View
2
Download
0
Category
Preview:
Citation preview
DATE
OES ENGINE #
TYPE OF INVENTORY:
(Check One)
STATE OF CALIFORNIA - GOVERNOR'S OFFICE OF EMERGENCY SERVICESFire and Rescue Branch
FIRE APPARATUS INVENTORY AND RECORD CONVERSION WORKSHEET- OES ENGINE S 253 - 256
y ANNUAL
TRANSFER:
ASSIGNED DEPARTMENT^CA EXEMPT LICENSE #
[JFIRE: FIRE NAME:HOME REGION
HOME LOCATION
MILEAGE
STRIKE TEAM #:
HOME OPERATIONAL AREA
SHORT#
ISSUED # /ACTUAL #
ISSUED # /ACTUAL #
2 /.
SHORT#
SHORTn
ISSUED #/
ACTUAL #
1 /
ACCOUNTABLE PROPERTY & EQUIPMENT
Passenger Side, Rear Compartment, cont96 Chainsaw Kit (see “Tool Info Sheet")
ACCOUNTABLE PROPERTY & EQUIPMENT
Engineer's Compartment, cont.51 Wrench, Wildland Spanner (1* to 1'A' Forestry)
Rope, 1/2” x 50’, Utility in bag
ACCOUNTABLE PROPERTY & EQUIPMENT
Apparatus Cab1 Radio, Mobile
Serial #OES #DGS #
2 Radio, HandheldSerial #OES #DGS #
3 First Aid Kit (DOT)4 Intercom Headset
MI100101 Flotopump
Serial #OES #
102
52 Wrench, Suction Hose Spanner 1 /53 Wye, 214" NH F x 2-1 Vf NH M 1 /54 San Francisco Hydrant Adapler (3~ F x 2 W M) 1 /
Driver's Side, Compartment Above Rear Tires55 Caribiner, Locking "D", 11 mm 12 /56 Edge Protection 2 /
58 Ffiction Device, Fig. 8 & Breaker Bar 1 ea/59 Harness, Body, Commercial 21
1 /1 /
1 /4 /
5 Log Book, w / Credit Card 1 /6 Hand Lantern, 12-Volt 1 /
Compartment , Cross-Thru w/Slide Tool Tray7 Axe, Pick Head 1 /8 Axe, Flat Head 1 /9 Chain, 25’ Tow w / Grab Hooks 1 /10 Clamp, Hebert Hose 1 /11 Bar, Claw, Wrecking, 3‘ 2112 Bar, Pinch Point, 60'13 Cutter, Bolt, 30"14 Extinguisher. 5# A:B:C
4 /1 /1/
15 Hammer, 3 - 4 lb. Sledge, Short 2116 Hammer, 8 - 10 lb. Sledge 2117 Hose, 5" x 12’ Soft Suction 1 /18 Jack, 8-ton Hydraulic w / Handle 2119 McLeod20 Picket, Steel, 1" x 4
1 /6 /
21 Pulaski 1 /22 Triangle Reflector Set 1 /23 Shovel, Round Point, Long Handle 1 /24 Shovel, Square Point, Long Handle 1 /25 Strainer, 5" Suction 1 /26 Wrench. Hose Spanner (iw to 21/2*) 4 /27 Wrench, Adjustable Hydrant 21
Engineer’s Compartment28 Adapter, 5" x 2 DF, Hydrant 1 /29 Adapter, 5” x 4", DF, Hydrant 1 /30 Adapter, 5" x 4 V/, DF,Hydrant 1 /.
34 Coupling, 2Vi Double Female35 Coupling, 2 Vz Double Male
37 Increaser, 1" NPSH F x 1 NH M 1 /38 Mallet, Rubber 1 /
I60 Litter Pre-Rig 1 /
63 Prusik Loop / Gibbs Ascender 6 /64 Pulley, Rescue, 2" / 4" 3 /65 Rope, Kernmantle,W x 150’ 2166 Webbing Kit (See “Tool Info Sheet")
Driver's Side, Rear Compartment1 /.
