shades Curtains Sheers Other __________



Lighting Ceiling Table Lamp Floor Wall Sconce Candles Other ___________________________________________________

Trash Receptacle Metal Plastic Plastic Bag Paper Bag

Other __________

Smoking Materials Ash Tray Lighter Matches Cigarettes Cigar Pipe(s) Other ____________________________________________________

Furnishings Locator Sheet 3

HVACCentral Air: Manufacturer____________ Model____________ Serial Number ___________Window A/C: Manufacturer____________ Model____________ Serial Number ___________Furnace: Manufacturer____________ Model____________ Serial Number ___________

Gas Electric Space Heater: Manufacturer____________ Model____________ Serial Number ___________

Electric Oil-filled Kerosene

Outlets Powerstrips Extension Cord Air Freshener Multi-plug Tap


Lawrence-Douglas County Fire Medical DepartmentFire Investigation Job AidFurnishings Locator Sheet 4



Vehicle Fire Field Notes

TYPE OF VEHICLE

Car Pickup Panel van Straight truck Truck tractor Full size Mid size Compact Sub compact Police vehicle Ambulance Fire truck Trailer Semi trailer Double trailer Taxi Public bus School bus Church bus Motorcylce: _____cc Motorized bicycle Bicycle Construction equipment Farm equipment Motorhome Train ATV/UTV: _________ Other __________________________________

VEHICLE INFORMATION

Year: _________ Make: _________________ Model: _______________ VIN: _______________ License: ______________ _ State: _______________ Color: ______________ Odometer: _____________ Tampered

Destroyed

INTERIOR EXAMINATION

Component Intact Consumed Partially Missing Tampered DestroyedFirewall

DashboardRadio

SpeakersGlove boxSteering column

Front seatBack seat

Ignition: Intact Destroyed Pulled Locked On / Off Thumb assist off Other __________________________________Ignition key: In ignition None found

Service Stickers:Oil Mileage ___________________ Date _____________Brakes Mileage ___________________ Date _____________

Personal Effects: Yes No List of Items: ________________________

_________________________________________________________________________________________________________

Additional Notes: __________________________________________________________________________________________________________________________________________________________________________________________________________



_______________________________________________________________________EXTERIOR EXAMINATION

Tires Type / Manufacturer OEM wheel / Aftermarket / Cover

Lugs Missing

Left FrontRight Front

Left RearRight Rear

NOTES:______________________________________________________________________________________________________________________________________________________________________________________

Intact Damaged Melted Missing Leakage Noted

N/A

Fuel TankGas CapFill Pipe

Transmission

Oil PanNOTES:_______________________________________________________________________________________________________________________________________________________________________________________

Areas Inspected √ Previous damage, defects, rust, and severity / vehicle functionalityFront Bumper

GrillHood

Left FenderDrivers Door

Left Rear DoorLeft ¼ Panel

Trunk LidRear Bumper

RoofRight ¼ Panel

Right Rear DoorPassenger Door

Right FenderRear SignalsFront SignalsTail LampsHeadlights

Rear Cargo DoorSide Cargo Door

FoglightsTailgateOtherOther

NOTES:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



GLASS CONDITION

Broken Melted Cracked Missing Intact Up DownWindshield

Rear WindowDrivers Window

Passenger WindowLeft Rear

Right RearNOTES:_______________________________________________________________________________________________________________________________________________________________________________________

Electric Windows: Yes NoSunroof: Open Closed Melted N/AConvertible: Up Down Missing N/AT – Tops: On Removed Melted N/A

DOOR LOCK CYLINDERS

Intact Melted Punched MissingDrivers Door

Left Rear DoorPassenger DoorRight Rear Door

NOTES:_______________________________________________________________________________________________________________________________________________________________________________________

TRUNK / COMPARTMENT EXAMINATIONCar Pick-up Van Trunk/Compartment Lock: Intact Melted Locked Forced Missing

Trunk/Compartment Release: Yes Location:____________________ No Unknown

Forced Entry: Yes By Whom:___________________ Method:_____________________________No

Trunk / Compartment Contents:Spare Tire Tire Changing Tools Other NOTES:________________________________________________________________________________________________________________________________________________________________________

ENGINE COMPARTMENT

Engine Accessibility: Limited (Hood Jammed) Open By Whom:__________________________________Engine: Intact Stripped Burned Not Present Type:________________________________Battery: Intact Melted Burned None Present

Manufacturer:_________________________Radiator: Intact Consumed Removed Missing Hoses / Belts: Intact Broken/Missing None Present Unknown



Full Less Than Full Empty UnknownOil Level

Radiator LevelBrake Fluid

Power SteeringTransmission Fluid

PAGE INTENTIONALLY LEFT BLANK



APPENDIX A

Fire Investigator Scene Safety and Health Hazard Assessment

Physical Hazards Yes NoStanding WaterHoles in the floor(s)Damaged / Unstable structure or structural members presenting potential collapse hazardFree-standing Chimney or other unsecured structural componentsFalling DebrisSlip / Trip / Fall HazardsProtruding Nails / Broken or Jagged GlassExcessive Noise

