HomeMy WebLinkAbouthazmat investigation 1988I?B-44
1. Incident locatlon .eddre6s
Nane
5. Agency Involv edt Nbel/- ?olice-
Nat. Resources DPl./
Coast Guard Other
7. MateriaLs tr'ound:
DOT lftuberss /3t 3
,7i.., l{3-3
,. Investigatl ''g Officer(s)Zzn,rt 0ilEr fu*
4. Investigation Requested by:firrtz,,/ flzBpZUr
Eealth 1,/ater
DE0X
B. Action Taken:1,,,,o fF'/tT c/K(L//7- 8r(/AtUZ
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AREA q?Z€D/ D D
Incident }lo. F &- 5
YIM{OI]IIE tr'IEg DPINT],IENT
EAZARDOIIS I'IATBRI T,S INIT$TIGATION BEPO*I
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6. S,rn}les Taket Y- lt-g' By lllho
Photos Taken _ N_Z_ By llho
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MASSACHUSETTS FIRE INCIDENT REPORT
DEPAFTMENT OF PUBUC SAFETY
1010 Commonweallh Avenue
OFFICE OF THE STATE FIRE MAFSI{AL
Boston. Massachusetts 0221 5
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10 FDID#Department Revis€d
Repo.l
lncident #DATT l Sun 2 Mon 3Tu€
4 Wed sThu 6Fri TSstzootrz<l)o
d
14 O Bru.h, sr....1.@.
15 D Tr$h, rubbi.h
16 tr Elplo.ion. No rlr.r n..
t7 - Our.ad..pall with nr.
lA D olh.r tiG nor cl...ili.d
4il tr Posr limdo{n
/r5 tr ,fti.g .r@i.i. .q!ip6..t
CALTS 6aCYiJ<<F
2 C F.-u. or A-i!i.ne
3 ! lnw.rig.rion orny
5OStdby
6 tr S.lv.s.
MUTUALAID
2 - Give.
FIXEO PROPERTY USE (Occupancy)
II
IGNMON FAfiOR
1I
12 {LASI FIRSI MI)ADDRESS IELEPHONE
13
METTI@ OF ALABM
2 tasnidpd !Lm.ya.63 PriEt.Lm.y.r.n
7 Ti.lln.l9li,
CO iNSPECTION
orsTarcT @
NO RBE SEFN,flCE P€RSONNEL
RESPOND€D
NO, ENGINES
RESPOND€D
NO AERIAL APPAIiATUS
RESPOND€D
SHIFT HAZARMUS MA-IERIAL PRES€NT7
YES D NOtr
SUESTANCE
NO,NO OTHER \iEHICI."E S
HESPOND€O RESPOND€D
USE FP 33
FOF ALL
CASUALTIESSpecial Equafrnent Used?
FIRE
SERVICE
NUMEER OF
INJURIES
NUMBER OF
FATAUNES
NUMBEF OF
ITTJURIES
orxEn
NUMBER OF
FATALITIES
BESCUES
MOBILE PROPEBry TYP€
12 BUS
13 UqIOACYCLE
21 TiUCK OVES r TON
?2IFUC( UNOES 1 TOX
41 SOAI UNO€A 65',
08 NONE
VEHICLE STOLEN?Yestr No!
ESTIMATED TOTAL
DOLLAR LOSS
lnsurance Co.
E Total lnsurance $laim Paid
30
YEAR MAKE MODEL COLOR LICENSE NO,
/O IF EOUIPMENT INVOLVED
IN GNMON YEAA MAKE MODEL SERIAL NO,
COMPTEX
I
AREA OF
ORIGIN INVOLVED IN IGNMON
I
HEATIGNITION MATERIAL IGNITED FOEM ryPE
IMETHOD OF
EXTINGUISHMENT
1
2
3
5
6
7
8
aotrooDCtr
Altm.ric 6n. .y.rmF .onGt hdinlhr @lyPr.soEr h*, hyd'.nr dr.ft rlndliron n<l-l.ij ho../hyd..ht d..n .r..d!xrE
LEVEL OF FIRE ORIGIN
1
2
3
5
6
78
9
0
a l0lo 19L.tD 20 to 29 L.i- 3O to 49 i..itr 50 ro 70 i.n
- Nor clEilEd .hoE
Numbor d Sto.i6
1 C 1 .to.y2 a 2root
8 [] 50..o,i6 o. mo..