67 Can. Fuel (for generator) 1 /68 Generator 1 /
Serial #OES #
Rear Compartment, Lower69 Belt, Carpenter 2170 Blade, Hacksaw, Package 3 /71 Chisel, Cold, 1" x 7 7/8" 21
73 Hacksaw 2174 Handsaw, Crosscut, 26" 2 /75 Hammer, 24 oz. Framini 2 /
79 Marking Kit, Building (See‘Tool info Sheet’) | 1 /80 Nails @ 25 lb. ea, 16d, 8d, & 16d dpi81 Shovel, Scoop w / UD" Handle82 Square, TriorS|
84 Tape Measure, 25’
8586 Tape, Duct
Rear Compartment, Upper88 Backboard89 Ladder, 10’ Attic90 Ladder, 14’ Roof91 Ladder, 24’ Extension92 Pike Pole, 10’
Passenger Side, Rear Compartment94 Can(s), Fuel (Chainsaw & Flotopump)
103104Passenger Side, Compartment Above Rear Tires105106 Blanket, Disposable 21.107 Litter Cover (if not in use) 1 /108 Trauma Kit 1 /
Passenger Side, Compartment Ahead of Rear Tires109 Thermo Gel Concentrate, 5 gallons 2 /110 Thermo Gel Backpack 1 /.111 Thermo Gel Nozzle / Eductor / Hose 1 /112 Thermo Gel Pick-Up Tube 1 /113 Mount, Ground Deluge 1 /.
Hosebed and Reel Line Area115 Crbbing & Wedge Kit (See ‘Tool info Sheep n116 Hose, 1" NPSHx 50’ Wildland 8 /117 Hose, 1 %" NHx 100’ Wildland 8 /118 Hose, 1V{ NH x 50' Structural 12 /119 Hose. 2 1/2" NH x 50' Structural 24 /120 Hose, Booster, 1" NPSH x 150’ 1 /121 Litter, Stokes Basket 1 /122 Deluge Monitor 1 /123 Stream Straightener 1 /124 Nozzles, Deluge (13f-1y/-2") 1 /125 Nozzle, Deluge, 350 - 500 GPM
Apparatus Exterior1 /
126 Cap, 2 V/ Discharge 5 /.127 Chock Block128 Hose, Hard Suction, 5" x 10’129 Hose. 2 1/2" x 12’ Soft Suction
21.21.1 /
130 Plug, 21/a" SuctionFront Bumper
2 /
131 Hose, 1 x 35’ Truck Protection 1L132 Nozzle, 1 K", Combo (Wildland) 1 /NOTE: CELL SHADING indicates a DIFFERENCE in theitems assigned to this engine vs. those on OES E314- E359.It may be the number of items or the configuration of the items.Note any equipment damage below:
2121211 /
39 Nozzle, 1" NPSH Combo Wildland40 Nozzle, 1Vi Combo Structural41 Nozzle, 1Vi NH Combo Wildland42 Nozzle, 1Vi Foam, Air Aspirating
1 /.21
43 Nozzle, 2 Vi Shutoff w / Fog tip44 Nozzle, 2 Vi Shutoff w / 3 tips45 Reducer, 1 NH F x 1* NPSH M 1 / Recap All OES-Owned Special Equipment Carried:46 Reducer. 2W F x 1Vi M 1 / 133 Lug wrench w/bars 1 /47 Siamese, 2 Vi M x 2-2%9 F 1 / 134 Manuals: Engine, Chassis 1 ea./48 Strap, Hose & Ladder 4 / 95 Chainsaw w/24" bar 1 /. Transmission, and Pump49 Clamp, Wildland Hose 21 Serial # 135 Straps, Pickoff 2150 Tee, Wildland Hose, 1 Vi NH x 1“ NPSH
CORRECT PER ACTUAL COUNT
3 /
SIGNED:ASSIGNEE REPRESENTATIVE
DISTRIBUTION: Original: OES. Sacramento
TITLE:
OES # 136 Cord, Electrical 2 1.
