Reidsville Gas Leak August 2004
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Reidsville Fire Department - 402 S. Scales St., Reidsville, NC 27320
A
07907
NC
08/31/2004
FS3
2004001502
00
FDID
State
Incident Date
Station
Incident Number
Exposure
Location
B
336-349-1024
NFIRS -1 Basic
See Wildland Fire Module for Location
1 Street address
Census Tract
1401
W
HARRISON
ST
Number/Milepost
Prefix
Street or Highway
Street Type
Apt./Suite/Room
REIDSVILLE
NC
27320-
City
State
Zip Code
Suffix
RAMP Cross Street or Directions
Incident Type
C
Dates & Times
E1
424 Carbon monoxide incident
Date
Incident Type
D
Dispatch
Aid Given or Received
x
N None
Arrival
Action Taken
G1
Last Unit Cleared
0 0 2
0 0 2
Other
Check box if resource counts include aid received resources.
Additional Action Taken (3)
J
Fire-2 Structure-3 Civilian Fire Cas.-4 Fire Serv. Casualty-5 EMS-6 HazMat-7 Wildland Fire-8 Apparatus-9 Personnel-10 Arson-11
H1
Casualties
Fire Service
Deaths
x
None
H3
Local Option
D
0
Shift or platoon
Alarms
E3
1 District
Special Studies Local Option
09:15:12
G2 Personnel
EMS
Additional Action Taken (2)
08:31:23 08:31:23
Shifts & Alarms
Special Study ID#
Apparatus Suppression
42 HazMat detection, monitoring, sampling, &
Completed Modules
08/31/2004
Resources
Primary Action Taken (1)
Time
: :
Check this box and skip this section if an Apparatus or Personnel form is used.
86 Investigate
x x
08/31/2004 08/31/2004
Controlled
x
F
E2
Special Study Value
Estimated Dollar Losses & Values
LOSSES: Required for all fires if known.
None
Optional for non fires.
Property
$
Contents
$
0 0
x x
0 0
x x
PRE-INCIDENT VALUE: Property
$
Contents
$
Hazardous Materials Release
I
Mixed Use Property
Injuries N None
NN Not mixed use
Civilian
H2
Detector
Property Use 593 Office: veterinary or research
M
Authorization 530 D Officer in charge ID
Signature
BATTCH
C5
08/31/2004
Rank
Assignment
Date
BATTCH
C5
08/31/2004
Rank
Assignment
Date
John E Harris Check box if same as Officer in charge
x 530 D Member making report ID
Signature
John E Harris
Reidsville Fire Department - 402 S. Scales St., Reidsville, NC 27320
336-349-1024 Incident: 2004001502-00
K1
Person/Entity Involved
REIDSVILLE VETERINARY HOS
(336) 349-3194
Local Option
Business name (if applicable)
Phone Number
Check this box if same address as incident location. Then skip the three duplicate address lines.
DR
JOSEPH
Mr., Ms., Mrs.
First Name
KINNARNEY MI
Last Name
Suffix
1401
W
HARRISON
ST
Number
Prefix
Street or Highway
Street Type
Suffix
REIDSVILLE Post Office Box
K2
Owner
x
Local Option
Apt./Suite/Room
NC
27320-
State
Zip Code
City
REIDSVILLE VETERINARY HOS
(336) 349-3194
Same as person involved? Then check this box and skip Business name (if applicable) the rest of this section.
Check this box if same address as incident location. Then skip the three duplicate address lines.
DR
JOSEPH
Mr., Ms., Mrs.
