NFIRS Module 3 - Structure Fire

National Fire Incident Reporting System (NFIRS) Version 5.0

NFIRS Module 3 - Structure Fire

OMB: 1660-0069

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1660-0069 can be found here:

2023-06-06 - Extension without change of a currently approved collection

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NFIRS 5.0 Self-Study Program

Structure Fire Module:
NFIRS-3

Objectives
After completing the Structure Fire Module the student will be able to:
1. Describe when the Structure Fire Module is to be used.
2. Demonstrate how to correctly complete various sections of the
Structure Fire Module, given scenarios of hypothetical incidents.

3-1

Table of Contents
Pretest #3 - Structure Fire Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Using the Structure Fire Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
Section I: Structure Type, Building Status, Building Height, Main Floor Size . . . . . . . . . . . . . 3-4
Section J: Fire Origin, Fire Spread, Number of Stories Damaged by Flame. . . . . . . . . . . . . . . 3-6
Section K: Material Contributing Most to Flame Spread . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
Section L: Presence of Detectors, Detector Type, Detector Power Supply,
Detector Operation, Detector Effectiveness, Detector Failure Reason. . . . . . . . . . . . . . . . 3-8
Section M: Presence of Automatic Extinguishing System, Type of Automatic
Extinguishing System, Operation of Automatic Extinguishing System,
Number of Sprinkler Heads Operating, Reason for Automatic Extinguishing
System Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-10
SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11
EXAMPLE: Residential Fire. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-12
EXERCISE SCENARIO 3-1: Warehouse Fire. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-14
EXERCISE SCENARIO 3-2: Cary Street Fire. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-17
Structure Module Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-22

NFIRS 5.0 Self-Study Program

Pretest #3 - Structure Fire Module
1. All structures are buildings.

(a) True.

(b) False.

2. A Structure Fire Module is required to be completed for a hostile fire confined to a chimney.

(a) True.

(b) False.

3. The Structure Fire Module is a required NFIRS module if the fire occurs in or on a structure.

(a) True.

(b) False.

4. All buildings are structures.

(a) True.

(b) False.

5. A Structure Fire Module should be completed for all building fires that extend beyond a noncombustible container.

(a) True.

(b) False.

3-3

NFIRS 5.0 Self-Study Program

Using the Structure Fire Module

he Structure Fire Module furnishes information regarding the buildings involved in the fire,
how the fire started, and detection and suppression equipment present.

The Structure Fire Module (NFIRS-3) should be completed for all structure fires that extend beyond
a noncombustible container. A structure is an assembly of materials forming a construction for
occupancy or use to serve a specific purpose. This includes, but is not limited to, buildings, open
platforms, bridges, roof assemblies over open storage or process areas, tents, air-supported structures, and grandstands. Like the other modules, the Structure Fire Module is divided into sections
and further subdivided into blocks. The sections and blocks ask for information on different factors
or items involved in the building fire.

Section I: Structure Type, Building Status,
Building Height, Main Floor Size
I1
1
2
3
4
5
6
7
8
0

Structure Type
If fire was in an enclosed building or a
portable/mobile structure, complete the
rest of this form.

Enclosed building
Portable/mobile structure
Open structure
Air-supported structure
Tent
Open platform (e.g., piers)
Underground structure (work areas)
Connective structure (e.g., fences)
Other type of structure

Building Status

1
2
3
4
5
6
7
0
U

Under construction
Occupied & operating
Idle, not routinely used
Under major renovation
Vacant and secured
Vacant and unsecured
Being demolished
Other
Undetermined

Building
Height

Count the roof as part of the
highest story.

Total number of stories at or
above grade

Total number of stories
below grade

Fire
Number
Damaged
by Flame
Block I1 records information regarding
theOrigin
type of structure. If the
is in of
anStories
enclosed
building,
J1
J3 fire
Count
the
roof
as
part
of
the
highest
story.
complete this entire module. The rest of the module would
not be completed if the structure is
Below grade

• an open structure - such as a bridge;
fire origin

Number of stories w/minor damage
(1 to 24% flame damage)

• an air-supported structure;

Number of stories w/significant damage
(25 to 49% flame damage)

Story of

• a tent;

Fire Spread
If fire spread was confined to object of origin,
do not check a box (Ref. Block D3, Fire Module).

Confined to floor of origin
4
to or
building
of origin
suchConfined
as a fence
pipeline;
and/or
5
Beyond building of origin

Number of stories w/extreme damage
(75 to 100% flame damage)

• an underground structure - such as flood tunnel.

Detector Power Supply

Presence of Detectors

L1 for (Inenclosed
3
Complete the Structure Fire Module
Examples L
include
residential buildings,
area of the buildings.
fire)
Battery only
1 be completed
commercial buildings, subway station, or similar structures. ItSkip
also
for portable/
to must
N
None Present
M
Hardwire only
2
mobile structures such as job-site trailers, portable offices, orSection
similar
structures.
1

Present

Information about the status of the building
is collected in Block I2.
Undetermined
U

L2
1
2

Detector Type

3-4
Smoke
Heat

Typ
to F

Check
same
Fire M

Ite

Number of stories w/heavy damage
(50 to 74% flame damage)

to room of origin
• an open platform - such 23as a Confined
pier, dock;

• a connective structure -

3
4
5
6
7

0
U

Plug-in
Hardwire with battery
Plug-in with battery
Mechanical
Multiple detectors & power
supplies
Other
Undetermined

T
m

L5
1
2
3
4
U

A
A
t
T
F
U

NFIRS 5.0 Self-Study Program

I1
1
2
3
4
5
6
7
8
0

Structure Type
If fire was in an enclosed building or a
portable/mobile structure, complete the
rest of this form.

