Webform Run number: Date of Incident Person submitting this form: Email of Person Submitting Form Location of Incident: What type of incident? structure fire wildland fire vehicle accident false alarm smoke report medical call rafting/water/ice accident mitigation/slash burning/chipping community service vehicle fire other What stations responded? Station 1 Station 2 Station 3 Station 4 What vehicles were used in the operation? E 611 E 612 Rescue 1 Rescue 2 E 621 T 321 E 641 E 642 E 241 E 631 Squad 3 Personal Vehicle Support Vehicle Which volunteers participated from Station 1? 115 Daniel Albano 124 Chad Bertram 125 Nicole Bertram 119 Krista Eberhardt 123 Kellie Falbo 147 Tony Falbo 141 Dominic Gambone 128 Boots Jaffee 130 Amy Maddox 118 Brian Maddox 199 Gene Mericle 117 Ethan Montgomery 122 Rob Overstreet 170 Rick Stonecipher 177 Mike Wyman 120 Hayley Spurrier 108 Tyler West Which volunteers participated from Station 2? 249 Greg Danhoff 224 Jared Gassen 260 Joe Jay 205 Marv Keller 222 Hugh Mackay 220 Becky McGraw 221 Paul McGraw 225 Jacob Udel 217 Greg Venette 227 Tom Allen 215 Brady Warner 214 Jerry Zapp 226 Dan Bond 230 Curtis Samples 231 Becky Jensen Which volunteers participated from Station 3? 303 Brett Ridges 304 Tasha Collins 305 Andy Collins Which volunteers participated from Station 4? 402 Bette Blinde 404 Hugh Collins 405 Paula Collins 416 Buz Elden 408 Cheryl (Mickey) York 410 Karl Brown 411 Judy Brown 412 Ben Wasserstein List any other people responding. Describe the incident: Mutual aid provided to: Mutual aid was received from: Larimer County Emergency Service Rist Canyon VFD Glacier View VFD Red Feather Lakes VFD Crystal Lakes VFD Jackson County Poudre Fire Authority Colorado Parks and Wildlife Dive Rescue SAR Time paged out: Time arrived on scene: Time incident controlled: Time back in service: Total time of incident: Where does the patient live? Patient Tranport Miles Save DraftSubmit