First Name
Phone Number
KINNARNEY MI
Last Name
Suffix
1401
W
HARRISON
ST
Number
Prefix
Street or Highway
Street Type
Suffix
REIDSVILLE Post Office Box
L
Apt./Suite/Room
NC
27320-
State
Zip Code
City
Remarks: Local Option
FM HARRIS AT REQUEST OF RCSD AND RCFMO ARRIVED AT ABOVE LOCATION TO CHECK POTENTIAL CARBON MONOXIDE PROBLEM. UPON ARRIVAL FM HARRIS AND BATTALION CHIEF J. WILLIAMS SPOKE WITH CAPT. BOBBY LAWSON AND ANIMAL CONTROL OFFICERS WHO REQUESTED THAT THE EUTHANASIA CHAMBER USED AT THE ABOVE LOCATION BE CHECKED FOR POSSIBLE CARBON MONOXIDE LEAKS DURING OPERATION. FM HARRIS CHECKED THE CHAMBER FINDING THAT THE DOOR SEALS TO THE CHAMBER WERE IS DIS-REPAIR AND DAMAGED IN SEVERAL LOCATIONS, HARRIS ALSO OBSERVED WHERE ATTEMPTS TO REPAIR THE SEALS WERE MADE WITH WHAT APPEARED TO BE CAULKING. ALSO NOTED THAT THE INTEGRAL SAFETY SYSTEMS FOR MONITORING CARBON MONOXIDE LEVELS HAD BEEN DISABLED ( HORN ACTIVATION AT 100 ppm DISABLED ). VENT PIPE FROM THE TOP PORTION OF THE CHAMBER IS POORLY FITTED AND SEALED WITH WHAT APPEARS TO BE ADHESIVE TAPE. DURING OPERATION OF THE EUTHANASIA CHAMBER CARBON MONOXIDE MONITORS WERE USED TO TEST Reidsville Fire Department - 402 S. Scales St., Reidsville, NC 27320
K
K3
336-349-1024
07907
NC
08/31/2004
FS3
2004001502
00
FDID
State
Incident Date
Station
Incident Number
Exposure
Person/Entity Involved
MR
1088
NC
27375-
State
Zip Code
Change
ROCKINGHAM CO. SHERIFF
(336) 634-3030 Phone Number
LAWSON MI
Last Name
Suffix
HWY 65 Street of highway
Street Type
WENTWORTH Post office box
NFIRS - 1S Supplemental
Business name if applicable
BOBBY
Check this box if Mr., Ms., Mrs. First Name same address as incident location. Then skip these three duplicate address Number Prefix lines.
Delete
Apt./Suite/Room
City
Suffix
L2
Remarks: Local Option
LEVELS PRESENT ADJACENT TO THE CHAMBER, TWO SEPARATE METERS WERE USED ( MSAMINICO RESPONDER, AIMS 350 MULTI GAS METER ) DURING OPERATION, CARBON MONOXIDE LEVELS EXCEEDED 984ppm IN THE AREA OF THE CHAMBER, INTEGRAL ALARM LIGHTS ACTIVATED AT 35ppm AND AGAIN AT 100ppm. THE AUDIBLE WARNING DID NOT ACTIVATE. AFTER THE COMPLETED CYCLE DURING PURGE READINGS WERE FOUND AT 243ppm AT THE VENT PIPE ABOVE THE CHAMBER, AND AT 28 ppm IN THE ADJOINING ROOM. UPON COMPLETION OF ALL CYCLES, AFTER THE PURGE CYCLE DURING REMOVAL OF ANIMALS A READING OF 460ppm STILL REMAINING IN THE CHAMBER AS OFFICERS REMOVED ANIMALS. FM HARRIS AND CHIEF WILLIAMS ADVISED CAPT. LAWSON OF THE RESULTS AND ADVISED THAT THE CHAMBER SHOULD NOT BE USED, THAT IT WAS A CLEAR DANGER TO THOSE OPERATING IT WITH CARBON MONOXIDE LEVELS PRESENT 28 TIMES THE MAXIMUM ALLOWABLE CONCENTRATION FOR CONTINUOUS EXPOSURE, CAPT. LAWSON ADVISED HE CONTACTED DR. J. KINNARNEY WHO WOULD CONTACT THE MANUFACTURER FOR REPAIRS. A COPY OF THE RFD CARBON MONOXIDE NOTICE OF FINDINGS WAS SIGNED AND LEFT WITH DEPUTY W.LeSUER ALONG WITH AN MSA CO DOSEMETER TUBE LEFT AT THE SITE FOR FURTHER EVALUATION. FM HARRIS ADVISED THAT THE CHAMBER SHOULD NOT BE USED UNTIL REPAIRS WERE MADE AND UNIT TESTED.