Building Status

1
2
3
4
5
6
7
0
U

Under construction
Occupied & operating
Idle, not routinely used
Under major renovation
Vacant and secured
Vacant and unsecured
Being demolished
Other
Undetermined

Building
Height

Below grade
Story of
fire origin

ructure Type

Building Status

re was in an enclosed building or a
table/mobile structure, complete the
Fire Spread
t of this form.
2 If fire spread was
Under
construction
1 confined
to object
of origin,
closed building
do not check a2box (Ref.
Block D3, Fire&
Module).
Occupied
operating

Main Floor Size

NFIR
Struc
Fire

Count the roof as part of the
highest story.

Total number of stories at or
above grade

,
Total square feet

OR
Total number of stories
below grade

Origin the status of the building
Number
of Stories
Damaged
2 captures
Block IFire
involved
in the
fire. by Flame

Count the roof as part of the highest story.

Length in feet

Width in feet

Type of Material Contributing Most
to Flame Spread
Check if no flame spread OR if
same as Material First Ignited (Block D4,

Number of stories w/minor damage
(1 to 24% flame damage)

Main Floor SizeFire Module)NFIRS–3
Building
OR if unable to determine.
I3 Height
I4
Structure
Number of stories w/significant damage
Count
part ofdamage)
the
(25 the
to roof
49%as
flame
highest story.

Fire
Item contributing most to flame spread

Number of stories w/heavy damage

(50 to 74% flame damage)
,
,
rtable/mobile structure
Idle, of
not
routinely used
Confined3to room
origin
Total number of stories at or
2
Total square feet
K
2
grade
pen structure
Under
major renovation above
3
Confined4to floor
of origin
Type of material contributing
Number of stories w/extreme damage
Required only if item
r-supported structure
most to flame spread
Vacant of
and
secured
4
contributing code is 00
(75 to 100% flame damage)
Confined5to building
origin
OR
nt
Vacant
and unsecured
6
5
Beyond building
of origin
pen platform (e.g., piers)
Being demolished
7
BY
,
,
nderground structure (work areas) 0
Total number of stories
Length in feet
Width
in feet
Detector
Effectiveness
Power Supply
Presence ofOther
Detectors
belowDetector
grade
onnective structureL(e.g.,
1 fences)
L
3
L
5
Required if detector operated.
Undetermined
U
(In area of the fire)
her type of structure
1
Alerted occupants, occupants resp
Battery only
1
Skip to
N
None Present
Section M
2
Alerted occupants, occupants faile
Hardwire only
2
Fire Origin
Number
of Stories
Damaged
by Flame
Material
Most
In Block1 I3 enter
the total
number
of stories
atPlug-in
or above Type
gradeoflevel,
thenContributing
enter thetototal
number of
respond
Present
3
J3 Count the roof as part of the highest story. 4
K
to
Flame
Spread
3
There
were
no occupants
Hardwire
with battery
stories below
grade level. Do not count normally
inaccessible
attics, attics with
less
than
standing
Undetermined
U
Below grade
4regard
Failed
to alert
occupants
with
battery
5 of IPlug-in
Check
if no flame spread OR if
Number
of
storiesBoth
w/minorparts
damage
3
must
be
completed
without
to
how
height,
or
the
roof
as
a
story.
tory of
Skipmany
to
same as Material First Ignited (Block U
D4,
(1
to
24%
flame
damage)
Undetermined
Mechanical
6
e origin
Detector Type
Section L
Fire Module) OR if unable to determine.
floors
L2 were involved in the fire.
Multiple detectors & power
7
Number of stories w/significant damage
Detector Failure Reason
supplies
L6
(25 to 49% flame damage)
Fire Spread
K
1
Other
0
Item contributing most to flame spread
Required if detector failed to operate
spread was confined to object 1
of origin, Smoke
Number of stories w/heavyMain
damage
check a
box (Ref. Block
D3, Fire Module).
U FloorUndetermined
Building
Status
Building
Size
NFIRS–3
2
HeatI3
(50 to 74% flame damage)
I2
I4
Height
nfined to room of origin
Structure
1
Power failure, shutoff, or disconnec
DetectorK
Operation
3
Combination
smoke
and
heat
2
Count the roof as part of the
L
4
nfined to floor of origin
Fire
2
Improper
Type
of
material
contributing
Number
of
stories
w/extreme
damage
Required
only if item installation or placement
highest story.
4
Sprinkler,
water flow detection
Under
construction
1
most to flame spread
contributing
code is 00 or <70.
(75 to 100% flame damage)
nfined
to building
of origin
3
Defective
Fire too small to activate
1
operating
2ond Occupied
5
More than one type present
building of&origin
4
Lack of maintenance, includes
,
,
Idle, not routinely
3
0 used
OtherTotal number of stories at or
Total square feet
Complete
not cleaning
above grade
2
Operated
Block L5
Under major renovation
4
U
UndeterminedDetector Power Supply
Detector Effectiveness
Presence of Detectors
Battery missing or disconnected
5
Vacant and secured
5
L
3
L
5
OR
Required if detector operated.
Battery discharged or dead
6
Complete
of the fire)
3
Failed to operate
Vacant
and unsecured
6(In area
Block L6
Otherresponded
0
1
Alerted
occupants,
occupants
Battery
only
1
Skip to
Being
7
N
None demolished
Present
BY
, U
,
Undetermined
U
Section M Total2
2
Alerted
occupants,
occupants
failed
Hardwire
only
number of stories
Undetermined
Other
0
Length in feet
Width in feet
below grade
to respond
Present
Plug-in
1U
3
Undetermined
3
There were no occupants
Hardwire with battery
4
Undetermined
U
Operation
of Automatic
Presence of5 Automatic
Extinguishing
System
Reason for Automatic
4 3 Failed
to alert
occupants
Plug-in
with
battery
1
M
M N
M5 Extinguishing System Fa
Extinguishing System
None
Present
U
Undetermined
Mechanical
6
Detector
NumberType
of Stories
Damaged
by
Flame
Type
of Materialthe
Contributing
Most
Block
I14 offers
two
options
fordetectors
indicating
main floorRequired
size.if Enter
either
therange
number of square
fire was within
designed
Present
Required iffeet
system failed or not effective
Complete
rest of
Multiple
& power
7
K to
Flame
Spread
Operated/effective
(go to M4)
Section
M width in
Detector
Failure
Reason
1
Count the roof as part of the
2structure’s
Partialmain
System
Present
onhighest
thestory.
floor
or
its
length
and
feet.
supplies
1
System
shut off
L26 Operated/not effective (go to M4)
U damage
Undetermined
Check if no flame spread OR if
Number of stories w/minor
Other
0
2
Not
enough
agent disch
Required
if
detector
failed
to
operate
Smoke
same as Material First Ignited (Block D4,
Fire Skip
tootosmall to activate
3
(1 to 24% flame damage)
Undetermined
U
Section L
Fire Module) OR if unable
to determine.
3
Agent
discharged
but di
Type
of
Automatic
Extinguishing
System
Heat
Failed to operate (go to M5)
4
Mw/significant
2
reach
fire
Required
if fire was within
designed
range
of
AES
Number
of
stories
damage
1
Power
failure,
shutoff,
or
disconnect
Detector Operation
Other
0
Combination smoke and heat
4
Wrong type of system
(25 to 49% flame damage)
L4 sprinkler
K1
2U
Improper installation or placement
Wet-pipe
Undetermined
1
Sprinkler, water flow detection
Item contributing most to flame spread
5
Fire not in area protecte
3
Defective
Dry-pipe
sprinkler
Number of stories w/heavy
damage
2
3-5
Fire too small to activate
1
More (50
than
one
type
present
6
System components dam
to 74% flame damage)
Number
of Sprinklerincludes
4
of maintenance,
Other sprinkler system
3
M4 Lack
7
Lack of maintenance
Other
Complete
Heads
Operating
not cleaning
K2
4
Dry chemical
system
2
Operated
Block L5
8
Manual intervention
Type of material contributing
Number of stories w/extreme
damage
Undetermined
Required
if
system
operated
Battery
missing
or
disconnected
5
Required
only
if
item
5
Foam system
most to flame spread
contributing code is 00 or <70.
(75 to 100% flame damage)
0
Other