SIGNED: TITLE:OFFICE OF EMERGENCY SERVICES. FIRE & RESCUE BRANCH REPRESENTATIVE
Yellow Copy: OES Field Assistant Chief Pink Copy: Assignee FORM F-157A (Revised 12/22/10)
STATE OF CALIFORNIA - EMERGENCY MANAGEMENT AGENCYFire and Rescue Branch
FIRE APPARATUS INVENTORY AND RECORD- ENGINE’S 314 - 359
DATEENGINE # - 2TYPE OF INVENTORY:
(Check One)
ASSIGNED DEPARTMENT.CA EXEMPT LICENSE #
ANNUALTRANSFER:
FIRE: FIRE NAME:
HOME REGION
HOME LOCATIONMILEAGE
HOME OPERATIONAL AREA
STRIKE TEAM #:
ACCOUNTABLE PROPERTY & EQUIPMENT ISSUED */ACTUAL r
Apparatus Cab1 Radio, Mobile 1 /
Serial #OES #DGS #
2 Radio, Handheld 1 /Sena! #OES #DGS #
3 First Aid Kit (DOT) 1 /4 Intercom Headset 4 /5 Log Book, w / Credit Card 1 /6 Hand Lantern, 12-Volt (Streamlight)
Compartment , Cross-Thru w/Slide Tool Tray7 Axe, Pick Head 1 /8 Axe. Flat Head 1 /9 Chain, 25' Tow w / Grab Hooks 1 /10 Clamp. Hebert Hose 1 /11 Bar, Claw, Wrecking. 3' 2 /.12 Bar, Pinch Point, 60" 4 /13 Cutter. Bolt, 30" 1 /14 Extinguisher. 5# A:B:C 1 /15 Hammer, 3 - 4 lb. Sledge, Short 2116 Hammer, 8 -10 lb. Sledge 21.17 HoseS x 12' Soft Suction18 Jack , 8-ton Hydraulic w / Handle
1 /21
/19 McLeod / Thac Claw *20 Picket, Steel 1" x 4' 6 /21 Pulaski22 Triangle Reflector Set
1 /1 /
23 Shovel, Round Point, Long Handle24 Shovel, Square Point, Long Handle
1 /1 /
25 Strainer,Jf Suction
E1 /
26 Wrencn Hose Spanner (1 w to 21/D27 Wrench, Adjustable Hydrant
Engineer's Compartment
28 Adapte' £ x 2 Vz” , DF, Hydrant 1 /29 Adapter J" x 4”, DF, Hydrant 1 /30 Adapter X * 4 Vz , DF, Hydrant 1 /
32 Ani.Mtir. ttNMSii r fcIPSM M31 Aflepwf 1“ NP6*IF w 1" Ml » 4
33 -ArrHoGo wr noaalQ34 Coupling, 2 Vz" Double Female
4421
35 Coupling, 2 Vz Double Male 2 136 Crank, I looo Rooi 4437 Increaser, 1" NPSH F x 1 Vz NH M 1 /38 Mallet, Rubber 1 /39 Nozzle. 1’NPSH Combo Wildland40 Nozzle, 1 Vz Combo Structural41 Nozzle, 1 Vz NH Combo Wildland42 Nozzle, 1Vz Foam, Air Aspirating43 Nozzle, 2 Vz Shutoff w / Fog tip
44 Nozzle,2 14" Shutoff w / 3 bps45 Reducer, 1Vz N H F x 1’NPSH M46 Reducer, 2 %" F x 1 Vt M47 Siamese. 2 1/2" x 2-21/2"48 Strap, Hose & Ladder49 Clamp, Wildland Hose53 Tee, Wildland Hose, 1V NH x 1* NPSH
CORRECT PER ACTUAL COUNT
4 /2121.1 /1 /2 /1 /1 /1 /4 /213 /
SHORT#
ACCOUNTABLE PROPERTY & EQUIPMENT ISSUED * /ACTUAL *
Engineer's Compartment, cont.51 Wreocfi, Wildland Spannor (1* to 1 16* Forestry) 2152 Wrench, Suction Hose Spanner 1 /53 Wye, 2 Vz NH F x 2-1 Vz NH M54 San Francisco Hydrant Adapter (3* Fx 2W M)
1 /1 /
Driver's Side, Compartment Above Rear Tires55 Caribiner, Locking “D*. 11 mrr BJ.
