Issued Equipment Inventory Page 2
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2Rescue/Extrication Equipment
Description
Condition
Date Issued
Serial #
Model #
Code
Extrication Jumpsuit
Rescue Helmet
Rescue Boots
Rescue Gloves
Rescue Glasses
Rescue Gear Bag
Condition Codes: 1=New 2=Good 3=Fair 4=Poor 5=Not Issued
Notes:_________________________________________________________________________
Signature of Receipt: ____________________________ Date: __________
Signature of Return: ____________________________ Date: __________
Approval of Return: ____________________________ Date: __________
Wildland Task Force Equipment
Description
Condition
Date Issued
Serial #
Model #
Code
Wildland Jumpsuit
Wildland Helmet
Wildland Boots
Wildland Gloves
Wildland Gear Bag
Condition Codes: 1=New 2=Good 3=Fair 4=Poor 5=Not Issued
Notes:_________________________________________________________________________
Signature of Receipt: ____________________________ Date: __________
Signature of Return: ____________________________ Date: __________
Approval of Return: ____________________________ Date: __________
First Responder Medical Equipment
Description
Condition
Date Issued
Serial #
Model #
Code
EMS Trauma Bag
O2 Regulator
AED
Condition Codes: 1=New 2=Good 3=Fair 4=Poor 5=Not Issued
Notes:_________________________________________________________________________
Signature of Receipt: ____________________________ Date: __________
Signature of Return: ____________________________ Date: __________
Approval of Return: ____________________________ Date: __________
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