Structure Type

NFIRS
5.0in Self-Study
Programor a
If fire was
an enclosed building

Building Status

portable/mobile structure, complete the
rest of this form.

Building
Height

Count the roof as part of the

highest story.
Under construction
1
1
Enclosed building
Occupied & operating
2
2
Portable/mobile structure
Idle, not routinely used
3
Total number of stories at or
3
Open structure
Under major renovation above grade
4
4
Air-supported structure
Vacant and secured
5
5
Tent
Vacant
and
unsecured
6
Structure
Type
Building
Status
Building
6I1
Open platform (e.g., piers)
I
3
7I2 Being demolished
Height
If
fire
was
in
an
enclosed
building
or
a
In Section J you will record data 7that will
help describe
where
the fire
started,
whether or not itTotal number
Underground
structure
(work areas)
of stories
portable/mobile structure, complete the
Other
0
Count
thegrade
roof as part of the
below
8
rest ofthat
this form.
Connective
structure
(e.g.,by
fences)
spread, and the percentage of the structure
was
damaged
flame.U
highest story.
Undetermined
Under construction
1
0
Other
typebuilding
of structure
1
Enclosed
Occupied & operating
2
2
Portable/mobile structure
Idle, not routinely used
3
Total number of stories at or
3
above grade
Open
Underofmajor
renovation
4 Number
Fire structure
Origin
Stories
Damaged by
Flame
T
4J1 Air-supported structure
J3 5 CountVacant
K to
the roof asand
part ofsecured
the highest story.
5
Tent
Below grade
Vacant and unsecured
6
Ch
Number of stories w/minor damage
6
Open
Story ofplatform (e.g., piers)
sam
Being
demolished
7
(1 to 24%
flame damage)
fire
origin
7
Underground structure (work areas) 0
Total number of stories Fir
Other
below grade
8
Connective structure (e.g., fences)
Number of stories w/significant damage
Undetermined
U
0
(25 to 49% flame damage)
Other
of structure
Fire type
Spread
K1
J2 If fire spreadin
was Block
confined to J
object
of origin,
1. This
Enter the story on which the fire originated
story number is assumed to be at or

Section J: Fire Origin, Fire Spread,
Number of Stories Damaged by Flame

Number of stories w/heavy damage

do not check a box (Ref. Block D3, Fire Module).

(50 to
74%
flame1.
damage)
above grade unless the Below Grade boxFire
is marked.
Count the groundNumber
level
asof
story
In case ofby Flame
Origin
Stories
Damaged
to room of origin
2J1 Confined
J3origin
most residential basements, you would
enter
“1”
for
the
Story
of
fire
and
then
check
Count the roof as part of the highestthe
story.box
3
Confined to floor of origin
Number of stories w/extreme damage
Below grade
to indicate it was below grade. 4 Confined
(75
to 100%
flame damage)
to building of origin
Number
of stories
w/minor damage
Story of

L
J21

Ch
sam
Fir

(1 to 24% flame damage)

fire originbuilding of origin
Beyond

Presence
of Detectors
Fire Spread

K
K2 to

If fire spread
was
to object of origin,
(In area
ofconfined
the fire)
do not check a box (Ref. Block D3, Fire Module).
1
Skip to
Building
Status
Building
N
None
Present
Confined
to room
of originSection
M
2

Number of stories w/significant damage
Detector
(25 to
49% flamePower
damage)Supply
Number of stories w/heavy damage
(50 to Battery
74% flameonly
damage)

LK51

1
Main Floor Size
NFIRS–3
Hardwire
only
I
4
K2 2
Height
If fire was in an enclosed building or a
Structure
Present
Plug-in
1
of stories w/extreme damage
3 Number
portable/mobile structure, complete the
Count the roof as part of the
4
100% flame with
damage)
Confined to building of origin
Fire 3
rest of this form.
battery
4 (75 toHardwire
Undetermined highest story.
U construction
15 Under
Beyond
building
of
origin
4
Plug-in
with
battery
5
1
Enclosed building
Occupied & operating
2
U
Mechanical
6
,
,
2
Portable/mobile structure
Type used
not routinely
3 L2 Idle,Detector
Total number of stories at or
Total square
feet Supply
Detector
Power
Presence
of
Detectors
Multiple
detectors
& power
7
captures the extent of fire4 spread
in
terms
of
how
far
the
flame
extended.
T
he
extent
3 Block
above
grade damage
OpenJ2structure
renovation
L1 Under(Inmajor
L3
L5
4 ofAir-supported
of the fire) and does not include thesupplies
L6
flame damagestructure
is the area actually
or
area receivingOR
only
Vacant area
andcharred
secured
5 burned
Other
0
1
5
Battery only
Tent
1
Skip toextent
and
unsecured
6 1 Vacant
heat,
smoke, or water damage. Mark
theNSmoke
box
best
describing Section
the
of fireUndetermined
spread.only
If the fire
None
Present
M
U
2
6
Hardwire
Open platform (e.g., piers)
2
demolished
7 2ofBeing
Heat
Fire, Module BY
was ,
was confined
to (work
theareas)
object
origin
(1)
and the boxTotal
in number
Block
D33 on the
7 spread
Present
Plug-in
1
Underground
structure
of stories
1
0 3 Other
Detector
Length inOperation
feet
Width in feet
Combination smoke and
heat
below
grade
8 marked,
do not
mark the
box here.
Hardwire with battery
Connective
structure
(e.g., fences)
L44
Undetermined
23
U 4 Undetermined
U
Sprinkler, water flow detection
0
Plug-in with battery
Other type of structure
5
34
Fire
too small to activate
16
5
More than
one type present
Mechanical
Detector
Type
4U
L0 2 Other
Multiple detectors & power
7
Complete
Fire Origin
Number of Stories Damaged by Flame 2
Type
of Material Contributing
Most
Operated
Block L5
supplies
J1
J3 Count
K
U
Undetermined
L56
to Flame Spread
the roof as part of the highest story.
Other
0
6
1
Smoke
Complete
Below grade
3
Failed
tospread
operate
if no flame
OR if
Number of stories w/minor damage
Undetermined
U Check
Block L6
0Skip to
Story of
same
as
Material
First
Ignited
(Block
D4,
2
Heat
(1 to 24% flame damage)
fire origin
Section
Fire Module) OR if unable to determine.
U
U
1
Detector
Operation
Undetermined
3
Combination smoke and heat
L4
Number of stories w/significant damage
2
4 (25 toSprinkler,
water flow detection
49% flame damage)
Fire Spread
K
1
3
Firecontributing
too small
toflame
activate
1 System
J2 If fire spread was confined to object of origin,
Item
most to
spread
5 Presence
More than
one type present
Operation
of Automatic
of Automatic
Extinguishing
4
Number
of
stories
w/heavy
damage
do not check a box (Ref. Block D3, Fire Module).
M3 Extinguishing
M
0 1(50NtoOther
Complete System
74% flame
Nonedamage)
Present
2
Operated Required if fire was Block
L5
Confined to room of origin
2
within designed
range
Present
1 Undetermined
U
5
Complete
KSection
2 rest of
3
Confined to floor of origin
(go
Operated/effective
M
1 contributing
Type of material
Number
of Partial
stories w/extreme
2
Systemdamage
Present
6 to M
Required
only
if
item
Complete
3
Failed
to spread
operate
most to flame
4
contributing
code is 00 or(go
(75U
to 100%Undetermined
flame damage)
Confined to building of origin
Operated/not
effective
Block L6
2
0 <70
5
Beyond building of origin
Fire too small to activate
3
U
Type of Automatic Extinguishing U
SystemUndetermined
Failed to operate (go to M5)
4
M2 Required if fire was within designed range of AES
Detector
Detector Power
Supply
Presence
of Detectors
J3 captures
the number of stories damaged
by flame
spread. Flame damage
is the0Effectiveness
area Other
actually
L1 Block
L
31
L
5
Required if detector operated.
Wet-pipe
sprinkler
Undetermined
U
Operation of Automatic
Presence
of Automatic
Extinguishing
System
(In area
the fire) and does not include
burned
orofcharred
areas
receiving
only
heat,
smoke,
or
water
damage.
12
M3 Extinguishing
M
Dry-pipe
sprinkler
1
Alerted
occupants,
occupants System
responde
Battery
only
1
None
Present
N
Skip to
Number of Sprinkler
N
None Present
Other
sprinkler
system
Section M
2
Alerted occupants,
failed
if fireoccupants
was within designed
range
MRequired
4
only
2 3 1 Hardwire
Present
Complete rest of
Heads Operating(go to M
4
Dry
chemical
system
Operated/effective
Section
M
to
respond
1
Present
Plug-in
1
3
2
Partial System Present
Required if system operated
Foam
system
2 noOperated/not
3
There were
occupants effective (go
with battery
Undetermined
4 5 U Hardwire
Undetermined
U
6
Halogen-type
system
too small to activate
4
Failed to3alert Fire
occupants
Plug-in3-6
with battery
5
Type
of Automatic
Extinguishing
System
Carbon
dioxide (CO
Failed to operate (go to M5)
4
2) system
U
Undetermined
Mechanical
6 27
Detector Type
M
Number of sprinkler heads operating
Required
if firespecial
was within hazard
designed range
of AES
Other
system
Other
L2
0
Multiple
detectors
& power
7 0
Detector
Failure
Reason
U
Undetermined
Wet-pipe sprinkler
Undetermined
1
U
supplies
L6

Structure Type

I232

I3
Confined to floor of origin

as)

)

Building Status

Building
Height

Count the roof as part of the

Main Floor Size

NFIRS–3
Structure
NFIRS 5.0 Self-Study Program Fire

highest story.
Under construction
Occupied & operating
,
,
Idle, not routinely used
Total number of stories at or
Total square feet
Enter
the
number
of
stories
damaged
by
flame
according
to the indicated criteria. If the roof was the
Under major renovation above grade
onlysecured
part of the structure that burned, count it asOR
part of the top story.
Vacant and
Vacant and unsecured
Being demolished
BY
,
,
Total number of stories
Other
Length in feet
Width in feet
below grade
Undetermined

1
2
3
4
5
6
7
0
U

Section K: Material Contributing Most to Flame Spread

Number of Stories Damaged by Flame
Count the roof as part of the highest story.

