Auto fire investigation

Download 0.77 Mb.

Page	3/4
Date	20.05.2018
Size	0.77 Mb.
	#49637

1 2 3 4

-

Registered owner of vehicle _I

Sex I Male ^FemaleI Race I Caucasian Black ^{Hispanic/Latino}^Asian^{Native American}^Other

DOB

Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec.

Day

¹²³⁴⁵⁶⁷⁸⁹¹⁰¹¹¹²¹³¹⁴¹⁵¹⁶¹⁷¹⁸¹⁹²⁰²¹²²²³²⁴²⁵²⁶²⁷²⁸²⁹³⁰³¹^I^Year¹⁹ 20

Home phone
...

_I_I_-Cell phone _-_I

Employer

Location at time of fire

Notified of fire by

Vehicle Status

Owned Leased vehicle Financed Other

Insurance

Full coverage Liability only None Insurance Company:

Other Person _I
^Sex^I^Male ^Female		Race Caucasian Black ^{Hispanic/Latino}^Asian^{Native American}^Other
DOB	Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec.
Day	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 11 18 19 20 21 22 23 24 25 26 21 28 29 30 31 , .Year j 19 _I₂₀
Home phone I I		^-I Cell phoneI ^-_I
Location at time of fire ·.
Observations of fire ..
. . Actions taken

Other Person _I '
^SexI Male ^Female		Race I Caucasian Black ^{Hispanic/Latino}^Asian^{Native American}^Other
DOB	Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec.
1 Day ··	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 _I_Year_I₁₉_I₂₀
Home phone I ^I		^-I Cell phone ^-_I
Location at time of fire
Observations of fire
Actions taken .

ADDITIONAL NOTES

Exterior Examination
Front bumper	No damage Damaged by fire Physical damage only Missing Not Applicable
Grill	No damage Damaged by fire ^Physical^damage^only Missing Not Applicable
Hood	Open on arrival of FD Closed on arrival of FD Forced open by FD No damage Damaged by fire Physical damage only Missing Not Applicable
Driver side front quarter panel		No damage Damaged by fire Physical damage only Missing Not Applicable
Driver side front door		Open on arrival of FD Closed on arrival of FD Forced open by FD No damage Damaged by fire Physical damage Missing Not Applicable
Driver side rear door		Open on arrival of FD Closed on arrival of FD Forced open by FD No damage Damaged by fire Physical damage Missing Not Applicable
Drivers rear quarter panel		No damage Damaged by fire Physical damage Missing Not Applicable
Passenger side front quarter panel		No damage Damaged by fire Physical damage Missing Not Applicable
Passenger side front door		Open on arrival of FD Closed on arrival of FD Forced open by FD No damage Damaged by fire Physical damage Missing Not Applicable
Passenger side rear door		Open on arrival of FD Closed on arrival of FD Forced open by FD No damage Damaged by fire Physical damage Missing Not Applicable
Passenger side rear quarter panel		No damage Damaged by fire Physical damage Missing Not Applicable
Trunk lid		Open on arrival of FD Closed on arrival of FD Forced open by FD No damage Damaged by fire Physical damage Missing Not Applicable
Rear bumper		No damage Damaged by fire Physical damage Missing Not Applicable
Roof		Hard top Convertible Not Applicable No damage Damaged by fire Physical damage Missing
^Van,^SUV^or^Cargo^Type^vehicles "
Rear cargo door(s)		Open on arrival of FD Closed on arrival of FD Forced open by FD ^{No damage}^{Damaged by fire} Physical damage Missing Not Applicable
Side cargo door(s)		Open on arrival of FD Closed on arrival of FD Forced open by FD ^{No damage}^{Damaged by fire}^{Physical damage}^Missing Not Applicable

Door locks I cylinders
Driver side front door	Intact Evidence of forced entry Melted and or missing due to the fire Not Applicable
Driver side rear door	Intact Evidence of forced entry Melted and or missing due to the fire Not Applicable
Passenger side front door	Intact Evidence of forced entry Melted and or missing due to the fire Not Applicable
Passenger side front door	Intact Evidence of forced entry Melted and or missing due to the fire Not Applicable
Rear cargo door(s)	Intact Evidence of forced entry Melted and o missing due to the fire Not Applicable
Side cargo door(s)	Intact Evidence of forced entry Melted and or missing due to the fire Not Applicable

Glass Condition ^·-_'
Windshield	No damage Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable
Rear window	No damage Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable
Driver side front door		No damage Up position Down position Partially open Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable
Driver side rear door		No damage Up position Down position Partially open Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable
Passenger side front door		No damage Up position Down position Partially open Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable
Passenger side rear door		No damage Up position Down position Partially open Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable
		No damage Open position Closed position Partially open Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable
Rear cargo door(s)		No damage Open position Closed position Partially open Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable
Side cargo door(s)		No damage Open position Closed position Partially open Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable

Wheels

Factory

Custom

All wheels missing All wheels match

Wheels mixed Other

(see notes below)

Tires

.·

·.