56 Edge Protection 2 /57 - 4458 Friction Device. Fig. 8& Breaker Bar 1ea'59 Harness, Body NFf¥r 2 /60 Litter Pre-Rig 1 /.61 Load ROIQQOO62 Multi-point Cetocton Plate63 Prusik Loop r /Cft
£ / ""44rW
64 Pulley. Rescue. PfuoiftMtfHhng-2?V\^i65 Rope, Kemmantle,!4" x 150' * 2166 Webbing Kit (See Tool Info Sheer)
Driver's Side, Rear CompartmentU
67 Can, Fuei (for generator/pcnabie pump) 1 /68 Generator 1 /
Serial #OES #
Rear Compartment, Lower69 Belt, Carpenter70 Blade, Hacksaw, Gartwdo i71 Chisel, Cold, 1" x 7 7/8" 2 /72 GfrOffweet Light (Gee ^eol iwte Ghee* £473 Hacksaw74 Handsaw. Crosscut, 26"
2 /21
75 Hammer76 Hammer.. 24 oz. Framing
3 4 lb, Stodge, -Shart. Z.44
77 Knifa. Utility- 4478 LOMOI , 6" Toffiooe- 3479 Marking Kit. Building (See ‘Tool into sneer) 1 /80 Nails @ 25 lb. ea, 16d S 8c .U.,) 1ea/
81 Shovel, Scoop w / "D" Handle 1 /.82 Square, Tri or Speed X83 Square, Framing. 24- 44
85 4m-Jirrtor84 Tape Measure. 25’ 3 /
86 Tape. Duct»00 •
i 00".nw:, - 2 /4487 TQ4 Kit i
Rear Compartment, Upper88 Backboard 1 /89 Ladder. 10’ Attic 1 /90 Ladder, 14’ Roof 1 /91 Ladder, 24' Extension92 Pike Pole £-«44' /O'93 Interface Hose Bars iu»w S338)
1 /1«aI34
Passenger Side, Rear Compartment94 Can(s), Fuel (Chainsaw & Flotopump) il
Netofor #67 & #04; OES £339 £860 hove &
( jiit.olino (portabie^wnp & (K>rwfaU)f » 'aB4totek two (0) fuei cons one for straight-ono for 80i1miwod fuel (ohoiftoowk
95 Chainsaw w/24” barSerial #
1 /
OES #
SHORT#
ACCOUNTABLE PROPERTY & EQUIPMENT ISSUEDACTUAL* /
»SHORT
*Passenger Side, Rear Compartment, cont.
96 Chainsaw Kit (see Tool Info Sheet") M97 ^ i
98 Rope, 1/99 Wrench..2* x
Ad50’. Utility in bag
|UEtabte Hydrant21
100 Wranirh Hnse Spammer •: t« a* 4101 Flotopump (E314-E338) 1 /
Sena! #OES #
102 Portaolo flump (C330Sow* ft
44
QEC103 I lose >! ! IPTIWOUCUVTTTLUT'
104 Strainer, Section V* (3339 S334 4Passenger Side, Compartment Above Rear Tires105 Bacfcboard Hood ImrooMiaor 44106 Blanket. Disposable 21.107 Litter Cover (if not in use) 1 /.108 Trauma Kit 1 /
Passenger Side, Compartment Ahead of Rear Tires109 Thermo Gel Concentrate, 5 gallons 21110 Thermo Gel Backpack 1 /111 Thermo Gel Nozzle / Eductor / Hose 1 /112 Thermo Gel Pick-Up Tube 1 /113 Mount. Ground Deluge114 Solvofp Govoro Gome*
1 /
Hosebed and Reel Line Area115 Cribbing & Wedge Kit (See 'Tool Info Sheet') 1 /116 Hose, r NPSH xJPWildland117 Hose. 1 Vz NH x 100' Wildland
8 /m
118 Hose, 1 Vz NH x 50’ Structural 12 /24 /.119 HoseZffi- * 50’ Structural
120 Hose Booster, 1" NPSP xl&O JL121 Litter, Stokes Basket 1 /.122 Deluge Monitor 1 /123 Stream Straightener 1 /124 Nozzles. Deluge (WT-1!4"-17) 1 /125 Nozzle, Deluge. C O M P Q > 1 /
Apparatus Exterior
127 Chock Block 2 /126 Cap, 2 Vz Discharge %
128 Hose, Hard S u c t i o n 1 0’ 21129 Hose, 12’ Soft Suction130 Plug, 2%*Suctior
121
Front Bumper131 Hose, 1 Vz x 35’ Truck Protection 1 /132 Nozzle, 1 Combo (Wildland) 1 /
NOTES:CELL SHADING INDICATES US&R INVENTORY"Tool Info Sheet" can be found in OES Yellow BinderNote any equipment damage below:
/3/' A • JAP
Recap All CfES-OwnedSpecial Equipment Carried:
/J* c?
SIGNED:ASSIGNEE REPRESENTATIVE
DISTRIBUTION: Original: EMA, SacramentoOSP 08 110428
TITLE:
Yellow Copy: Field Assistant Chief
SIGNED:FIRE & RESCUE BRANCH REPRESENTATIVE
Pink Copy: Assignee
TITLE:
FORM F-157A (Revised 1/6/09)
Recommended