Check if no flame spread OR if
same as Material First Ignited (Block D4,
Fire Module) OR if unable to determine.

Number of stories w/minor damage
(1 to 24% flame damage)

Type of Material Contributing Most
to Flame Spread

Building
Status
Building
Number of stories w/significant damage
I3 Height
(25 to 49% flame damage)
K1

Section K is completed
Count the roof only
as part ofif:
the

Main Floor Size

Item contributing most to flame spread

highest story.
Number of stories w/heavy damage
Under
construction
(50 to 74% flame damage)

Skip to
Section L

NFIRS–3
Structure
Fire

1
1. & operating
The flame spread is beyond the object of origin.
Occupied
2
,
,
K2
Idle,
not
routinely
used damage
3
Total number of stories at or
Total
square
feet
Type of
material
contributing
Number of2.
stories
w/extreme
Requiredis
onlydifferent
if item
The
material
contributing
most
to
the
flame
spread
from the Item First Ignited
above
grade
most to flame spread
Under
major
renovation
4
contributing code is 00 or <70.
(75 to 100%
flame
damage)
3
of
NFIRS-2
Fire
Module).
(recorded
in
D
Vacant and secured
5
OR
Main Floor Size
Building
Status
Building
and
unsecured I3
6I2 Vacant
I4 not apply, mark the boxNFIRS–3
If either
one
of theseHeight
conditions does
and skip the rest of the section.
Being
demolished
7
Detector
Detector
Power
Supply
BY
, Effectiveness
, Structure
as)
Totalthe
number
ofpart
stories
Count
roof as
of5the
L
0 L3Other
Required
if
detector
operated.
Fire
Length in feet
Width in feet
belowstory.
grade
In Block K1 youhighest
will
enter the code for
the Item Contributing
Most to Flame Spread. Fill in this item
)
Under
construction
1
Undetermined
U
1
Alerted
occupants,
occupants
responded
Battery
only
& operating
2 1 Occupied
to
only
if:
,
,
nM
2
Alerted
occupants,
occupants
failed
Hardwire
only
2
Idle, not routinely used
3
Total number of stories at or
Total square feet
above grade
to
respond
major
renovation
4 3 UnderPlug-in
1. The
flame spread
beyond the object
of origin.
Number
of Stories
Damaged
of Material
Most
There
were noContributing
occupants
Hardwire
with
batteryby Flame K3 Type
4 Vacant
and secured
OR
J3 5 Count
to
Flame
Spread
the
roof
as
part
of
the
highest
story.
4
Failed
to
alert
occupants
Plug-in
with
battery
6 5 Vacant and
2. unsecured
The item contributing most to flame spread is different from the Item First Ignited.
U CheckUndetermined
if no flame spread OR if
Mechanical
Number
of stories w/minor damage
demolished
7 6 Being
BY
,
,
Skip to
as)
Total number of stories same as Material First Ignited (Block D4,
(1 to 24%
flame damage)
Multiple
detectors & power
0 7 Other
Section L
Fire Module)
OR ifinunable
Length
feet to determine. Width in feet
below grade
Detector
Failure
Reason
)
supplies
Undetermined
U
L6
Number of stories w/significant damage
0 (25 to Other
49% flame damage)
K1 Required if detector failed to operate
Undetermined
U
Item contributing most to flame spread

at3
J
ion

Number of stories w/heavy damage

Number
of
Damaged by Flame
(50 toDetector
74%Stories
flame Operation
damage)
L4
Count the roof as part of the highest story.
1
2

Type of Material Contributing Most

1
Power failure, shutoff, or disconnect
K
to
Flame Spread
2
installation or placement
K2 areImproper
The codes used in this section
the same as those for the Item First Ignited and are found in the

Number
of
stories
w/extreme
damage
Number
oftoo
stories
w/minor
damage
Fire
small
to activate
(75
100%
flame
damage)
(1 toto24%
flame
damage)

CRG.

Operated

3
4

Type
of flame
material
contributing
Defective
Required only if item
Check
if no
spread
OR if
most
to flameFirst
spread
to
contributing
code is 00Skip
or <70.
same
as Material
Ignited (Block D4,
Lack
of maintenance,
includes
Section L
Fire Module) OR if unable to determine.

not cleaning

Complete

the
Type missing
of Material
Contributing Most to the Flame Spread.
You will use Block K to record
Battery
or disconnected
5

Block L5
Number of stories w/significant damage
2
(25 to 49% flame damage)

