SIRF Menifee Middlebury 4.3.2019 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 4/3/2019 11:04:00 AM
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
City of Menifee
19CARRU04855 Single Family Residence
Middlebury $75,000.00
Fire, Str. Residential $250,000.00
28560 Middlebury Present, Activated
0
Menifee Unintentional
0 0 0 0
0 0 0 0
0 0
Not Applicable Not Applicable
0 0 0 0
1 0 0 0
0 0 0 1
7 Sun City
7 1 0
1 0 0
1 1 0
32 0 0
1 0 0
0 0 3 Hours
CAL Fire
Building and Safety Department
RSO
Riv. County Env. Health
None
Meter removed
Meter Removed/Locked
Unknown
Unknown
CAL FIRE / Riverside County Firefighters responded to a reported residential structure fire at 28560 Middlebury Road in the City of Menifee. The first arriving
engine company reported heavy smoke and fire showing from a single story residence. Upon entry approximately 60 percent of the residence was involved with
fire. While conducting overhaul operations several containers with an unknown liquid were discovered. The Riverside County Fire Department Haz Mat Team was
requested to evaluate the liquid. It was determined that the product was nonhazardous. There were no firefighter or civilian injuries reported.
Phone and Email
ACM Jeff Wyman
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Date/Time Complete 4/3/2019 01:29:20 PM
Date/Time Contacted 4/3/2019 12:08:00 PM
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