HomeMy WebLinkAbout073-160-021AP 73-1621
T.A. Westphal Jr.
Old Fo'rbestown Rd.
.(FIRE DAMAGE REPORT — 7/8/80)
� s
p
dl
11
i
I.
I
1
11
M C.fl
� ��
i
lRECTlO
1
`
ORDER ,NUMBER
B.L.M.
REG.
R.U.
JINCIDENT NO.
� �
START MO.
_
DAT6�Elp'q JYEAR C/OUNT
L_ C,
FIRE NUMBER
OTHER^"
FIRE NAME:
w L`hm P 0 R 7 1
C-18 (1/Bo) — __z Y_ -,
ORIGIN LOCATION_
SEC. TOWNSHIFION RANGE ®E
/_�LLee99(Is ❑W
INCIDENT TYPE _
I-fIRt;'I FALSE ALARM �
❑
4�'
T 10
amp,
GO 0
w
aRESPONSIBILITY(AT ORIGIN) 46
DIRECT :PRAT. RESP.('D.P.R•) STATUTORY
Ref. J STATE ZONE RESPONSIBILITY
VtILDLAND S.URNED OR THREATENED
'�3,
, SCHEDULE A D.P.R. �J STATE
UNPROTECTED DISTRICT
OTHER AGENCY D.P.R. El CITY'
LOCAL ZONE ❑*COUNTY
OH SCHEDULE A D.P.R.
Q❑ OTHER AGENCY D.P.R. (Unincorp,) B.L.W
FEDERAL ZONE CJ B.IA.
Q7, ❑ FEDERWOKCODt Military) D.P:R. N.P.S.
SCHEDULE A D.P.R. Ej OTHER FEDERAL
®'0 MISC./OTHER(•ZONE•) 11 OTHER
5 CAUSE (STARTS IN o0
Did hot stag in 1 2 5 or t)
[] LIGHTNING
[] CAMPFIRE
6 LAND USE(^STARTS IN
❑ Did not start in 01 <O >a(
DOMESTIC �/
[] RANCH -FARM
[] DUMP
❑ ROAD
❑ UTILITY, RAILROAD
UTILITY, ELECTRIC
[] U C
'�DARflAGE ( 1
❑ NO DAMAGE INDAMAGE IN
TIMBER d/OR
YOUNG GROWTH
WILDLAND VEGETATION
(Other than T& YG)
AGRICULTURAL PROD
(Other than T & Y G )
DWELLINGS
d/OR CONTENTS
OTHER STRUCTURES
8/OR CONTENTS
r VEHICLES 8 CONTENTS
OTHER
TOTAL
nrll 1 r'
.— — — 0 1 — , I ��- � - -e)a .� / 4A
MILES
lRECTlO
®FROM OIN NATIONAL FOREST, FIRE DIST.; CIT 8 STREET NO.,
ETC. '
U.S.F.S.
&RQONLY)
❑ SMOKING E] EQUIPMENT
[]DEBRIS ' [] PLAY W/FIRE
n ARSON 5a OTHER/MISC.
OR >ONLY)
E] FOREST NDUSTRY
E]RECREATION
[]OTHER INDUSTRY-COMRCL.
[]WILDLAND
ANON-WILDLAND
[]OTHER
'VORV ONLY)
Number $ DAMAGE
of (Neared 10
Veh/Owlg 1 2 b/or
0
8A ACRES OF VEGETATION. BURNED
R CT
DI E
PROTECTION
A o
GEN
ACRES BURNED
C S U D .
ZEROi
GO TO
10
CDF
�A'.25 ACRE OR LESS
E19 B .26-9 ACRES
Y
C 10-99 ACRES
D 100-299 ACRES
E 300-999 ACRES i•* 1
F 1000-4999 "ACRES
a G 5000 ACRES OR MORE
9 ON ARRIVAL
r 1 VEGETATION FIRE ❑ OTHER, GO TO 10
` SIZE DISTANCE (Origin to head)
t 3
ACRES
WEATHER (ESTIMATE AT SCENE)
i' WIND DIRECTION FROM TEMPERATURE
M.P.H.
� rY
10
OVER PLEASE
8C
ACRES BURNED
TIMBER
WOOD
(AND
BRUSH
GRASS®�
AGRIC.
'> PROD.
COF ��.--nn
TOTAL J�'O /
8D
w -.L
STATUT.
RESPON.
OF
O ACRES BURNED
STATE',
U.S.F.S.
B.L.M.
W .P.R.S..
Ex -80R)
OTHER
FED.
OTHER^"
TOTAL
FEET
1
OF
GDF 7540-13.0-0118
�741.Z-)'„(, 140 104 LLP
.r
Owner:_ 14
Address
Tenant:
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
SPECIAL INSPECTION REPORT
A. P. #
Date of Inspection'?
Inspector
Building Location:
Type of Inspection requested
1. Housing" / / 2. Financing 3. Change of Occupancy to
4.• Other (specify)_
2
' -Present use, of buildin
'A. Sanitation (Housins)
1. Water closet::. '.-
2. Lavatory:
3 Bathtub or shower:
4. Kitchen sink•
5. Hot and cold water to fixtures:
..6. Heating facilities:
7. Natural light and. ventilation:
8. Room and space requirements:
9.. Bedroom window or'door for second exit:
10. Infestation of insects, vermin, or rodents:
11. Connection..to sewage disposal:
12. Connection to,water'supply:
13. Rubbish and garbage facilities:
14. Comments:
B. Structural
1. Piers and footings:
2. Floor construction:
3'. Wall construction:
4. Ceiling and'roof construction:
5. -Fireplaces:,
6. .Comments d
C. Electrical .
1. -Service "and ground-
2.
round:2. Receptacles:
3. Fusing:
4. Continent s:
D. Plumbing
1. Fixtures connected and vented:
2. Gas water heater:
3. Gas heating vents:
4.. Comments /40 a
(continued on back)
E. Other
1. Maintenance and repair:
2. Fire hazards:
3. Safety hazards:
4. Weatt).er protection:
S. Underfloor and attic ventilation:
6. Comments:
F. Commercial Buildings
1. Roof covering:
2. Distance to property lines:
3. Physically handicapped:
4. Restroom floors and walls:
5. Exits:
6. Improvements:
7. Zoning:_,.
8. Comments:
G. Field Probl.eius or Violations
1. Problet5 or j:jolatignn'give complete description) :
2. What action taken (give complete description):
3, recommended:
- Information only
/ / B. Hold for ten. (10) days, then write letter.
/ / %C. Write letter,
/% D. Other: