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NFIRS 5.

0 Self-Study Program

Fire Module:
NFIRS-2

Objectives
After completing the Fire Module the student will be able to:
1. Describe when the Fire Module is to be used.
2. Demonstrate how to complete various sections of the Fire Module,
given scenarios of hypothetical incidents.

2-1

Table of Contents
Pretest #2 - Fire Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
Using The Fire Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4
Section A: Fdid, State, Incident Date, Station, Incident Number, Exposure Number . . . . . . . 2-4
Section B: Property Details. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4
Section C: Onsite Materials or Products. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-5
Section D: Ignition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
Section E: Cause of Ignition, Factors Contributing To Ignition, Human Factors
Contributing To Ignition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
Section F: Equipment Involved in Ignition, Equipment Power Source,
Equipment Portability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
Section G: Fire Suppression Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-10
Section H: Mobile Property Involved In Ignition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-10
Local Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11
SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11
EXAMPLE: Dwelling Fire. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-12
EXERCISE SCENARIO 2-1: Laundromat Fire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-14
EXERCISE SCENARIO 2-2: Vehicle Fire on I-95. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-17

NFIRS 5.0 Self-Study Program

Pretest #2 - Fire Module


1. The Fire Module should be completed for all fires in a structure.

(a) True.

(b) False.

2. The Fire Module is a required NFIRS module.


(a) True.

(b) False.

3. The Wildland Fire Module can be used in place of the Fire Module for certain incident types.

(a) True.

(b) False.

4. The Fire Module should be completed for outside rubbish fires with no casualties or
property loss.

(a) True.

(b) False.

5. The Fire Module is used to document detector performance.


(a) True.

(b) False.

2-3

NFIRS 5.0 Self-Study Program

Using The Fire Module

he inset labeled, Fire Module Required? in the Remarks section (Block L) of the Basic Module
will tell you if you need to use the Fire Module or other modules. The Fire Module is used for all
fires except for those contained fires with incident type codes 113 to 118 and outside rubbish fires
codes 150 to 155. Use the Fire Module to record information on incidents involving fires, including
building fires, outside storage fires, vehicle fires, and vegetation fires. The Wildland Fire Module also
can be used for vegetation and other outside fires as a second option.

Section A: FDID, State, Incident Date,


Station, Incident Number, Exposure Number
DD
Complete this side forMMall fires

FDID

State

YYYY

Delete

Incident Date

Station

Incident Number

NFIRS2

Change

Exposure

Fire

Property Details
On-Site Materials
commercial,
energy,
or agricultural
products or Use
The
is drawn fromNone
Section
A industrial,
of the
Basic
Module.
B information in Section A of the Fire Module
C or Products
or materials on the property, whether or not they became involved
On-Site
Materials
Enter up
to three
codes. Check one
box for each code
the data in the Basic Module to help you supply
the
requested
information.
If you
are using an autoStorage Use
entered.
Not Residential
B1 system
1
Bulk
storage or warehousing
Estimated number
of residential
living
units into be entered only once, then they will be transferred
mated
the
data
need
automatically
into
2
Processing or manufacturing
building of origin whether or not all units
3
Packaged goods for sale
became involved
4
Repair or service
other modules that use the data.
On-site material (1)
U
Undetermined
Complete if there were any significant amounts of

B2
B3

A Section
None

FDID

D1
D2

E1

B1
Area of fire origin

Heat source

B2

D3
1

Type of material first ignited

MM

DD

YYYY

Incident Date

State

Cause of Ignition

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

Incident
Number
Station
1
Bulk storage
or warehousing

2
3
4
U

Not Residential

Exposure

Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

On-Site Materials
or Products
Human Factors

Skip to
Section G

Check box if this is an exposure report.

None

Complete if th
commercial, in
or materials on

E3EnterContributing
up to three codes.
Check one box for each code
to Ignition
entered.

Check all applicable boxes

Estimated1number
of residential living units in
Intentional
building of origin whether or not all units
2
Unintentional
became involved

None

1 Asleep
3
Failure of equipment or heat source
Possibly
impaired
by
2 On-site
material
(1)
4
Act of nature
alcohol or drugs
5
Cause under investigation
3 Unattended person
Buildings
not involved
Cause undetermined
after investigation
4 Possibly mentally disabled
U
Number of buildings involved
5 Physically disabled
Factors Contributing to Ignition
None
Multiple
persons
involved
6 On-site
E2
material
(2)

Check box if fire spread was


confined to object of origin.

B3

D4

On-site material (2)

Property DetailsOn-site material (3)

Ignition

Item first ignited

B: Property Details

Less than one acre

Acres burned (outside fires)

B
D

1
2
3
4
U

Buildings not involved


Number of buildings involved

, contributing to ignition (1)


Factor

Acres
Required only if item
first
ignited code is 00 or <70

Estimated age of
person involved

Less than one acre

burned (outside fires)

Age was a factor

None

On-site
material (3) 2
1
Male

Factor contributing to ignition (2)

Female

Equipment Involved in Ignition Ignition


Fire Suppression
Equipment Power Source
None
Cause Factors
of
Block
the
building
ofIgnition
origin. The
total
F1 B1 records data regarding
F2 of residential living units
G inE
D the number
1
Enter up to three
codes.
Check
box
if
this
is
an
exposure
report.
equipment
was not
involved, skip
to
numberNone
of unitsIfSection
must
be
entered
without
regard to how many actually became involved in the incident.
G

Skip to
Section G

1
Intentional
D1
For apartment buildings,
townhouses, and
row
houses
enter the number of
Fire suppression
(1)
Area ofcondominiums,
fire origin
2 factorUnintentional
Equipment Involved
Equipment Portability
F3
separately owned or rented units.
3
Failure of equipment or heat source
Brand
Equipment Power Source

D2

Model

Heat source

Serial #

Item first ignited

H1

Mobile Property Involved

None

D4

Portable

Stationary

Portable equipment normally can be moved by


one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

D3

Year

H2

4
5
U

Act of nature
Cause under investigation
Cause undetermined after investigation

Fire suppression factor (2)

Factors Contributing to Ignition

Fire suppression factor (3)

2-4
Check box if fire spread was

E2

confined to object of origin.

Mobile Property Type and Make

Local Use
Factor contributing to ignition (1)

Pre-Fire Plan Available

None

ate

NFIRS 5.0 Self-Study Program

For hotels, motels, and the like enter the number of lodging units.
If it is not a residential unit, simply mark the Not Residential box.
Enter the total number of buildings involved in the fire in Block B2 for the initial fire. This field is
not completed on exposure reports. Each exposure is numbered sequentially starting at 001. For
outside fires that also consume buildings, exposure reports should be completed. If no buildings
were involved, check the Buildings not involved box.
B3 has space to record the number of acres burned in an outside fire. Two boxes are available - one to
indicate None and the other to specify Less than one acre. This should be your best estimate.
For vegetation and outside fires, the department may choose to use the Wildland Module: NFIRS-8
instead of the Fire Module: NFIRS-2.

MM

DD

Delete

Incident Date

Station

C
Not Residential

Incident Number

On-Site Materials
or Products

Change

Exposure

None

Complete if there were any significant amounts of


commercial, industrial, energy, or agricultural products or
or materials on the property, whether or not they became involved

Enter up to three codes. Check one box for each code


entered.

On-Site Materials
Storage Use

On-site material (1)

1
2
3
4
U

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

On-site material (2)

1
2
3
4
U

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

1
2
3
4
U

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

esidential living units in


er or not all units

Buildings not involved

olved

fires)

NFIRS2

Fire
Section C: Onsite Materials or Products

YYYY

None
Less than one acre
On-site material (3)

Cause
of Ignition
Human
Factorsproducts or materials are
If no significant
amounts
of commercial, industrial, agricultural,
or energy
E1 Check
E3 Contributing
Skip to
to Ignition
box if this is an exposure report.
G
stored on this property mark the None box inSection
Block
C.
Check all applicable boxes

None

Intentional
If any of 2the listed
products or materials were present, whether
or not they became involved, the rest
Unintentional
1 Asleep
of Block 3C should
beofcompleted.
Failure
equipment or heat source
2 Possibly impaired by
4

Act of nature

alcohol or drugs

To complete
Block
enterinvestigation
a code (found in the NFIRS Complete
Reference Guide
(CRG)) for any significant
5
CauseC,under
person
3 Unattended
amount U
of material
stored, processed,
sold, or used for4providing
the property involved.
Cause undetermined
after investigation
Possiblyservices
mentallyatdisabled
PhysicallyInformation
disabled
5 materials.
Lines are provided
to
identify
information
for
up
to
three
is entered whether
Factors Contributing to Ignition
None
6 Multiple persons involved
E
2
Check box if fire spread
orwas
not the material was involved in the fire.
confined to object of origin.

Example:
Factor contributing to ignition (1)

Age was a factor

Estimated age of

person involved
A crack house could be coded as a Residential Property
Use (419) and the Onsite Material
1
2
could Factor
be coded
asto ignition
545:(2)Illegal Drugs.
contributing
Male
Female

Required only if item first


ignited code is 00 or <70

For each OnsiteEquipment


Material Power
entry Source
made, you must
mark one of
the four boxes
to the right. Mark
Fire Suppression
Factors
None
F2
Processing/Manufacture
if the material G
is both stored and processed at this site. A box must be
Enter up to three codes.
pment was not involved,marked
skip to
whenever an Onsite Material entry is made.

ved in Ignition

on G

Equipment Power Source

F3

Equipment Portability
1

Portable

Stationary

Fire suppression factor (1)

2-5

Fire suppression factor (2)

B2

Buildings not involved


Number of buildings involved

NFIRS 5.0 Self-Study Program

B3

D
D1
D2

On-site material (2)

None

Section D: Ignition

Less than one acre

Acres burned (outside fires)

On-site material (3)

Ignition

E1

Area of fire origin

Heat source

D3
Item first ignited

Check box if fire spread was


confined to object of origin.

D4

Cause of Ignition

Skip
Secti

Check box if this is an exposure report.

1
2
3
4
5
U

Intentional
Unintentional
Failure of equipment or heat source
Act of nature
Cause under investigation
Cause undetermined after investigation

E2

Factors Contributing to Ignition

Factor contributing to ignition (1)


Type of material first ignited

Required only if item first


ignited code is 00 or <70
Factor contributing to ignition (2)

Equipment
Involved
in Ignition regarding the area
Equipment
Powerheat
Source
Separate lines of Block D willFallow
you to capture
information
of fire origin,
1
F2
G
source, item first ignited, and type of materialIf equipment
first ignited.
was not involved, skip to
None

Fire S

Enter u

Section G

the Source
fire started. The
Use Line D1 for entering a code (found in the NFIRS Handbook) to indicate where
Equipment Power
code list is organized into three
areas:
Equipment Involved
Structure
Vehicle
Outside

F3

Brand
Model
Serial #

Equipment Portability

Portable

Stationary

Portable equipment normally can be moved by


one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

This section must be completed


for all fires.
Year

Fire suppression

Fire suppression

Fire suppression

Lines D2 and D3 furnish spaces to enter codes for the Heat source and the Item first ignited. You
are required to make entries on both
lines.
If the fire spread was confined to object
of origin, check
Property Involved
Mobile Property Type and Make
None
H1 Mobile
H2 the
box means that the fire spread beyond
object of origin.
the box below line D3. An unmarked
Not involved
in ignition,
burned
1
Line D4 is for recording information
regarding
thebuttype
of material first ignited. You should fill in
Mobile property type
2
Involved
in
ignition,
but
did
not
this line whenever the item code first ignited is betweenburn
00 and 70.
3

Involved in ignition and burned


Mobile property make

Section E: Cause of Ignition, Factors Contributing To


Ignition, Human Factors Contributing To Ignition
Mobile property model

Year

License Plate Number

State

VIN

Structure fire? Please be sure to complete the Structure Fire form (NFIRS3).

In combination, Sections D and E provide excellent information on how and why a fire started. All
fields in Section E are required entries.

2-6

Lo

B2

Buildings not involved


Number of buildings involved
On-site material (2)

B3

B
D

B11
D

D2
B2
D3

B3
D4

MM

YYYY

Incident Date

State

Incident Number
Stationmaterial (3)
On-site

Property Details
Ignition

E1
Not Residential

1
2
3
4
5
Buildings not involved
U

Number of buildings involved

Equipment Involved in Ignition

Area of fire origin

None

Bulk storage
warehousing
Delete or NFIRS2
Processing or manufacturing
Packaged goods forFire
sale
RepairChange
or service
Undetermined

Check box if this is an exposure report.

Complete if there were any significant amounts of


Human
Factors
commercial, industrial, energy,
or agricultural
products or
3
or materials
on the property,
whether or not they became involved
Skip to

Section G

On-site material
(2)
Factors
Contributing
to Ignition

Contributing to Ignition
On-Site Materials
Check all
applicable Use
boxes
Storage
None
1

Bulk storage or warehousing

2
Processing or manufacturing
Asleep
3
Packaged goods for sale
4
Repair impaired
or service by
Possibly
U
Undetermined
alcohol or drugs
Unattended
person
1
Bulk storage or warehousing
2
Processing
or manufacturing
Possibly
mentally
disabled
3
Packaged goods for sale
Physically
4
Repair ordisabled
service
U
Undetermined
Multiple persons involved

1
2

3
4
5
None
6

F2

Fire Suppression
Factors
Check all applicable
boxes

Fire suppression factor (1)


5
Cause
under investigation
3
Equipment
Portability
4
UF3 Cause undetermined after investigation
5
Factors Portable
Contributing to Ignition
None
6
E2 1
Fire suppression factor (2)
2
Stationary
7

odel Item first ignited

Equipment Power Source

None

None
1 of Intentional
You also may record the cause
a fire incident as under investigation.
If no cause is ever determined,
Enter up to three codes.
2
Unintentional
1 Asleep
If equipment was not involved, skip to
the cause
can be changed to3 undetermined
after investigation. This allows2 managers
to better track
Section
G
Failure of equipment or heat source
Possibly impaired by
Power
Source
whether an investigator has4Equipment
updated
the
incident
report
with
the
actual
cause.
Act of nature
alcohol or drugs

and

Check box if fire spread was


confined to object of origin.

erial #

Portable equipment normally can be moved by


Factor
contributing
to ignition
(1) to be used in
one or
two persons,
is designed
multiple locations, and requires no tools to install.

Type of material first ignited

Required only if item first


ignited code is 00 or <70

Unattended person
Possibly mentally disabled
Physically disabled
Multiple persons involved
Age was a factor

Estimated age of
involved

Fire suppression factor (3)person

Factor contributing to ignition (2)

Mobile Property Involved


None
1 Equipment Involved in Ignition
2
Use
Block
E
to
record
1

Mobile Property Type and Make

Male

Female

Local Use

H2Factors
Fire Suppression Factors
Equipment
Powerto
Source
the
Contributing
Ignition.
(fromNone
the
F2
G Use the appropriate
Pre-Fire codes
Plan Available
Some
of
the
information
presented
in
this
report
may be
Enterto
up indicate
to three codes.
CRG).butYou
may note up to two factors or check the None box
that no factors were
Not involved in ignition,
burned
If equipment
was
not involved, skip to
None
based upon reports from other agencies:
Mobile
property
type
Section
involved.
Involved in ignition,
butGdid not burn
Equipment Power Source

Involved in ignition and burned


3

uipment Involved

and

Arson
attached
suppression
factor (1)
Block E offers a number ofMobile
options
to
recordPortability
human factorsFirethat
contribute
to thereport
ignition
of a fire.
property
make
Equipment
Police report attached
3
More than one factor can beFmarked.
Coroner report attached

obile property model


del

rial #
cense Plate Number

None

Intentional
Unintentional
Failure
equipment
or heat source
On-siteof
material
(1)
Act of nature
Cause under investigation
Cause undetermined after investigation

E2

Check box if fire spread was


Noneof origin.
confined to object

HeatInvolved
source
uipment

ar

1
2
3
4
U

1 filling out Block E1, the first question to be answered is whether or not this is an exposure
When
wasstorage
a factor
7 Age
Bulk
or warehousing
report.
thenthancheck
the box and go directly to Section G. Skip the rest
of12 Sections
E orand
all of
Processing
manufacturing
Acres burned (outside
fires) If it is, Less
one acre
3
Packaged
goods for sale
Factor contributing to ignition (1)
Estimated
age
of
4
Repair
or
service
1
Section F. If this is not an exposure On-site
report
mark
one
of
the
other
boxes
in
E
to
indicate
the
cause
of
material (3)
person
U involved
Undetermined
Required only if item first
Type of material first ignited
ignited
code is 00 or versions
<70
ignition. In
previous
of NFIRS, users were forced to decide between incendiary and suspiFactor contributing
to ignition
(2)
Male
Female
Ignition
Causeadded
of
Ignition
Factors
cious. The measurement of arson
those
two codes together. Now 1youHuman
are able
to2 indicate
E1 fires
E
3
Skip to
Contributing
to
Ignition
Check
box
if
this
is
an
exposure
report.
that a fire was intentionally set without stating that a crime was committed.
Section G
Item first ignited

11

ear

On-Site
Materials
Cause
Ignition
C orofProducts

Exposure

Enter up to three codes. Check one box for each code


entered.

Estimated number of residential living units in


Area of fire origin
building of origin whether or not all units
became involved

Heat source

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

NFIRS 5.0 Self-Study Program


DD

Less than one acre

Acres burned (outside fires)


FDID

None

1
2
3
4
U

Portable Year

Stationary

Portable equipment normally can be moved by


one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

VIN

State

Structure fire? Please be sure to complete the Structure Fire form (NFIRS3).

Other reports attached


Fire suppression factor (2)

Fire suppression factor (3)


NFIRS2 Revision 01/01/05

Mobile Property Involved

None

H2

Mobile Property Type and Make

Local Use
Pre-Fire Plan Available
Some of the information presented in this report may be
based upon reports from other agencies:

Not involved in ignition, but burned


Mobile property type

Involved in ignition, but did not burn


Involved in ignition and burned

Mobile property make

obile property model

Year

Arson report attached


Police report attached
Coroner report attached
Other reports attached

2-7

ense Plate Number

State

VIN

Structure fire? Please be sure to complete the Structure Fire form (NFIRS3).
NFIRS2 Revision 01/01/05

On-site material (2)

ne acre

E1

1
2

Bulk storage or warehousing


Processing or manufacturing

4
U

Repair or service
Undetermined

Cause of Ignition
Check box if this is an exposure report.

Skip to
Section G

Human Factors
MM
Contributing to Ignition

E3

DD

YYYY

Check all applicable boxes

1
2
3
4
5
U

E2

Incident
Date
FDID
State
None
Intentional
Unintentional
1 Asleep
Details impaired by
Failure of equipment or heat source B Property
2 Possibly
Act of nature
alcohol or drugs
Cause under investigation
3 Unattended person
Not Residential
Cause undetermined after investigation
mentally disabled
4 Possibly
B1 Estimated
number of residential living units in
5 Physically
building
of origin whetherdisabled
or not all units
Factors Contributing to Ignition
None became involved
6 Multiple persons involved

Station

Incident Number

On-Site Materials
or Products

Expo

None

Complet
commer
or mater

Enter up to three codes. Check one box for each cod


entered.

On-site material (1)

Age was a factor

B2

Factor contributing to ignition (1)

Buildings not involved

Estimated age of
person involved

Number of buildings involved

rst
70

On-site material (2)

Factor contributing to ignition (2)

B3
Equipment Power Source

Male

Female

,
Acres burned (outside fires)

Fire Suppression Factors

None
Less than one acre

None
The last part of E3 can G
be useful in tracking juvenile firesetter
trends and the effect ofOn-site
firematerial
on the
(3) elderly.
Enter
up
to
three
codes.
In this field mark the Age was a factor box when there is evidence that age was a factor in ignition.
Ignition
Causeoroffemale.
Ignition
Then enter the estimated age of the
person involved, and whether the person is male
Equipment Power Source

F2

to

Packaged goods for sale


Repair or service
Undetermined

3
Packaged
goodsProgram
for sale
NFIRS
5.0 Self-Study
On-site material (3)

3
4
U

F3

Equipment Portability

Skip t
Sectio

Check box if this is an exposure report.

D1

1
2
3
4
5
U

Intentional
Unintentional
Failure of equipment or heat source
Act of nature
Cause under investigation
Cause undetermined after investigation

Section F: Equipment Involved in


D2
Ignition, Equipment
Power Source, Equipment Portability

Portable

Stationary

Portable equipment normally can be moved by


one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

H2

E1

Fire suppression factor (1)

Area of fire origin

Fire suppression factor (2)

Heat source

Fire suppression factor (3)

Factors
Contributing
to Ignition
3 equipment involved in this ignition? Equipment
First answer the question, Is D
there
involved
is a piece
E2
Item first ignited
Check
box
if
fire
spread
was
1 confined
of equipment that provided the principal heat source
to cause
ignition.
If the answer is no, then check
to object
of origin.
Mobile the
Property
Type
and
Make
Local
Use
None box and go directly to Section G.

D4

Factor contributing to ignition (1)

Pre-Fire Plan Available

Type of material first ignited


Required only if item first
If you do not mark the NoneSome
box
mustpresented
complete
themay
rest
of the Block F1.
of you
the information
in this ignited
report
codebe
is 00 or <70
based upon reports from other agencies:

Mobile property type

Factor contributing to ignition (2)

F1

Mobile property make

Year

Arson report attached


Equipment Involved in Ignition
Police report attached
Coroner report attached
If equipment was not involved, skip to
NoneOther reports
attached
Section G

F2

Equipment Power Source

Fire S

Enter u
Equipment Power Source

VIN

tructure Fire form (NFIRS3).