CONSTRUCTION TYPE
1
2
3
5
6
7
8
9
0
DDtrCCEo
Proi.cr.d mMmbonibl6Unprorocr.d rcEstr/libro
Pior.cr.d mod tr.tuU.groa.crcd rcod lrm.Nor.lr.lili.d lbow.- Un<r.reman6d or nor reporrod
EXIENI OF OAMAGE
1 Colin.d ro rh. oqod ol dlch2 C6ti..d lo p.n ol r@m or...r ol oncin3 Conntr.d to@molorio'na Confi^.d ro rh. ftsi.r.d como ol o.iein6 Co.fio.d lo floor oloriqi^a C6rin.d ro .rr*ru.6 ol oasin7 En o.t d beyodd rtr*turo ol ondn
I iao d.mh. ol lhi. ryoo lN/A)
D€IECTOA PERFOflMANCEI D Oa. In 106 o, .p&. ol ,'r. onoin oo€r
2 ! Oor. not i. rm o. .o!.. ol tne o.iorn - oE.3fl Oor. n rm o,.pft.oloncrn-.<ioo6r4 Ll Dcr nor in rm. or.D.c6olo.orn no ooer5 tr Dd )n h. or.p6c6 ottn€ orioin buatte roo tm.ilro opo.9 ! Nor cr.i.ili6d abovo0 -- Und6I.rmin6d o. not r6lonsdI a No der..ror. p.oe lN A)
SPf,INKLER PERFORMANCEI ll EquiOnonl op€rared2ll Eqoiomo^r .hould h.ve op6rat6d -3tl
9f]0trafl
Equipm.d p... bur Ii e r@.m.ll
Ud.l.rm'nod or nor rooorrod
No oqu'gm.nr ereenr (N/Al
If SMOKE SPREAD
AE}ONO R@Mof oRtGtN
MATIFIAL GENEAATING MOST SMO(E rYPE I
I
WEATHER
CONDITIONS
AVENUE OF SMOKE
1 : An h.ndlinC ducr
2 I Corido.a OFnr.s '. co^rr,u.tion
otroD
Uril'ry orEning in ll@,
U nd.l.rm'ned or .or .€!D 6dNo !v..ue ol.hole tr.wllN/4,
E.iri8contrin.d in thir r.po^ sre iotended lor th6 sot6use olrh. Srar. Fn6 M66h.l. Estimations and evatu.tion.m.da h.16r. r6pr6io.r "moi.lrrsly" snd _mosr probabt6'@u$ and.ltet Any r6pr6.6nt6ron as to I hs vat'dn v o,6@ur.q ot r.porr.d conditions oulsrdo rh6 Stato tr6Marsh.l! ollic., i3 n.ith6r int..d6d no. imph€d.
FIRE MAFSHALEM-1t-l Y.3 2trNo
DATEMEMEER MAKING REPORT
I
ORlGltlAL: FIRE DEPARIMENT CIREON COPY: SIAIE FIRE MABSHAL
FOBM
FP.32
Day Of
@ABECT AODRESS (U p to maximum of 21 cha racters)zrP cooEllrt CENSUS IRACTtlltr
OCCUPANT NAME {LAS[ FIRSI MI)TELEPHONE ROOM or API
L}A/NEF NAME
a !bic. .ieNl m0oi.ip.l d.m
I ilor clb.ifod ,!or,.
O Und€G6i..d d nor ,€rDri.d
m
t,
$
@
Statlon I Day srill
Duty 0fflcer: DePutY Greene
Reported gasollne leek at the South .Yarmouth Sunoco Statlon by Poud St'
SouEh Yarmouth' rrest dlsPenser. Leak reported by FF Steven Albecht'
On arrlvel found approxlmately I plnt of gasollne on the cement pad near
the dispenser under the flluer and hose.
The attendant shut donn the dtspenser called the maneger and Put sPeedy-
dry on the spll l '
Mr.Tom Marti[ the manager arrlver thanged the fltter end gasket and checked
under the dlpenser for gasoline and as none $as found the dlspenser was
turned on. No further actlon rec.ulred.