Reidsville Fire Department - 402 S. Scales St., Reidsville, NC 27320
A B
2
Delete
07907
NC
08/31/2004
FS3
2004001502
00
FDID
State
Incident Date
Station
Incident Number
Exposure
Apparatus or Resource
Dates and Times
Sent
Check if same date as alarm date
Use codes listed below
1
336-349-1024
ID
C5
Type
92
ID
C2
Type
92
X
Number of People
Use
X X X
08/31/2004 08/31/2004 08/31/2004
0831 0831 0915
1
X Other
Dispatch Arrival Clear
X X X
08/31/2004 08/31/2004 08/31/2004
0831 0831 0915
1
X Other
Ground Fire Suppression 11 Engine 12 Truck or aerial 13 Quint 14 Tanker & pumper combination 16 Brush truck 17 ARF (Aircraft Rescue and Firefighting) 10 Ground fire suppression, other
Aircraft 41 Aircraft: fixed wing tanker 42 Helitanker 43 Helicopter 40 Aircraft, other Marine Equipment 51 Fire boat with pump 52 Boat, no pump 50 Marine apparatus, other
Heavy Ground Equipment 21 Dozer or plow 22 Tractor 24 Tanker or tender 20 Heavy equipment, other
Support Equipment 61 Breathing apparatus support 62 Light and air unit 60 Support apparatus, other
Actions Taken
Check ONE box for each apparatus to indicate its main use at the incident.
Dispatch Arrival Clear
Type of Apparatus or Resource
Change
NFIRS - 9 Apparatus or Resources
86
42
86
42
Medical & Rescue 71 Rescue unit 72 Urban search & rescue unit 73 High angle rescue unit 75 BLS unit 76 ALS unit 70 Medical and rescue unit, other
More apparatus? Use additional sheets.
Other 91 Mobile command post 92 Chief officer car 93 HazMat unit 94 Type 1 hand crew 95 Type 2 hand crew 99 Privately owned vehicle 00 Other apparatus/resource
NN None UU Undetermined
Reidsville Fire Department - 402 S. Scales St., Reidsville, NC 27320
A B
07907
NC
08/31/2004
FS3
2004001502
00
FDID
State
Incident Date
Station
Incident Number
Exposure
Apparatus or Resource
Dates and Times
Sent
Check if same date as alarm date
Use codes listed below
1
ID
C2
Type
92
Dispatch Arrival Clear
X X X
08/31/2004 08/31/2004 08/31/2004
Personnel ID
95
B
C
Name
ID
C5
Sent
Check if same date as alarm date
Type
92
X X X
08/31/2004 08/31/2004 08/31/2004
Personnel ID
530 D
Name
Harris, John E
1 Attend
0831 0831 0915
X
1
BATTCH
Use
86
Number of People
Rank or Grade
Change
Check ONE box for each apparatus to indicate its main use at the incident.
Action Taken
Action Taken
Use
86
Action Taken
42
Action Taken
42
Check ONE box for each apparatus to indicate its main use at the incident.
