5109.14,22,Exs. 01-02 Page 1 of 3 FSH 5109.14 - INDIVIDUAL FIRE REPORT HANDBOOK, FORM FS-5100-29 WO AMENDMENT 5109.14-95-1 EFFECTIVE 9/5/95 22 - Exhibit 01 Sample of Form FS-5100-29 for Wildland Fire USDA - Forest Service Fire Name Independence INDIVIDUAL FIRE REPORT Local Fire Number 17 (Ref. FSH 5109.14) Location T/R/S/SS/Mer _14.0N _19.0W 10 SWNE 08 IDENTIFICATION 1. Region/Forest/District ID and SO Fire Number 01/05/02/050 2. Protecting Agency at Origin USF 3. Ownership at Origin/State at Origin/County 1/ID/___ 4. Fire Management Zone ___3 5. Adjoining Forest (entry no longer used) __/__/__/___ OCCURRENCE 6. Point of Origin lat= 46 22.0 long = 115 10.5 7. Time of Ignition 08/16/94/1600 8. Time of Discovery 08/16/94/1645 9. Detection Method 1 10. Statistical/General/Specific Cause/Class of People 1/_/__/_ 11. Unplanned Ignition Designated as Prescribed Fire N ACTION 12. Initial Suppression Strategy 3 13. Escaped Fire N 14. Time of Initial Action 08/16/94/1715 15. Time Final Suppression Strategy Attained 08/16/94/2300 16. Time Fire Out 08/17/94/1500 17. Forces Used A1/F/01 P1/F/06 E6/C/01 Up to Time of _/_/__ _/_/__ _/_/__ Attainment of _/_/__ _/_/__ _/_/__ Initial Strategy _/_/__ _/_/__ _/_/__ or Escape _/_/__ _/_/__ _/_/__ DESCRIPTION 18. Estimated FFF Cost (whole dollars) ___41 19. FMZ NVC per Acre (whole $) _90 20. FS Acres (All Forests) ____2.0 21. Non-FS Acres Protected by FS ___12.0 22. Acres outside FS Protection _____._ Total Acres= 14.0 23. Fire Intensity Level 2 24. Representative Weather Station 101031 25. NFDRS Fuel Model/Cover Type G/15 26. Aspect/Slope percent 4/_25 27. Elevation (feet in hundreds) 38 OPTIONS 28. Special Code PP/71023 _/_____ _/_____ _/_____ _/_____ _/_____ _/_____ _/_____ _/_____ _/_____ _/_____ _/_____ REMARKS Fire attacked by AT-67 and 6 firefighters. Reinforced by state engine Submitted/s/ D.RANGER /d/ 8-25-94 Approved/s/ R.SUPERVISOR /d/ 8/27/94 FS-5100-29 (8/95) 22 - Exhibit 01--Continued Sample of Form FS-5100-29 for Wildland Fire USDA - Forest Service Fire Name Independence INDIVIDUAL FIRE REPORT Local Fire Number 17 (Ref. FSH 5109.14) SUPPLEMENT FOR LARGE FIRE ACRES BURNED 1. Region/Forest/District ID and SO Fire Number 01/05/02/050 20. FS Acres (All Forests) ____2.0 21. Non-FS Acres Protected by FS ___12.0 22. Acres Outside FS Protection _____._ Total Acres= 14.0 Prot Land Agency FS Unit Ownership Acres USF 01/05 USF _______2.0 USF 01/05 BLM _______2.0 USF 01/05 PVT ______10.0 ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ ___ __/__ ___ ________._ FS-5100-29 (8/95) 22 - Exhibit 02 Sample of Form FS-5100-29 for Prescribed Natural Fire in Wilderness USDA - Forest Service Fire Name Flat Rock INDIVIDUAL FIRE REPORT Local Fire Number 23 (Ref. FSH 5109.14) Location T/R/S/SS/Mer _18.0N _17.0W 36 SESW 08 IDENTIFICATION 1. Region/Forest/District ID and SO Fire Number 01/05/03/058 2. Protecting Agency at Origin USF 3. Ownership at Origin/State at Origin/County 1/ID/___ 4. Fire Management Zone __5 5. Adjoining Forest (entry no longer used) _/__/__/___ OCCURRENCE 6. Point of Origin lat= 46 44.1 long = 114 56.3 7. Time of Ignition 08/16/94/1600 8. Time of Discovery 08/16/94/1715 9. Detection Method 1 10. Statistical/General/Specific Cause/Class of People 1/_/__/_ 11. Unplanned Ignition Designated as Prescribed Fire Y ACTION 12. Initial Suppression Strategy 1 13. Escaped Fire N 14. Time of Initial Action 08/23/94/1400 15. Time Final Suppression Strategy Attained 09/11/94/1500 16. Time Fire Out 10/21/94/1500 17. Forces Used P1/F/06 __/_/__ __/_/__ Up to Time of _/_/__ _/_/__ _/_/__ Attainment of _/_/__ _/_/__ _/_/__ Initial Strategy _/_/__ _/_/__ _/_/__ or Escape _/_/__ _/_/__ _/_/__ DESCRIPTION 18. Estimated FFF Costs (whole dollars) ____9 19. FMZ NVC per Acre (whole $) _-7 20. FS Acres (All Forests) ___98.0 21. Non-FS Acres Protected by FS _____._ 22. Acres Outside FS Protection _____._ Total Acres= 98.0 23. Fire Intensity Level 2 24. Representative Weather Station 101036 25. NFDRS Fuel Model/Cover Type G/15 26. Aspect/Slope percent 4/___ 27. Elevation (feet in hundreds) 67 OPTIONS 28. Special Code WL/__044 _/_____ _/_____ _/_____ _/_____ _/_____ _/_____ _/_____ _/_____ _/_____ _/_____ _/_____ REMARKS Submitted/s/ S.RANGER /d/ 10/25/94 Approved/s/ R.SUPERVISOR /d/11/01/94 FS-5100-29 (8/95)