Intact

Tread wear

Fire Damaged

Physical Damage

Missing

D/S Front

Yes No

New Good Fair Poor

D/S Rear

Yes No

New Good Fair Poor

P/S Front

Yes No

P/S Rear

Yes No

Describe any other damage or information on wheels and tires:

^... ^',^<^.'^",.^-^,^.^.^.^.^.^·^..^,._,-.

Under Vehicle ^.^.^::-^..^.^,..
Catalytic converter	Intact Missing Not Applicable	Condition	New Good Fair Poor
Exhaust	Intact Missing Not Applicable	Condition	New Good Fair Poor
Fuel line	Intact Missing Not Applicable	Type	Plastic I Nylon Metal Unknown
Transmission	Intact Missing Not Applicable
Describe any fire damage to underside:

Fuel System ^:,^·^.^.^.
^Gasoline Diesel LPG Electric Hybrid Other
Fuel tank	Plastic /Nylon Metal	Condition	Intact Partially burned Physical Damage Missing
Fuel tank cap	Plastic /Nylon Metal	Condition	Intact Partially burned Physical Damage Missing

Engine Compartment .. .
Engine condition	Intact Physical Damage Fire Damage Removed prior to fire
Battery	Intact Physical Damage Fire Damage Removed prior to fire Unknown
Battery cables	Intact Physical Damage Fire Damage Removed prior to fire Unknown
Radiator	Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown
Upper radiator hoses	Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown
Lower radiator hoses	Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown
Belt(s) condition	Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown
Electronic components	Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown
List any obvious missing engine parts:




Describe fire damage to engine compartment:

Passenger Compartment
Dashboard				Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown
Airbag(s): Driver Side		Intact Deployed Fire Damage Missing due to fire Removed prior to fire Unknown Not Applicable
Airbag(s): Passenger side		Intact Deployed Fire Damage Missing due to fire Removed prior to fire Unknown Not Applicable
Steering Column				Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown
Steering Wheel				Intact Locked Lock defeated Missing due to fire Located in debris Unknown Not Applicable
Odometer Reading				Damage due to fire Unknown Not Applicable
Ignition switch				,. Intact On position Off position Locked Tampered with Tampered with/defeated Missing due to fire Located in debris
Ignition key	In ignition Found in debris None found In possession of owner/driver Unknown Not Applicable
Radio	Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown Not Applicable
Radio Speakers			Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown Not Applicable
Headliner			Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire unknown Not Applicable
Driver side front seat(s)			Intact Physical Damage Covering and padding partially consumed Covering and padding missing due to fire Seat removed prior to fire Unknown Not Applicable Manual seat(s) Power seat(s) Seat warmer(s)
Driver side front floorboard			Intact Floor mats partially consumed Carpet and padding partially consumed Floor mats partially consumed Carpet and padding missing due to fire Not Applicable
Passenger side front seat(s)			Intact Physical Damage Covering and padding partially consumed Covering and padding missing due to fire Seat removed prior to fire Unknown Not Applicable Manual seat(s) Power seat(s) Seat warmer(s)
Passenger side front floorboard			Intact Floor mats partially consumed Carpet and padding partially consumed Floor mats partially consumed Carpet and padding missing due to fire Not Applicable

Rear seat(s)	Intact Physical Damage Covering and padding partially consumed Covering and padding missing due to fire Seat removed prior to fire Unknown Not Applicable
Driver side rear floorboard	Intact Floor mats partially consumed Carpet and padding partially consumed Floor mats partially consumed Carpet and padding missing due to fire Not Applicable
Passenger side rear floorboard	Intact Floor mats partially consumed Carpet and padding partially consumed Floor mats partially consumed Carpet and padding missing due to fire Unknown Not Applicable
Personal effects in passenger compartment:

Trunk and Cargo Area

^TR^.^"C . ^..
Intact Physical Damage Fire Damage
Trunk Jock	Intact Evidence of forced entry Melted and or missing due to the fire Not Applicable
Spare tire	Intact Missing Melted and or missing due to the fire Unknown Not Applicable Located in other area
Jack and equipment	Intact Missing Melted and or missing due to the fire Unknown Not Applicable Located in other area
Other contents/personal effects:

Miscellaneous Items _'
Anti theft alarm system	Intact No Unknown Not applicable
Describe any aftermarket equipment:

Directory: wp-content -> uploads -> 2014
2014 -> For want of a nail
2014 -> Stop Militarizing Law Enforcement Act of 2014
2014 -> Ihbb asian Championships 2014 middle school bowl Round 4 First Quarter
2014 -> Ihbb european Championships 2014 Bowl Round 4 First Quarter
2014 -> International History Bee and Bowl 2013-14 Asian Division Question Set Bowl Round Six
2014 -> United states patent and trademark office
2014 -> Coffs harbour eisteddfod vocal syllabus
2014 -> Listen News Programs Schedule pledge now
2014 -> Slow club announce third album complete surrender

Download 0.77 Mb.

Share with your friends:

1 2 3 4