Action Taken
Actions Taken List up to 4 actions for each apparatus and each personnel
86
Actions Taken List up to 4 actions for each apparatus and each personnel
86
X Other
Attend
NFIRS - 10 Personnel
Delete
X Other
BATTCH
Dates and Times Dispatch Arrival Clear
Number of People
Rank or Grade
Williams, Jeff C
Apparatus or Resource
X
0831 0831 0915
Use codes listed below
2
336-349-1024
Action Taken
42
Action Taken
42
Action Taken
A
07907
NC
08/31/2004
FS3
2004001502
00
FDID
State
Incident Date
Station
Incident Number
Exposure
Location
B
336-349-1024
NFIRS -1 Basic
See Wildland Fire Module for Location
1 Street address
Census Tract
1401
W
HARRISON
ST
Number/Milepost
Prefix
Street or Highway
Street Type
Apt./Suite/Room
REIDSVILLE
NC
27320-
City
State
Zip Code
Suffix
RAMP Cross Street or Directions
Incident Type
C
Dates & Times
E1
424 Carbon monoxide incident
Date
Incident Type
D
Dispatch
Aid Given or Received
x
N None
Arrival
Action Taken
G1
Last Unit Cleared
0 0 2
0 0 2
Other
Check box if resource counts include aid received resources.
Additional Action Taken (3)
J
Fire-2 Structure-3 Civilian Fire Cas.-4 Fire Serv. Casualty-5 EMS-6 HazMat-7 Wildland Fire-8 Apparatus-9 Personnel-10 Arson-11
H1
Casualties
Fire Service
Deaths
x
None
H3
Local Option
D
0
Shift or platoon
Alarms
E3
1 District
Special Studies Local Option
09:15:12
G2 Personnel
EMS
Additional Action Taken (2)
08:31:23 08:31:23
Shifts & Alarms
Special Study ID#
Apparatus Suppression
42 HazMat detection, monitoring, sampling, &
Completed Modules
08/31/2004
Resources
Primary Action Taken (1)
Time
: :
Check this box and skip this section if an Apparatus or Personnel form is used.
86 Investigate
x x
08/31/2004 08/31/2004
Controlled
x
F
E2
Special Study Value
Estimated Dollar Losses & Values
LOSSES: Required for all fires if known.
None
Optional for non fires.
Property
$
Contents
$
0 0
x x
0 0
x x
PRE-INCIDENT VALUE: Property
$
Contents
$
Hazardous Materials Release
I
Mixed Use Property
Injuries N None
NN Not mixed use
Civilian
H2
Detector
Property Use 593 Office: veterinary or research
M
Authorization 530 D Officer in charge ID
Signature
BATTCH
C5
08/31/2004
Rank
Assignment
Date
BATTCH
C5
08/31/2004
Rank
Assignment
Date
John E Harris Check box if same as Officer in charge
x 530 D Member making report ID
Signature
John E Harris
Reidsville Fire Department - 402 S. Scales St., Reidsville, NC 27320
336-349-1024 Incident: 2004001502-00
K1
Person/Entity Involved
REIDSVILLE VETERINARY HOS
(336) 349-3194
Local Option
Business name (if applicable)
Phone Number
Check this box if same address as incident location. Then skip the three duplicate address lines.
DR
JOSEPH
Mr., Ms., Mrs.
First Name
KINNARNEY MI
Last Name
Suffix
1401
W
HARRISON
ST
Number
Prefix
Street or Highway
Street Type
Suffix
REIDSVILLE Post Office Box
K2
Owner
x
Local Option
Apt./Suite/Room
NC
27320-
State
Zip Code
City
REIDSVILLE VETERINARY HOS
(336) 349-3194
Same as person involved? Then check this box and skip Business name (if applicable) the rest of this section.
Check this box if same address as incident location. Then skip the three duplicate address lines.
DR
JOSEPH
Mr., Ms., Mrs.
