PUBLIC INFORMATION SECTOR WORKSHEET

Incident Number: _______________ (1) Address: ___________________________________

Occupant: ________________________________________

Owner & Address: _____________________________________________________________________________

ASSIGNMENT: (2)

Engines: _________ Aerial Towers/Ladders: ________ Rescue Units: ________

Ambulances: ______ Chiefs: _____ Total Manpower: __________

TIMES: (3)

Dispatch: ____________ On-Scene: __________ Mutual-Aid: _____________

Under Control: ________ Out-Tap: ____________ In-Service: __________

SITUATION ENCOUNTERED / ACTION TAKEN (4)

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INJURIES / FATALITIES (5)

SPECIAL HAZARDS / ACCOMPLISHMENTS (6)

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DAMAGE ESTIMATE (7) $_______________________

CAUSE:_________________________________________________________________________________________________________________________________________________________________________________