K1
L605

Detector
Effectiveness
Battery discharged
or dead
Other
(50 to 74% flame damage)
Undetermined
U1
Alerted occupants, occupants responded
Battery only
U1
o
Undetermined
K
2
nM
2
Alerted occupants, occupants failed
Hardwire only
2
Type of material contributing
Number of stories w/extreme damage
Required only if item
to respond
Plug-in
3 (75 to 100% flame damage)
most
to flame spread
contributing code is 00 or <70.
Operation of Automatic
uishing4 System
for Automatic
3
There wereReason
no occupants
Hardwire with battery
M
3
M5 Extinguishing
Extinguishing System
4
Failed to alert
occupants System Failure
Plug-in with battery
5
Required
if
fire
was
within
designed
range
Complete
this
Block
when
the
code
for
Type
ofif Material
00 and
U
Undetermined
Required
system failed oris
notbetween
effective
6
Complete
restMechanical
of
Detector Effectiveness
Power
Supply
(go
to
M4)
Operated/effective
Section Detector
M
1
Multiple
detectors
& power when
supply
this information
typeif1of
material
is 70 or greater.
L73
L5 theRequired
detector
operated. code
System
shut off
Detector
Failure
Reason
Operated/not effective (go to
M4)
supplies2
2
Not
enough
agent
L
6
1
Alerted occupants, occupantsdischarged
responded
Fire too small to activate
Battery
1
3
o
Other only
0
Agent
did not
Required3if detector
failed todischarged
operate
shing
System
nM
2 M5) Alerted
occupants,
occupantsbut
failed
Failed
to
operate
(go
to
Hardwire
only
2
4
Undetermined
U
reach fire
f AES
to
respond
Plug-in 0
Other
3
4 failure,
Wrong
typeor
ofdisconnect
system
13
Power
Detector
Operation
There were
no shutoff,
occupants
HardwireU
withUndetermined
battery
4
at
L54
5
Fire
not
in
area
protected
24
Improper
installation
or placement
Failed to alert
occupants
Plug-in with battery
ion
6
System
components
damaged
3
Defective
U
Undetermined
Mechanical
Fire
too small
activate of Sprinkler
16
M4 to Number
7 maintenance,
Lack of maintenance
4
Lack
of
includes
Heads
Operating
Multiple detectors & power
7
8 Failure
Manual
intervention
Detector
Reason
cleaning
operated
supplies Required if systemComplete
2
Operated
L56 not
Block L5
0
Other
Battery missing or disconnected
Other
0
RequiredU
if detector failed to operate
Undetermined
Battery
discharged
or dead
6
Complete
Undetermined
stem 3U
Failed
to operate
Block
L6operating
Number of sprinkler
heads
Other
0
3-7
tem
1
Power
failure, shutoff, orNFIRS–3
disconnect
Detector Operation
at
Undetermined
U
Revision 01/01/06
U4
Undetermined
L
2
Improper installation or placement
ion
3
Defective
Fire too small to activate
1
4
Lack of maintenance, includes
Detector Power Supply

Complete
33
Failed to operate
L
Number of stories w/heavy damageBlock L6

Item contributing most to flame spread
Required if detector operated.

70. It is not necessary to

5
6
J1
7
8
0

Tent
Vacant and unsecured
6
Fire platform
Origin (e.g., piers)
Number of Stories Damaged by Flame
Typ
Open
Being demolished
J
37
K
the roof as part of the highest story.
Underground structure (work areas) 0 CountOther
Total number of stories to F
below grade
Below grade
Connective structure
(e.g., fences)
Check
Number of stories w/minor damage
Undetermined
U
Story of
same a
(1 to 24% flame damage)
Other
type
structure
fire origin
NFIRS
5.0 of
Self-Study
Program
Fire Mo
Number of stories w/significant damage

FireOrigin
Spread
Fire

(25 to of
49%
flame damage)
Number
Stories
Damaged by Flame

J12
Section L: Presence
of Detectors,J3Detector Type,
Confined
to room of
origin
2
Detector Power
Supply,
Detector
Operation,
3
Confined to floor of origin
4
Confined to building
of origin Failure Reason
Detector Effectiveness,
Detector
Fire Spread
5
Beyond
building of origin
If fire spread was confined to object of origin,
do not check a box (Ref. Block D3, Fire Module).
Below grade
Story of
fire origin

I1
1
2
3
4
5
6
7
8
0

J2
2
3
4
5

L2
1
2
3
4
5
0
U

2L1
3
4
5I2

If fire spread was confined to object of origin,
do not check a box (Ref. Block D3, Fire Module).

Count the
roof asof
part
of the highest
story.
Number
stories
w/heavy
damage

(50 to 74% flame damage)
Number of stories w/minor damage
(1 to 24% flame damage)
Number of stories w/extreme damage
(75 to 100%
flame damage)
Number
of stories
w/significant damage
(25 to 49% flame damage)
Number of stories w/heavy damage
(50 to
74% flamePower
damage)Supply
Detector

Presence of Detectors
Confined to room of origin
L3
(In area of the fire)
Confined to floor of origin
of stories w/extreme damage
Battery
only
1 Number
Skip to
(75 to 100% flame damage)
Confined
to building
of origin
N
None
Present
Section
M
Hardwire
onlyFloor Size
2
Main
Building
Status
Building
Beyond building of origin I3
I4
Present
Plug-in
1
Height3