First Name
Phone Number
KINNARNEY MI
Last Name
Suffix
1401
W
HARRISON
ST
Number
Prefix
Street or Highway
Street Type
Suffix
REIDSVILLE Post Office Box
L
Apt./Suite/Room
NC
27320-
State
Zip Code
City
Remarks: Local Option
FM HARRIS AT REQUEST OF RCSD AND RCFMO ARRIVED AT ABOVE LOCATION TO CHECK POTENTIAL CARBON MONOXIDE PROBLEM. UPON ARRIVAL FM HARRIS AND BATTALION CHIEF J. WILLIAMS SPOKE WITH CAPT. BOBBY LAWSON AND ANIMAL CONTROL OFFICERS WHO REQUESTED THAT THE EUTHANASIA CHAMBER USED AT THE ABOVE LOCATION BE CHECKED FOR POSSIBLE CARBON MONOXIDE LEAKS DURING OPERATION. FM HARRIS CHECKED THE CHAMBER FINDING THAT THE DOOR SEALS TO THE CHAMBER WERE IS DIS-REPAIR AND DAMAGED IN SEVERAL LOCATIONS, HARRIS ALSO OBSERVED WHERE ATTEMPTS TO REPAIR THE SEALS WERE MADE WITH WHAT APPEARED TO BE CAULKING. ALSO NOTED THAT THE INTEGRAL SAFETY SYSTEMS FOR MONITORING CARBON MONOXIDE LEVELS HAD BEEN DISABLED ( HORN ACTIVATION AT 100 ppm DISABLED ). VENT PIPE FROM THE TOP PORTION OF THE CHAMBER IS POORLY FITTED AND SEALED WITH WHAT APPEARS TO BE ADHESIVE TAPE. DURING OPERATION OF THE EUTHANASIA CHAMBER CARBON MONOXIDE MONITORS WERE USED TO TEST Reidsville Fire Department - 402 S. Scales St., Reidsville, NC 27320
K
K3
336-349-1024
07907
NC
08/31/2004
FS3
2004001502
00
FDID
State
Incident Date
Station
Incident Number
Exposure
Person/Entity Involved
MR
1088
NC
27375-
State
Zip Code
Change
ROCKINGHAM CO. SHERIFF
(336) 634-3030 Phone Number
LAWSON MI
Last Name
Suffix
HWY 65 Street of highway
Street Type
WENTWORTH Post office box
NFIRS - 1S Supplemental
Business name if applicable
BOBBY
Check this box if Mr., Ms., Mrs. First Name same address as incident location. Then skip these three duplicate address Number Prefix lines.
Delete
Apt./Suite/Room
City
Suffix
L2
Remarks: Local Option
LEVELS PRESENT ADJACENT TO THE CHAMBER, TWO SEPARATE METERS WERE USED ( MSAMINICO RESPONDER, AIMS 350 MULTI GAS METER ) DURING OPERATION, CARBON MONOXIDE LEVELS EXCEEDED 984ppm IN THE AREA OF THE CHAMBER, INTEGRAL ALARM LIGHTS ACTIVATED AT 35ppm AND AGAIN AT 100ppm. THE AUDIBLE WARNING DID NOT ACTIVATE. AFTER THE COMPLETED CYCLE DURING PURGE READINGS WERE FOUND AT 243ppm AT THE VENT PIPE ABOVE THE CHAMBER, AND AT 28 ppm IN THE ADJOINING ROOM. UPON COMPLETION OF ALL CYCLES, AFTER THE PURGE CYCLE DURING REMOVAL OF ANIMALS A READING OF 460ppm STILL REMAINING IN THE CHAMBER AS OFFICERS REMOVED ANIMALS. FM HARRIS AND CHIEF WILLIAMS ADVISED CAPT. LAWSON OF THE RESULTS AND ADVISED THAT THE CHAMBER SHOULD NOT BE USED, THAT IT WAS A CLEAR DANGER TO THOSE OPERATING IT WITH CARBON MONOXIDE LEVELS PRESENT 28 TIMES THE MAXIMUM ALLOWABLE CONCENTRATION FOR CONTINUOUS EXPOSURE, CAPT. LAWSON ADVISED HE CONTACTED DR. J. KINNARNEY WHO WOULD CONTACT THE MANUFACTURER FOR REPAIRS. A COPY OF THE RFD CARBON MONOXIDE NOTICE OF FINDINGS WAS SIGNED AND LEFT WITH DEPUTY W.LeSUER ALONG WITH AN MSA CO DOSEMETER TUBE LEFT AT THE SITE FOR FURTHER EVALUATION. FM HARRIS ADVISED THAT THE CHAMBER SHOULD NOT BE USED UNTIL REPAIRS WERE MADE AND UNIT TESTED.
