SIRF Menifee Derby 4.9.2019 Print this page
Riverside County Fire Department
Significant Incident Report Form
Incident Description
Incident Number Type of Occupancy
Incident Name Total $ Saved
Incident Type Total $ Loss
Location of Incident Smoke Detector
Date/Time Reported 4/9/2019 03:42:00 PM
Acres Burned
City/Area Fire Cause
Injuries Minor Moderate Major Fatalities
Civilian
Firefighter
Evacuations/Displaced Number of Displaced 0 Adult Child
Fire OES Red Cross
Evacuation Center Location
Property Damage Residential Commercial Out Buildings Vehicles
Damaged
Destroyed
Threatened
Resources
First Due Fire Station
Engines Squads Air Attacks
Truck Co's RVC Medic Unit Air Tankers
Breathing Support RVC Haz Mat Units Helicopters
Firefighters Ambulance - Air Fire Crews
Chief Officers Ambulance - Ground Water Tenders
Overhead Personnel Bulldozers Incident Duration
Cooperating Agencies Disposition of Utilities
Electric
Gas
Building Owner/Occupant
Owner Name:Owner Phone:
Occupant Name:Occupant Phone:
Incident Description
Notification To Direct City/Jurisdiction Notification
Person Contacted
by Phone
Prepared By Bischof, Joshua@CALFIREBischof, Joshua@CALFIRE
Date/Time Complete 4/9/2019 04:25:36 PM
Date/Time Contacted 4/9/2019 04:00:00 PM
City of Menifee
19CARRU045753 LRA Land
Derby $0.00
Medical, TC Cut & Rescue $0.00
Newport West of Sergeant Ke...
Menifee
0 0 1 0
0 0 0 0
0 0
Not Applicable Not Applicable
0 0 0 0
0 0 0 1
0 0 0 0
68 Menifee
2 0 0
1 0 0
0 0 0
10 0 0
1 1 0
0 0 1
RSO
None
Not Applicable
Not Applicable
Unknown
CAL FIRE Riverside County Firefighters responded to a reported traffic collision with extrication on Newport Road West of Sergeant Kelly Road in the City of
Menifee. Firefighters arrived on scene to find one vehicle involved with major damage rolled over up against a block wall. Truck 76 initiated rescue and extrication
to remove the patient from the vehicle. The single patient was transported to a local area hospital. There were no reported firefighter injuries during the incident.
Phone and Email
ACM Geoff Wyman
Page 1 of 1SIRF -19CARRU045753
5/7/2019http://intranet.rvcweb.org/sites/rvcweb/CentralOps/SIRF/Lists/SIRF/Item/displayifs.aspx?Li...