Equipment Involved

F3

Brand
NFIRS2 Revision 01/01/05

Model
Serial #

Equipment Portability
1

Portable

Stationary

Portable equipment normally can be moved by


one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

Year

H1

Mobile Property Involved

Not involved in ignition, but burned

Involved in ignition, but did not burn

Involved in ignition and burned

None

H2

Fire suppression

Fire suppression

Mobile Property Type and Make

Lo

S
b

Mobile property type

Mobile property make

2-8
Mobile property model

Fire suppression f

Year

A
B2
B

Estimated number of residential living units in


building of origin whether or not all units
Incident Date
FDIDbecame involved
State

Incident Number
Station
On-site material (1)

Property Details
Buildings not involved
Number of buildings involved

B1
B3

On-Site Materials

C5.0orSelf-Study
NFIRS
Program
Products

None

Complete if there were any significant amounts of


commercial, industrial,1energy,
or agricultural
products
or
Bulk
storage or
warehousing
or materials on the property,
whether or notor
they
became involved
2
Processing
manufacturing

3
Packaged
goods for sale
On-Site
4
RepairMaterials
or service
Storage
Use
U
Undetermined

Enter up to three codes. Check one box for each code


entered.

On-site material (2)

Not Residential

1
Bulkinvolved
storage or warehousing
Block F has a line for you to enter a code description which best identifies the equipment
2
Processing or manufacturing
3
Packaged
goods
for sale
1 choices:
Bulk storage
or warehousing
in the ignition. To find the correct code quickly, select a subsection from the following
4
Repair or service
2
Processing
or manufacturing

Estimated number1of residential living units in


building of origin whether or not all units None
,
became involved
Acres burned (outside fires)
Less than one acre

On-site material (1)

On-site material (3)


Heating, Ventilating & Air Conditioning;

Buildings not involved


B2 Number of buildings involved
Power
Transfer;
Ignition Electrical Distribution, Lighting and
Cause
of Ignition
On-site material (2)
D
E1 Check
box if this is an exposure report.

Skip to
Section G

Shop Tools & Industrial Equipment;

B13
D

None

1
Intentional
fires)
Commercial
&Less
Medical
than oneEquipment;
acre
AreaAcres
of fire burned
origin (outside
2
Unintentional
On-siteof
material
(3)
3
Failure
equipment
or heat source
Garden Tools & Agricultural4 Equipment;
Act of nature
D2 Heat source
5
Cause
investigation
Ignition Kitchen & Cooking Equipment;
Causeunder
of Ignition
D
E1 Cause
undetermined
after investigation
Skip to
U
Check box if this is an exposure report.

D
D31
D
D42
D3
F1

None

None
Bulk storage or warehousing
Processing or manufacturing

1
2

1
2

Required only if item first


ignited code is 00 or <70

Estimated age of
person involved

Equipment Power Source


Factor contributing to ignition (2)

Equipment Portability

Fire suppression factor (1)

Male

F3 the power source of the equipment involved with the fire igniBlock F2 asks for a code that describes
Equipment Involved in Ignition
Fire Suppression Factors
Equipment Power Source
tion. Examples are: gas, liquid fuels,Fsolid
and electrical. When
combined with other factors in
2 1 fuels,Portable
G
Fire suppression factor (2)

Brand

FModel
1

Nonethe

Portable equipment normally can be moved by


Equipment Power Source
one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

Year
Equipment Involved

F3

Brand

Mobile Property Involved

Serial #

Female

None

Enterfire.
up to three codes.
Stationary
ignition
sequence,
the skip
power
source 2can help
identify the cause of the
If equipment
was not involved,
to
Section G

Serial #

Not involved in ignition, but burned

2Year

Involved in ignition, but did not burn

Involved in ignition and burned

None

H2

Equipment Portability

Portable
1
Mobile Property Type and MakeFire suppression
Local
Use
factor (2)
2
Stationary
Pre-Fire Plan Available

Portable equipment normally can be moved by


one or two persons, is designed to be used in
Mobile
property
type and requires no tools to install.
multiple
locations,

Mobile property make

in Block
F3 by
MobileFill
Property
Involved

Fire suppression
suppression factor
factor (1)
(3)
Fire

Some of the information presented in this report may be


based upon reports from other agencies:
Fire suppression factor (3)

indicating
the equipment
involved
in the
Property Type
and Make
None whether Mobile
H
2
tionary.
Portable
equipment
has
three
characteristics:
Mobile property model
Year

Arson report attached


Police report attached
ignition
portablereport
or staLocalwas
Use
Coroner
attached
Other reports attached
Pre-Fire Plan Available
Some of the information presented in this report may be
based upon reports from other agencies:

Not involved in ignition, but burned

1. It can be moved by one person.Mobile property type

2License Involved
in ignition, but did not burn State
Plate Number
3

Check all applicable boxes

Factor contributing to ignition (1)

Equipment Involved

Undetermined
Packaged
goods for sale
Repair or service
Undetermined
Bulk storage or warehousing
Processing or manufacturing
Packaged
goods for sale
Human
Factors
Repair or
service
Undetermined to Ignition
Contributing

Enter up to three codes.

If equipment was not involved, skip to


Section G

Type of material first ignited

H1

E3

U
3
4
U
1
2
3
4
U

Asleep
3
Packaged goods for sale
4
Repair or service
Possibly
impaired by
U
Undetermined
alcohol or drugs
person
3 Unattended
Human Factors
mentally
disabled
4E3 Possibly
Contributing to Ignition
Section G
Physically
disabled
5
Electronic Equipment; and/or Factors Contributing to Ignition
None Check all applicable boxes
None
6 Multiple persons involved
E2 Intentional
1
Item first ignited
Check
box
if
fire
spread
was
1 confined to object of origin.
Area of fire origin
2
Unintentional
1 Asleep
Personal & Household Equipment:
Other.
7 Age was a factor
3
Failure of equipment or heat source
2 Possibly impaired by
contributing
to ignition
Estimated
age
4 Factor Act
of nature
alcohol
orofdrugs
Enter the brand name, model name/number,
serial(1) number, and model year of
the
equipment
person
involved person
Typesource
of material first ignited
Required only if item first
5
Cause
under
investigation
Unattended
3
Heat
involved, if known,
lines
ignitedon
codethe
is 00 or
<70 provided in Block F1.
Cause undetermined after investigation
4 Possibly mentally disabled
U
1
2
Factor contributing to ignition (2)
Male
Female
disabled
5 Physically
Factors Contributing to Ignition
None
6 Multiple persons involved
E2
Item first ignited
box if fire spread was
Equipment Involved
in Ignition
Equipment Power Source
Fire Suppression Factors
1 Check
None
confined to object of origin.
F2
G
7 Age was a factor

D4

Model
H
1

Processing or manufacturing
Fire
Packaged
goods for sale
Change
Repair or service
Undetermined

2
3
4
U

Exposure

VIN

2. It is designed to be used in multiple locations.

Involved in ignition and burned


Structure fire? Please be sure to complete the Structure Fire form (NFIRS3).

3. It requires no tools to install.

Mobile property make

Arson report attached


Police report
attached
NFIRS2
Revision 01/01/05
Coroner report attached
Other reports attached

Year
Equipment portability is another factor to be considered
in determining the cause of a fire.

Mobile property model

License Plate Number

State

VIN

Structure fire? Please be sure to complete the Structure Fire form (NFIRS3).
NFIRS2 Revision 01/01/05

2-9

B2 Number of after
Cause undetermined
buildingsinvestigation
involved

e spread was
ect of origin.

E2

Factors Contributing to Ignition

B3

None

Acres burned (outside fires)

was Program
a factor
NFIRS75.0 Age
Self-Study
Less than one acre

Estimated age of
person involved

Factor contributing to ignition (1)

Factor contributing to ignition


(2)
Ignition

F2

Area of fire origin

Equipment Power Source

F3

D2 Heat source
Equipment Portability

1
2

On-site material (3)

Section G: Fire Suppression


Factors
CauseFemale
of Ignition
Male

Equipment Power Source


D1

olved, skip to

Possibly mentally disabled


Physically disabled
On-site material (2)
Multiple persons involved

4
5
None
6

only if item first


de is 00 or <70

ate

Buildings not involved

E1

Stationary

Skip to
Section G

Check box if this is an exposure report.

Fire Suppression Factors


None
1
Intentional
Enter up to three codes.
2
Unintentional
3
Failure of equipment or heat source
4
Act of nature
5
Cause under investigation
Fire suppression factor (1)
Cause undetermined after investigation
U

DPortable
3
Item first ignited

Fire suppression
(2)
Check box iffactor
fire spread
was
confined to object of origin.

E2

Portable equipment normally can be moved by


one or two persons,4is designed to be used in
multiple locations, and requires
tools tofirst
install.
factor
Type ofno
material
ignited Fire suppression
Required
only(3)
if item first
ignited code is 00 or <70

Factors Contributing to Ignition

E3

2
3
4
U

Processing
Packaged g
Repair or se
Undetermin

1
2
3
4
U

Bulk storage
Processing
Packaged g
Repair or se
Undetermin

Human Fac
Contributin

Check all applicable boxes

3
4
5
None
6

Asleep
Possibly impa
alcohol or dru
Unattended p
Possibly men
Physically dis
Multiple pers

Age was a fac

1
2

Estimated age of
person involved

Factor contributing to ignition (1)

Factor contributing to ignition (2)

Male

Lines are provided to collect information regarding conditions or factors that affected the fire sup-

Mobile Property Type and Make


Local Use
Equipment Involved in Ignition
Fire Suppression Factors
Equipment Power Source
H2 pression
or fire management decisions.
If noPlan
Feffort
1
Fcondition
2 Availableor factor had an effect,
G mark the
Pre-Fire

None

Enter
up to three codes.
of the informationfor
presented
in this
report may
be
None box. Enter
in NFIRS
Handbook)
up to
three
factors
or conditions that
constiequipment was
not Some
involved,
skip to
None codesIf (found
based upon reports from other agencies:
Section
G
Mobiletuted
property a
type
significant suppression problem during the incident
or might be a fire prevention problem
Equipment Power Source
in the future.
Arson report attached
Fire suppression factor (1)

Equipment Portability
Police report attached

Equipment Involved
Mobile property make

F
3 due to trouble finding location after incorExample:
The first-due engine company was
delayed
Brand
Coroner
report
attached
Portable
1
rect information
(424) was given by the Other
dispatcher.
reports attached
Year
Model

Serial #
VIN

Stationary

Portable equipment normally can be moved by


one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

Fire suppression factor (2)

Section H: Mobile Property Involved In Ignition

Year

plete the Structure Fire form (NFIRS3).

Fire suppression factor (3)

NFIRS2 Revision 01/01/05

H1

Mobile Property Involved

Not involved in ignition, but burned

Involved in ignition, but did not burn

Involved in ignition and burned

None

H2

Mobile Property Type and Make

Local Use

Pre-Fire Plan A

Some of the information presented i


based upon reports from other agen

Mobile property type

Mobile property make

Mobile property model

License Plate Number

Year

State

Arson report at
Police report at
Coroner report
Other reports a

VIN

Structure fire? Please be sure to complete the Structure Fire form (NFIRS-3).
(NFIRS3).

NFIRS2

Block H1 has four boxes that can be marked to indicate the involvement of mobile property in an
ignition. If no such property is involved, mark the None box. When mobile property is involved,
you will need to mark Box 1, 2, or 3 to clarify the type of involvement.
Example: If the wheel rim on a car with a flat sends a spark that starts a grass fire but the car does
not burn, Box 2 would be marked.

2-10

Check box if this is an exposure report.

Check all applicable boxes

1
2
3
4
5
U

d was
igin.

E2

None
Intentional
Unintentional
1 Asleep
Failure of equipment or heat source
impaired
by
2 Possibly
NFIRS
5.0 Self-Study
Program
Act of nature
alcohol or drugs
Cause under investigation
3 Unattended person
Cause
undetermined
investigation
disabled
If Boxes
2 or 3 areafter
marked,
you should fill4 outPossibly
Section mentally
H2, which
uses codes to identify the type of mobile
5 Physically disabled
Factors
Contributing
Ignition
property
involved.toThe
codes are organized
into categories for ground, rail, air, and water vehicles.
None
6 Multiple persons involved

NOTE: When mobile property is used as a fixed 7building


transportation, check the Not Involved box and skip the
Age instead
was a of
factor
rest oftoSection
Moduleage
would
Factor contributing
ignition (1)H. In this situation, the Structure Fire
Estimated
of be completed.
person involved

em first
or <70

Codes also are used to indicate the make of the mobile property. The code list includes most vehicles.
1
2
Factor contributing
Maleand enter
Female
If theto ignition
make(2) you need is not found, use code
00
the
name of make on the line provided. If
known, enter the model name and four-digit year of the mobile property involved.

F2

skip to

Equipment Power Source

Fire Suppression Factors

None

If the mobile property has a Enter


license
plate, enter the plate number and the two-letter abbreviation
up to three codes.
of the State, Province, or Territory of the plate (or registration) on the appropriate lines. Refer to
Equipment Power
theSource
Abbreviations Section of the NFIRS Complete Reference Guide for a list of State, Province, and
Fire suppression
factor (1) Identification Number (VIN) as indicated.
Territory Portability
abbreviations. Enter
the Vehicle
Equipment

F3

1
2

The Portable
last block of Section H can be used as a local option. A box exists to indicate whether a prefire
Fire suppression
plan is available for the address
of factor
the (2)incident.
Stationary

Portable equipment normally can be moved by


one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

ne

Contributing to Ignition

Section G

H2

Fire suppression factor (3)

Mobile Property Type and Make

Local Use

Local Use
Pre-Fire Plan Available
Some of the information presented in this report may be
based upon reports from other agencies:

Mobile property type

Mobile property make

Year

Arson report attached


Police report attached
Coroner report attached
Other reports attached

VIN

he Structure Fire form (NFIRS3).


NFIRS2 Revision 01/01/05

Typically, a plan of attack or a prefire plan is developed by firefighters before a fire happens at significant structures; the plan is referenced during the emergency. Some of the information presented
in a prefire plan may be based on reports from other agencies. Mark the box that corresponds to the
report type to indicate which other agency reports are attached to the incident report.

SUMMARY
The Fire Module is used for any fire that extends beyond a noncombustible container. It is applicable for
a vehicle fire or building fire; or vegetation fire unless the Wildland Fire Module is used instead. The Fire
Module also can be used in conjunction with other modules such as the Structure Fire Module, when
appropriate, to provide a more complete picture of what happened. As an example, completing the Fire
Module collects details about the property involved. Details provided in the Structure Fire Module provide
clear information about the buildings involved in the fire, how the fire started, and detection and suppression
equipment present.

2-11

NFIRS 5.0 Self-Study Program

EXAMPLE: Dwelling Fire


Directions: Read the call information in the example below.Then look at the completed Fire Module Form. Look at each section
and follow along with the proper use of the information as applicable to the Fire Module.
The Jonesville, Wisconsin, Fire Department, Station 1, FDID #TR300, is called at 0156 hours on
July 4, 2002, to respond to a fire in a single-family dwelling. The first unit, Engine 3, arrives at
2022 and discovers heavy smoke and fire coming from the house.
A family of four occupied the house: a father, a mother, and two children, ages 3 and 7. Two crew
members from Engine 3 conducted a primary search for victims, located the family in bedrooms
on the second floor, and rescued all the family members from the structure.
The rest of the crew brought a hoseline into the house. The fire was confined to the first floor,
brought under control, and extinguished at 0215. There was significant fire damage to two rooms:
(1) the kitchen, where the fire originated from a defective toaster, which ignited a fire that went
up a wall, and (2) the dining room. The incident number was #9900332. The brand of the toaster
was a Toastwell, Model #ZX2, Serial #567X. The toaster was manufactured in 1985.

2-12

NFIRS 5.0 Self-Study Program

TR300
FDID

MM

WI

DD

07

YYYY

04

2002

001

Incident Date

State

Station

Property Details

Not Residential

Complete if there were any significant amounts of


commercial, industrial, energy, or agricultural products or
or materials on the property, whether or not they became involved

Enter up to three codes. Check one box for each code


entered.

On-Site Materials
Storage Use

On-site material (1)

1
2
3
4
U

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

On-site material (2)

1
2
3
4
U

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

1
2
3
4
U

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

Estimated number of residential living units in


building of origin whether or not all units
became involved

001

B2

Buildings not involved

Number of buildings involved

B3

X None

Less than one acre

Acres burned (outside fires)

On-site material (3)

Ignition

D1 2 4 Kitchen

1
2
3
4
5
U

Area of fire origin

D2

Heat from Powered


Equipment

10
Heat source

Interior Wall
Covering

D3 1 5

Item first ignited

D4

Cause of Ignition

E1

Check box if fire spread was


confined to object of origin.

Type of material first ignited

Skip to
Section G

Check box if this is an exposure report.

E3

Intentional
Unintentional
Failure of equipment or heat source
Act of nature
Cause under investigation
Cause undetermined after investigation

3
4
5
None
6

Factors Contributing to Ignition

Mechanical Failure

20

Estimated age of
person involved

Required only if item first


ignited code is 00 or <70

None

637

10

If equipment was not involved, skip to


Section G

Electric Toaster

F3

toastwell

Model

ZX2

Serial #

567X

Year

1985

H1

Mobile Property Involved

Not involved in ignition, but burned

Involved in ignition, but did not burn

Involved in ignition and burned

Male

Fire Suppression Factors

Female

X None

Enter up to three codes.

Electrical, other

Equipment Power Source

Equipment Involved
Brand

Equipment Power Source

F2

Age was a factor

Factor contributing to ignition (1)

Equipment Involved in Ignition

X None

Asleep
Possibly impaired by
alcohol or drugs
Unattended person
Possibly mentally disabled
Physically disabled
Multiple persons involved

1
2

Factor contributing to ignition (2)

F1

Human Factors
Contributing to Ignition

Check all applicable boxes

E2

6 5 Fiberboard

Fire

Change

Exposure

None

NFIRS2

Delete

000

Incident Number

On-Site Materials
or Products

0 0 0 1

B1

9 9 0 0 3 3 2

Equipment Portability
1

Portable
Stationary

Portable equipment normally can be moved by


one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

X None

H2

Fire suppression factor (1)

Fire suppression factor (2)

Fire suppression factor (3)

Mobile Property Type and Make

Local Use
Pre-Fire Plan Available
Some of the information presented in this report may be
based upon reports from other agencies:

Mobile property type

Mobile property make

Mobile property model

License Plate Number

Year

State

Arson report attached


Police report attached
Coroner report attached
Other reports attached

VIN

Structure fire? Please be sure to complete the Structure Fire form (NFIRS3).
NFIRS2 Revision 01/01/05

2-13

NFIRS 5.0 Self-Study Program

EXERCISE SCENARIO 2-1: Laundromat Fire


Directions: Read the call information in the exercise below. Use the information provided to complete the Fire Module form.
Compare your work to the answers provided on the completed Fire Module form. If your answers are different from the ones
provided, read over the Fire Module again.
On July 1, 2002, at 1338 hours, Station 1 of the Jonesville, Wisconsin, Fire Department (FDID
TR100) responded to a call from a police officer who observed heavy smoke in a Laundromat in a
multiple-use commercial structure. Engine 2 arrived at 1400 hours, and immediately called for a
second alarm. The other businesses in the structure were occupied, and the Laundromat was open
for business but no one was present. A lumber supply company was located next to the structure.
The laundromat was 50-percent involved with smoke and heavy visible fire. The fire service personnel on the scene conducted a primary search for victims, and found none. They evacuated all
employees in the other offices; performed horizontal ventilation at the site of the fire, protected
the exposure in the adjacent office and at the lumberyard. The fire was extinguished at 1430
hours. The fire was caused by flammable fibers caught in an improperly ventilated natural gas
clothes dryer, a GCM Model 1992G, Serial Number 688599332C. The dryer was manufactured in
1992. There was extensive damage to the laundromat. Most equipment and all of the furniture
were destroyed. The incident was reported as #9900211.

2-14

NFIRS 5.0 Self-Study Program

MM
FDID

DD

YYYY

Incident Date

State

Station

Property Details

B1

C
Not Residential

Incident Number

On-Site Materials
or Products

Change

Exposure

None

Enter up to three codes. Check one box for each code


entered.

On-Site Materials
Storage Use

On-site material (1)

1
2
3
4
U

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

On-site material (2)

1
2
3
4
U

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

1
2
3
4
U

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

Buildings not involved


Number of buildings involved

B3

None

Less than one acre

Acres burned (outside fires)

On-site material (3)

D
D1
D2

Ignition

E1

Area of fire origin

Heat source

D3
Item first ignited

Check box if fire spread was


confined to object of origin.

Cause of Ignition
Skip to
Section G

Check box if this is an exposure report.

E3

Intentional
Unintentional
Failure of equipment or heat source
Act of nature
Cause under investigation
Cause undetermined after investigation

E2

Factors Contributing to Ignition

3
4
5
None
6

Estimated age of
person involved

Required only if item first


ignited code is 00 or <70

Equipment Involved in Ignition


None

Age was a factor

Factor contributing to ignition (2)

F1

F2

None

Asleep
Possibly impaired by
alcohol or drugs
Unattended person
Possibly mentally disabled
Physically disabled
Multiple persons involved

1
2

Factor contributing to ignition (1)


Type of material first ignited

Human Factors
Contributing to Ignition

Check all applicable boxes

1
2
3
4
5
U

D4

Fire

Complete if there were any significant amounts of


commercial, industrial, energy, or agricultural products or
or materials on the property, whether or not they became involved

Estimated number of residential living units in


building of origin whether or not all units
became involved

B2

NFIRS2

Delete

Equipment Power Source

Male

Fire Suppression Factors

Female

None

Enter up to three codes.

If equipment was not involved, skip to


Section G
Equipment Power Source

Equipment Involved

F3

Brand
Model
Serial #

Equipment Portability
1

Portable

Stationary

Portable equipment normally can be moved by


one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

Year

H1

Mobile Property Involved

Not involved in ignition, but burned

Involved in ignition, but did not burn

Involved in ignition and burned

None

H2

Fire suppression factor (1)

Fire suppression factor (2)

Fire suppression factor (3)

Mobile Property Type and Make

Local Use
Pre-Fire Plan Available
Some of the information presented in this report may be
based upon reports from other agencies:

Mobile property type

Mobile property make

Mobile property model

License Plate Number

Year

State

Arson report attached


Police report attached
Coroner report attached
Other reports attached

VIN

Structure fire? Please be sure to complete the Structure Fire form (NFIRS3).
NFIRS2 Revision 01/01/05

2-15

NFIRS 5.0 Self-Study Program

TR100
FDID

MM

WI

DD

07

YYYY

01

2002

001

Incident Date

State

Station

Property Details

Incident Number

On-Site Materials
or Products

Estimated number of residential living units in


building of origin whether or not all units
became involved

Complete if there were any significant amounts of


commercial, industrial, energy, or agricultural products or
or materials on the property, whether or not they became involved

On-Site Materials
Storage Use

6 1 1 Industrial Machinery
On-site material (1)

001

B2

Buildings not involved

5 4 3 Cleaning Supplies

Number of buildings involved

On-site material (2)

B3

X None

0 0 0 Other

Less than one acre

Acres burned (outside fires)

On-site material (3)

Ignition

Laundry Area

D1 2 6

Area of fire origin

D2

Heat from Powered


Equip.; Other

10
Heat source

D3 9 4 Dust, fibers, lint


Item first ignited

D4

Cause of Ignition

E1

Check box if fire spread was


confined to object of origin.

1
2
3
4
5
U

Type of material first ignited

E3

Intentional
Unintentional
Failure of equipment or heat source
Act of nature
Cause under investigation
Cause undetermined after investigation
Factors Contributing to Ignition

3
4
5
None
6

Installation Deficiency

40

None

811

21

F3

GCM

Model

1992G

Serial #

688599332C

Year

1992

H1

Mobile Property Involved

Not involved in ignition, but burned

Involved in ignition, but did not burn

Involved in ignition and burned

1
2
3
4
U

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

Human Factors
Contributing to Ignition
None

Male

Fire Suppression Factors

Female

X None

Enter up to three codes.

Natural Gas

Equipment Power Source

Equipment Involved
Brand

Equipment Power Source

F2

Clothes Dryer

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

Estimated age of
person involved

Factor contributing to ignition (1)

If equipment was not involved, skip to


Section G

1
2
3
4
U

Age was a factor

Required only if item first


ignited code is 00 or <70

Equipment Involved in Ignition

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

Asleep
Possibly impaired by
alcohol or drugs
Unattended person
Possibly mentally disabled
Physically disabled
Multiple persons involved

1
2

Factor contributing to ignition (2)

F1

1
2
3
4
U

Check all applicable boxes

E2

7 1 Fabric

Skip to
Section G

Check box if this is an exposure report.

Fire

Change

Exposure

None

NFIRS2

Delete

000

Enter up to three codes. Check one box for each code


entered.

X Not Residential

B1

9 9 0 0 2 1 1

Equipment Portability
Portable

1
2

Stationary

Portable equipment normally can be moved by


one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

X None

H2

Fire suppression factor (1)

Fire suppression factor (2)

Fire suppression factor (3)

Mobile Property Type and Make

Local Use
Pre-Fire Plan Available
Some of the information presented in this report may be
based upon reports from other agencies:

Mobile property type

Mobile property make

Mobile property model

License Plate Number

Year

State

Arson report attached


Police report attached
Coroner report attached
Other reports attached

VIN

Structure fire? Please be sure to complete the Structure Fire form (NFIRS3).
NFIRS2 Revision 01/01/05

2-16

NFIRS 5.0 Self-Study Program

EXERCISE SCENARIO 2-2: Vehicle Fire on I-95


Directions: Read the call information in the exercise below. Use the information provided to complete the entire Fire Module
form and other required forms. Compare your work to the answers provided in Appendix A. If your answers are different from
the ones provided, read over the Fire Module again.
The Alberta Fire Department (FDID #92188) responded to a vehicle fire on I-95 near mile
marker 73 and Exit 2B in Brunswick, Virginia 23351 on May 3, 2002. The dispatcher assigned
the incident (#5455) to Engine Co. 2 and Truck 1 from Shift C. The units received the alarm
at 11:58 p.m. and arrived at the scene in 6 minutes with a four-person engine crew and a twoperson truck crew. Flame and smoke were coming from the vehicle. The owner of the vehicle,
Mr. Robert L. Anderson, was driving to Emporia, Virginia, to return his son, Joseph, to his mother.
Mr. Anderson lives at 630 Second Avenue, Jarrett, North Carolina 24501. His telephone number
is 414-432-0987. He said that his front seat caught on fire. In an effort to extinguish the fire, the
car crashed into the guardrail. He called 911 from his cellular telephone. He said that he was
driving for 2 hours and became drowsy from a prescription drug that he took. The vehicle was
a 1999 Ford Explorer, Virginia License Plate Number ACZ586, and VIN 1FBEU54XXABC45634.
The firefighters extinguished the fire; it was under control at 12:10 a.m. They determined that a
burning cigarette caused the fire. The cigarette ignited the seat causing $26,000 property damage and no content loss to the vehicle. The last unit cleared the scene at 12:35 a.m. FF1 Steve B.
LaCivita, Badge No. 230, completed the report after returning to Station No. 1. Captain Ernest
Greene, Badge No. 100, was the officer in charge. The fire department keeps records on the location of all responses. The incident was in Census Tract 501.2, District A05.

2-17

NFIRS 5.0 Self-Study Program


MM

Delete

Incident Date

State

Location Type

Station

Incident Number

Exposure

NFIRS1

Number/Milepost

Prefix

Basic

No Activity

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.

Street address
Intersection
In front of
Rear of
Adjacent to
Directions
US National Grid

Census Tract

Street or Highway

Street Type

Suffix

Apt./Suite/Room

City

State

ZIP Code

Cross Street, Directions or National Grid, as applicable

Incident Type

E1

Incident Type

YYYY

Change
FDID

DD

Aid Given or Received

None

Dates and Times

Midnight is 0000

Month

Check boxes if
dates are the
same as Alarm
Date.

Day

Year

Hour

E2

Min

Shifts and Alarms


Local Option

ALARM always required

Shift or
Platoon

Alarm

Alarms

District

ARRIVAL required, unless canceled or did not arrive

1
2
3
4
5

Mutual aid received


Auto. aid received
Mutual aid given
Auto. aid given
Other aid given

Their FDID

Last Unit
Cleared

G1

Resources

Primary Action Taken (1)

G2

Apparatus

Personnel

Suppression
Additional Action Taken (2)

Civilian Fire Cas.4


Fire Service Cas.5
EMS6
HazMat7
Wildland Fire8
Apparatus9
Personnel10
Arson11

Check box if resource counts include aid


received resources.

H1

Casualties

None

Deaths Injuries
Fire
Service
Civilian

H2
1
2
U

Detector
Required for confined fires.

Detector alerted occupants


Detector did not alert them
Unknown

H3
1
2
3
4
5
6
7
8
0

Special
Study Value

Estimated Dollar Losses and Values

LOSSES:

Required for all fires if known.


Optional for non-fires.