Reidsville Fire Department - 402 S. Scales St., Reidsville, NC 27320
A B
2
Delete
07907
NC
08/31/2004
FS3
2004001502
00
FDID
State
Incident Date
Station
Incident Number
Exposure
Apparatus or Resource
Dates and Times
Sent
Check if same date as alarm date
Use codes listed below
1
336-349-1024
ID
C5
Type
92
ID
C2
Type
92
X
Number of People
Use
X X X
08/31/2004 08/31/2004 08/31/2004
0831 0831 0915
1
X Other
Dispatch Arrival Clear
X X X
08/31/2004 08/31/2004 08/31/2004
0831 0831 0915
1
X Other
Ground Fire Suppression 11 Engine 12 Truck or aerial 13 Quint 14 Tanker & pumper combination 16 Brush truck 17 ARF (Aircraft Rescue and Firefighting) 10 Ground fire suppression, other
Aircraft 41 Aircraft: fixed wing tanker 42 Helitanker 43 Helicopter 40 Aircraft, other Marine Equipment 51 Fire boat with pump 52 Boat, no pump 50 Marine apparatus, other
Heavy Ground Equipment 21 Dozer or plow 22 Tractor 24 Tanker or tender 20 Heavy equipment, other
Support Equipment 61 Breathing apparatus support 62 Light and air unit 60 Support apparatus, other
Actions Taken
Check ONE box for each apparatus to indicate its main use at the incident.
Dispatch Arrival Clear
Type of Apparatus or Resource
Change
NFIRS - 9 Apparatus or Resources
86
42
86
42
Medical & Rescue 71 Rescue unit 72 Urban search & rescue unit 73 High angle rescue unit 75 BLS unit 76 ALS unit 70 Medical and rescue unit, other
More apparatus? Use additional sheets.
Other 91 Mobile command post 92 Chief officer car 93 HazMat unit 94 Type 1 hand crew 95 Type 2 hand crew 99 Privately owned vehicle 00 Other apparatus/resource
NN None UU Undetermined
Reidsville Fire Department - 402 S. Scales St., Reidsville, NC 27320
A B
07907
NC
08/31/2004
FS3
2004001502
00
FDID
State
Incident Date
Station
Incident Number
Exposure
Apparatus or Resource
Dates and Times
Sent
Check if same date as alarm date
Use codes listed below
1
ID
C2
Type
92
Dispatch Arrival Clear
X X X
08/31/2004 08/31/2004 08/31/2004
Personnel ID
95
B
C
Name
ID
C5
Sent
Check if same date as alarm date
Type
92
X X X
08/31/2004 08/31/2004 08/31/2004
Personnel ID
530 D
Name
Harris, John E
1 Attend
0831 0831 0915
X
1
BATTCH
Use
86
Number of People
Rank or Grade
Change
Check ONE box for each apparatus to indicate its main use at the incident.
Action Taken
Action Taken
Use
86
Action Taken
42
Action Taken
42
Check ONE box for each apparatus to indicate its main use at the incident.
Action Taken
Actions Taken List up to 4 actions for each apparatus and each personnel
86
Actions Taken List up to 4 actions for each apparatus and each personnel
86
X Other
Attend
NFIRS - 10 Personnel
Delete
X Other
BATTCH
Dates and Times Dispatch Arrival Clear
Number of People
Rank or Grade
Williams, Jeff C
Apparatus or Resource
X
0831 0831 0915
Use codes listed below
2
336-349-1024
Action Taken
42
Action Taken
42
Action Taken
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