Physical Hazard AbatementCollapse zones and safety zones establishedAreas containing standing water evaluated and measures taken to mitigate potential hazardsHoles in floor(s) covered or area cordoned off with appropriate physical barriersDamaged structural components shored up, removed, or otherwise secured or area cordoned offDamaged roof mounted HVAC or other equipment secured or removedSource(s) of falling debris secured, removed, or otherwise mitigatedSlip / Trip / Fall hazards isolated or removed or appropriate PPE used (i.e. fall protection)Protruding nails, broken glass, other sharp objects identified, covered, and or removedAppropriate head, hand, eye, hearing, and foot protection worn

Electrical / Utility HazardsDamaged Utility Services (electric / natural gas / propane) Overhead Service Underground ServiceDamaged Electrical Wiring / Equipment / Light Fixtures / Appliances or Natural Gas equipmentDowned Power Lines

Electrical / Utility Hazards AbatementElectric power and/or gas company notified?Appropriate lock-out/tag-out procedures implemented? Specify:Power disconnected at the Service Panel?Confirmation that all underground, above ground and overhead utility services are identified and verified to be de-energized prior to work commencing in areas where there is a risk of contact?Gas lines or equipment secured and shut down to prevent escape of gas/vapor?Structure/scene examined and all alternative sources of power identified and de-energized?Barriers deployed to secure the area to prevent accidental contact with damaged utility services?Is all machinery or equipment capable of movement de-energized, disengaged, or locked out?

Chemical HazardsToxilogical Hazards confirmed or suspected to be present – inhalation, absorption, ingestion,

injectionCarbon Monoxide (CO)Volatile Organic Compounds (VOC) - combustion by-products of petroleum based products



Hydrogen Cyanide (HCN) - combustion by-product of nylon, silk, woolHydrogen Chloride (HCl) – combustion by-product of PVC piping, electrical insulationAcrolein (C3H4O) – combustion by-product of wool, cotton, paper productsAcrylonitrile (C3H3N) – combustion by-product of polyurethane foamVinyl Chloride (CH2=CHCl) – vinyl chloride monomer; combustion by-product of plasticsAsbestosDusts / ParticulatesOxidizersWater Reactive Chemicals

Yes NoPolychlorinated Biphenyl (PCB) – liquid often found in old electrical equipment and devicesOther Known Chemical Hazards – Specify:

Air MonitoringIs or was air monitoring conducted at the scene? If yes provide the following information:

Type of monitoring equipment used: Time and location monitoring was performed: Amount of time since last readings were taken: Results:

Did the monitoring confirm the presence of any hazardous substances in concentrations above OSHA Permissible Exposure Limits (PEL)?

Personal Protective ClothingCoveralls with hard hat/helmet, gloves, eye protection, steel toed bootsStructural firefighting protective clothing ensembleTyvek outer garment with hard hat/helmet, gloves, eye protection, steel toed bootsLevel C ensemble and air purifying respiratorLevel B ensemble and SCBALevel A ensemble and SCBA

Respiratory ProtectionSCBAPowered Air Purifying Respirator (PAPR)Full-face Air Purifying Respirator (APR)Half-face Air Purifying Respirator (APR)N95 disposable particulate mask

DecontaminationAll members briefed on potential hazards and measures to prevent possible contamination?Appropriate measures taken to prevent contamination of members and equipment?All potentially contaminated members protective clothing and equipment decontaminated and/or proper disposal procedures followed?

Biological HazardsBloodborne Pathogens

Sharps or other potentially infectious materialsOther contaminated equipment or containersFire fatalities (victims and/or body parts)

Bloodborne Pathogen Hazards Protective MeasuresUniversal PrecautionsPersonal Protective Clothing and Equipment (protective outer wear, nitrile gloves, face mask, eye protection, footwear)

Special HazardsHazardous Materials / WMD / CBRN / Clandestine Drug Laboratory

Appropriate fire service and law enforcement agencies on scene or notified?Has the site or scene been declared a hazardous materials/hazardous waste site?Investigators equipped to work scene in accordance with 29 CFR 1910.120 requirements and agency SOP’s?



HAZMAT Site Safety Plan completed or operating in accordance with agency safety SOP?

Explosives / Bombing IncidentsHazardous Device Technicians / Bomb Squad on-scene or notified?Scene examined for presence of secondary devices or booby traps?Appropriate personnel safety procedures implemented in accordance with agency SOP’s?Site Safety Plan completed?

Confined SpacesInvestigators to work in any areas considered confined spaces?Any spaces determined to be Permit-Required Spaces?

Required testing, monitoring, ventilation, and personal safety procedures implemented prior to entry?

Overall Incident Risk Classification High Low



APPENDIX B



APPENDIX C


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