Property

Contents

None

PRE-INCIDENT VALUE: Optional

EMS
Other
Additional Action Taken (3)

Special
Study ID#

LAST UNIT CLEARED, required except for wildland fires

Check this box and skip this block if an


Apparatus or Personnel Module is used.

Fire2
Structure Fire3

Local Option

Controlled

Actions Taken

Completed Modules

Special Studies

CONTROLLED optional, except for wildland fires

Their
State

Their Incident Number

E3

Arrival

Property

Contents

Hazardous Materials Release

None

Natural gas: slow leak, no evacuation or HazMat actions


Propane gas: <21-lb tank (as in home BBQ grill)
Gasoline: vehicle fuel tank or portable container
Kerosene: fuel burning equipment or portable storage
Diesel fuel/fuel oil: vehicle fuel tank or portable storage
Household solvents: home/office spill, cleanup only
Motor oil: from engine or portable container
Paint: from paint cans totaling <55 gallons
Other: special HazMat actions required or spill > 55 gal
(Please complete the HazMat form.)

Mixed Use
Property
10
20
33
40
51
53
58
59
60
63
65
00

Not mixed

Assembly use
Education use
Medical use
Residential use
Row of stores
Enclosed mall
Business & residential
Office use
Industrial use
Military use
Farm use
Other mixed use

Property Use
None
Structures
Church, place of worship
131
Restaurant or cafeteria
161
Bar/tavern or nightclub
162
Elementary school, kindergarten
213
High school, junior high
215
College, adult education
241
Nursing home
311
Hospital
331

341
342
361
419
429
439
449
459
464
519

Clinic, clinic-type infirmary


Doctor/dentist office
Prison or jail, not juvenile
1- or 2-family dwelling
Multifamily dwelling
Rooming/boarding house
Commercial hotel or motel
Residential, board and care
Dormitory/barracks
Food and beverage sales

539
571
579
599
615
629
700
819
882
891

Household goods, sales, repairs


Gas or service station
Motor vehicle/boat sales/repairs
Business office
Electric-generating plant
Laboratory/science laboratory
Manufacturing plant
Livestock/poultry storage (barn)
Non-residential parking garage
Warehouse

Outside
Playground or park
124
Crops or orchard
655
Forest (timberland)
669
Outdoor storage area
807
Dump or sanitary landfill
919
Open land or field
931

936
938
946
951
960
961
962

Vacant lot
Graded/cared for plot of land
Lake, river, stream
Railroad right-of-way
Other street
Highway/divided highway
Residential street/driveway

981
984

Construction site
Industrial plant yard

2-18

Look up and enter a


Property Use code and
description only if you
have NOT checked a
Property Use box.

Property Use
Code
Property Use Description
NFIRS1 Revision 01/01/05

NFIRS 5.0 Self-Study Program


Person/Entity Involved

K1

Local Option

Check this box if same


address as incident
Location (Section B).
Then skip the three
duplicate address
lines.

Business Name (if applicable)

Mr., Ms., Mrs.

First Name

Number

Prefix

Post Office Box

State

Area Code

MI

Phone Number

Last Name

Suffix

Street or Highway

Street Type

Apt./Suite/Room

Suffix

City

ZIP Code

More people involved? Check this box and attach Supplemental Forms (NFIRS1S) as necessary.

Owner

K2

Local Option

Check this box if same


address as incident
Location (Section B).
Then skip the three
duplicate address
lines.

Same as person involved?


Then check this box and skip
the rest of this block.

Mr., Ms., Mrs.

Business Name (if applicable)

First Name

Number

MI

Prefix

Phone Number

Last Name

Suffix

Street or Highway

Street Type

Apt./Suite/Room

Post Office Box

State

Area Code

Suffix

City

ZIP Code

Remarks:

Local Option

Fire Module Required?


Check the box that applies and then complete the Fire Module
based on Incident Type, as follows:
Complete Fire & Structure Modules
Complete Fire Module &
Section I, Structure Module
Basic Module Only
Confined 113118
Complete Fire Module
Mobile property 120123
Complete Fire Module
Vehicle 130138
Complete Fire or Wildland Module
Vegetation 140143
Outside rubbish fire 150155 Basic Module Only
Complete Fire or Wildland Module
Special outside fire 160
Special outside fire 161163 Complete Fire Module
Complete Fire or Wildland Module
Crop fire 170173
Buildings 111
Special structure 112

ITEMS WITH A

MUST ALWAYS BE COMPLETED!

More remarks? Check this box and attach Supplemental Forms (NFIRS1S) as necessary.

Authorization

Check box if
same as
Officer in
charge.

Officer in charge ID

Signature

Position or rank

Assignment

Month

Day

Year

Member making report ID

Signature

Position or rank

Assignment

Month

Day

Year

2-19

NFIRS 5.0 Self-Study Program

MM
FDID

DD

YYYY

Incident Date

State

Station

Property Details

B1

C
Not Residential

Incident Number

On-Site Materials
or Products

Change

Exposure

None

Enter up to three codes. Check one box for each code


entered.

On-Site Materials
Storage Use

On-site material (1)

1
2
3
4
U

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

On-site material (2)

1
2
3
4
U

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

1
2
3
4
U

Bulk storage or warehousing


Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

Buildings not involved


Number of buildings involved

B3

None

Less than one acre

Acres burned (outside fires)

On-site material (3)

D
D1
D2

Ignition

E1

Area of fire origin

Heat source

D3
Item first ignited

Check box if fire spread was


confined to object of origin.

Cause of Ignition
Skip to
Section G

Check box if this is an exposure report.

E3

Intentional
Unintentional
Failure of equipment or heat source
Act of nature
Cause under investigation
Cause undetermined after investigation

E2

Factors Contributing to Ignition

3
4
5
None
6

Estimated age of
person involved

Required only if item first


ignited code is 00 or <70

Equipment Involved in Ignition


None

Age was a factor

Factor contributing to ignition (2)

F1

F2

None

Asleep
Possibly impaired by
alcohol or drugs
Unattended person
Possibly mentally disabled
Physically disabled
Multiple persons involved

1
2

Factor contributing to ignition (1)


Type of material first ignited

Human Factors
Contributing to Ignition

Check all applicable boxes

1
2
3
4
5
U

D4

Fire

Complete if there were any significant amounts of


commercial, industrial, energy, or agricultural products or
or materials on the property, whether or not they became involved

Estimated number of residential living units in


building of origin whether or not all units
became involved

B2

NFIRS2

Delete

Equipment Power Source

Male

Fire Suppression Factors

Female

None

Enter up to three codes.

If equipment was not involved, skip to


Section G
Equipment Power Source

Equipment Involved

F3

Brand
Model
Serial #

Equipment Portability
1

Portable

Stationary

Portable equipment normally can be moved by


one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

Year

H1

Mobile Property Involved

Not involved in ignition, but burned

Involved in ignition, but did not burn

Involved in ignition and burned

None

H2

Fire suppression factor (1)

Fire suppression factor (2)

Fire suppression factor (3)

Mobile Property Type and Make

Local Use
Pre-Fire Plan Available
Some of the information presented in this report may be
based upon reports from other agencies:

Mobile property type

Mobile property make

Mobile property model

License Plate Number

Year

State

Arson report attached


Police report attached
Coroner report attached
Other reports attached

VIN

Structure fire? Please be sure to complete the Structure Fire form (NFIRS3).
NFIRS2 Revision 01/01/05

2-20

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