Ahca Fire Incident Report Page 2
Download a blank fillable Ahca Fire Incident Report in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Ahca Fire Incident Report with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Type of fire fighting equipment used to extinguish fire:
Water
Dry Chemical
CO
Halon
Hose
2
Fire Extinguisher
None
Other
Known or probable cause of fire:
______________________________________________________________________
Extent of flame, smoke, water or other damage:
______________________________________________________________________
______________________________________________________________________
Estimated amount of dollars loss: $
What steps have been taken by the facility to prevent reoccurrence?
______________________________________________________________________
______________________________________________________________________
Describe the local fire department participation.
______________________________________________________________________
______________________________________________________________________
Name & Title of Person Making this Report
Signature of Person Making this Report
Date of Report
Page 2 of 2
AHCA 3500-0031, June 2011
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business