K1 Type
K to Item
Fl

Check i

a
K2 same
Fire Mo

Ty
mo

K1
LK52

Item

Req

Typ
1
A
mo
2
A
Structure Type
NFIRS–3
to
If fire was in an enclosed building or a
Structure
portable/mobile structure, complete the
3
T
Hardwire
with
battery
4
Count
the
roof
as
part
of
the
Undetermined
U
Fire
rest of this form.
De
Presence
of Detectors highest story.
Detector Power Supply
4
F
Plug-in
with
battery
5
1L1 Under construction
L3
L5 Req
Enclosed building
(In area of the
fire)
U
U
Mechanical
6
Occupied
operating
2
Detector& Type
, detectors & ,power
1
A
Portable/mobile structure
only
17 at or Battery
L2 Idle,
Skip number
to their
Multiple
not
routinely
used
Total
of stories
1 you should indicate3the existence
In
Block
L
of
detectors
within
designed
range
of
the
fire.
If
Total
square
feet
N
None Present
M
De
2
A
above grade
Open structure
Hardwire
2
supplies only
Under major renovation Section
L
6
no
detectors were
present, mark45 None
Present
and
skip
to
Section
M.
to
Air-supported
structure
Present
Plug-in
1
30
Other
and secured
OR
R
1 Vacant
Smoke
Tent
3
Th
Hardwire
with
battery
4
Undetermined
U
Vacant
and
unsecured
6
Undetermined
U
2
Heat
Open platform (e.g., piers)
4
Fa
Plug-in with battery
5
Being demolished
7
,Operation BY
,
1U
P
Detector
Underground structure (work areas) 03 Other
Total
number of stories
Combination
heat
U
Mechanical
6
Detector
Typesmoke and
L7 4 Multiple
Length in feet
Width in feet
below grade
2
Im
L
2
Connective structure (e.g., fences)
detectors & power
Sprinkler, water flow detection
U4 Undetermined
De
3
Other type of structure
supplies
Fire
too
small
to
activate
1
5
More than one type present
L46 DLa
Other
0
Re
10
Smoke
Other
Complete
no
Undetermined
2U
Operated
Block L5 Most
Fire Origin
of
Stories
Damaged
by
Flame
Type
of
Material
Contributing
2UNumber
Heat
Undetermined
B
5
J3 3Count theCombination
K toDetector
Flame Spread
16
Po
Operation
roof as part of the highest
story. and heat
B
smoke
Complete
3
Failed
to
operate
L4 Check if no flame spread OR if
Below grade
Block L6
20
Im
O
Number
of stories
w/minor
damage
4
Sprinkler,
water
flow
detection
Story of
Skip to
same as Material First Ignited (Block D4,
3
De
(1 to 24% flame damage)
U
U
Fire
too
small
to
activate
fire origin
1U
Section L
Fire
Module) OR if unable to determine.
Undetermined
5
More than one type present
4
La
0
Other
Number
of stories w/significant damage
Complete
no
2
Operated
Block L5
(25 to 49% flame damage)
Fire Spread
K
1
U Presence
Undetermined
Ba
5
Operation
of
Automatic
of
Automatic
Extinguishing
System
Item contributing most to flame spread
If fire spread was confined to object of origin,
M
3
M1 Number
Ba
6
of
stories
w/heavy
damage
Complete
Extinguishing
System
do not check a box (Ref. Block D3, Fire Module).
3
Failed
to
operate
None Present
N
Block L6
(50 to 74% flame damage)
O
0
Required if fire was within designed range
Present
1
Complete rest of
Confined
to L
room
of origin
2 Detector Type to identify the type of detector present in the
Use Block
area
of
fire
origin.
This
field
Un
U
(go
to
M4)
Operated/effective
K
2
Section
M
1
U
2
Partial System Present
Undetermined
Confined to floor of origin
Type of material contributing
Number of stories w/extreme damage
Requiredeffective
only if item (go to
Operated/not
is
required
if
the
fire
was
within
the
area
covered
by
the
detector.
2
Undetermined
U to 100%
most to flame spread
contributing code is 00 or <70.
(75
flame damage)
Confined to building of origin
Fire too small to activate
3
Beyond building of origin
Type ofofAutomatic
Operation
of Automatic
Presence
AutomaticExtinguishing
ExtinguishingSystem
System
Failed
to operate
(go to M5)
4
M
3
M12 N RequiredNone
if fire was within designed range of AES
Extinguishing
System
Other
Present
0
Presence of Detectors
Detector
Power
Supply
Detector Effectiveness
if fire was within designed range
sprinkler
Undetermined
Present
U Required
Complete
of
L31 1 Wet-pipe
L5 rest
Required
if detector
operated.
Operated/effective (go to M4)
Section
M
(In area of the fire)
1
Partial System
Dry-pipe
sprinkler
Present
2 2
1
Alerted2occupants,
occupants
responded
(go to M
Number
of effective
Sprinkler
only
1 3 U Battery
Undetermined
Other
sprinkler
system
Skip to
M4 Operated/not
N
None Present
Section M
2
Alerted3occupants,
failed
FireHeads
toooccupants
small
to activate
Operating
Hardwire
only system
24
Dry chemical
Type
of Automatic Extinguishing System to respond
Failed
to operate
(go to M5)
if system
operated
Present
Plug-in
1
4 Required
Foam system
M325 Required
if fire was within designed range of AES
Other
3
There were
no
occupants
Hardwire
with battery
0
46
Halogen-type
system
Undetermined
U
Wet-pipe
sprinkler
Undetermined
4
Failed to
occupants
Plug-in
battery
U alert
517
Carbonwith
dioxide
(CO2) system
Number of sprinkler heads operating
Dry-pipe
sprinkler
U
Undetermined
2
Mechanical
6
0
Detector Type
Other special hazard system
Number of Sprinkler
Other
sprinkler
system
Multiple
detectors
& power
73U
MFailure
4
Undetermined
Detector
Reason
Heads
Operating
4
Dry
chemical
system
supplies
L6
Required if system operated
5
Foam
system
Other
0
Required if detector failed to operate
Smoke
Undetermined
Halogen-type system
U6
Heat
7
Carbon dioxide (CO ) system
1
Power failure,
or disconnect
Detector Operation 2
Numbershutoff,
of sprinkler heads
operating
Combination smoke and heat
Other special hazard system
L04
2
Improper installation or placement
Sprinkler, water flow detection
U
Undetermined
3
Defective
Fire too small to activate
1
More than one type present
4
Lackfield
of maintenance,
Use Block L3 to describe the power supply for the detector that was found.
This
is required includes
if
Other
Complete
not cleaning
2
Operated
the fire was within the designed range
of
the detector.
Block L5
Undetermined
Battery missing or disconnected
5
Battery discharged or dead
6
Complete
3
Failed to operate
Block L6
Other
0
Undetermined
U
U
Undetermined

3-8
M1

Presence of Automatic Extinguishing System
None Present
N
Present
1

Operation of Automatic
Extinguishing System

Required if fire was within designed range

Reason for Automatic
Extinguishing System Failure

Required if system failed or not effective

Undetermined

Detector Type
L2 Status
Building

Building
Height

5
6
7

4
Plug-in with battery
U
Mechanical
Main Floor
Size & power
Multiple
detectors
NFIRS–3
I4 supplies
L6
NFIRS 5.0 Self-Study Program Structure
Other
Fire
Undetermined

Failed to alert occupants
Undetermined
Detector Failure Reason

Count the roof as part of the 0
Required if detector failed to operate
1
Smoke
highest story.
Under construction
1
U
2
Heat
Occupied & operating
2
,
,
1
Power failure, shutoff, or disconnect
Detector
Operation
3 not routinely
Combination
and heat
Idle,
usedsmoke
3
Total number
of stories at or
Total square feet
L
4
above grade
2
Improper installation or placement
Main
Floor
Size
Building
Status
Building
renovation
4
4 major
Sprinkler,
water flow
NFIRS–3
I2 Under
I3 detection
I
4
3
Defective
Height
Vacant
and
secured
5
Fire
too
small
to
activate
1
OR
Structure
5
More than one type present
4
Lack of maintenance, includes
Count the roof as part of the
Vacant and unsecured
6
Fire
0
Other
highest story.
Complete
not cleaning
Under
construction
1
Being demolished
7
2
Operated
BY
,
, Block L5
U
Undetermined
Battery missing or disconnected
5
eas)
Total number of stories
Occupied
&
operating
2
Other
0
Length in,feet
feet
, Width inComplete
below grade
Battery discharged or dead
6
s)
Idle, not routinely used
Total number of stories 3
at or
U 3 Undetermined
Failed
to
operate
Total square feet
Block L6
Other
0
Under major renovation above grade
4
Undetermined
U
Vacant and secured
5
U
UndeterminedOR
Vacant and unsecured
6
Number of Stories Damaged by Flame
Type of Material Contributing Most
Being demolished
J
3 7
K
BY
,
, of Automatic
to Flame
Spread
part of the highest
story.
areas) Count the roof as
Total
number of or
stories
Block
L4ofidentifies
whether
not
the detection
equipment
worked.
This field is required
if the
Operation
Automatic
Extinguishing
System
Reason
for fire
Automatic
OtherPresence
0
Length in feet
Width in feet
below grade
1
M
3
M
M
5 Extinguishing System Failure
ces)
Check if no flame spread OR if
Extinguishing
System
of
stories
w/minor
damage
Undetermined
U Number
was
within
the
designed
range
of
the
detector.
None Present
N
Skip to
same as Material First Ignited (Block D4,
(1 to 24% flame damage)
Required if fire was within designed
range
Section
L
Present
1
Fire Module)
OR
Required if system failed or not effective
Complete
rest
ofif unable to determine.
(go to M4)operation was undeterOperated/effective
Section
Mdetection
1 equipment
If
the
fire
was
too
small
to
activate
the
or
the
detector
2
Partial
System
Present
1
Number of stories w/significant damage
System shut off
Operated/not effective (go to M4)
2 Contributing
Undetermined
U
(25 to 49%
flame
damage)
mined
then
skip tobySection
Number
of
Stories
Damaged
Flame M.
Most
K1 Type of Material
2
Not enough agent discharged
J3 Count the roof as part of the highest story.
K to
Item contributing most 3
to flame Fire
spreadtoo small to activate
Flame Spread
3
Agent discharged but did not
Type of
Automatic
Number of stories
w/heavy
damage Extinguishing System
to operate (go to M5)
4 inFailed
5 is marked to indicate the detector’s
effectivethe
Operated
box
(2)
is marked,
then
a
box
L
M
(50
to274%When
flame
damage)
reach
fire
Required
if
fire
was
within
designed
range
of
AES
Check if no flame spread OR if Other
Number of stories w/minor damage
0 (Block D4,
Skip to
same
as
Material
First
Ignited
4skip to
Wrong
type
of system
6 can be skipped.
If
the
Failed
to
operate
box
(3)
is
marked,
then
Block
L6 to
ness,
and
Block
L
(1 to 24%
flame
damage)
K
2
Wet-pipe sprinkler
Undetermined Section L
Fire Module) OR if unable
1
U to determine.
Type of material contributing
Number of stories w/extreme damage
5
Fire not in area protected
Required only if item
show
the
reason
for
detector
failure.
Dry-pipe
sprinkler
most to flame spread
contributing code is 00 or <70.
(75Number
to 2
100%offlame
damage)
stories
w/significant damage
6
System components damaged
Number of Sprinkler
Other
sprinkler system
3 49% flame
(25 to
damage)
K1
M
4
7
Lack of maintenance
Heads Operating
Item contributing most to flame spread
4
Dry chemical system
8
Manual intervention
Number of stories w/heavy damage
e).
Required if system operated
5 74% flame
Foam
system
(50
to
damage)
Detector
Power
Supply
Detector Effectiveness
0
Other
6
L3
L5K2 Required if detector operated.
Halogen-type system
U
Undetermined
7 of stories
Carbon
dioxide
(CO2) system
Type of material contributing
Number
w/extreme
damage
Required
only
if
item
1
Alerted
occupants,
occupants
responded
Battery
only
1
heads operating
most to flame spread Number of sprinkler
0 100% flame
contributing code is 00 or <70.
(75 to
damage)
nto
Other
special hazard system
nM
2
Alerted occupants, occupants failed
Hardwire
only
2
NFIRS–3 Revision 01/01/06
U
Undetermined
to respond
Plug-in
3
3
There were no occupants
Hardwire with battery
4
Detector Effectiveness
Detector Power Supply
4L5 Failed
to alert occupants
Plug-in with battery
5L3
Required if detector operated.
U
Undetermined
Mechanical
6
1
Alerted occupants, occupants responded
Batterydetectors
only
kip to
Multiple
& power
71
tion M
Detector
Reason
2
AlertedFailure
occupants,
occupants failed
Hardwire
only
2
supplies
L6 describing
5 mark the box best
In
Block
L
the
effectiveness
of the detector. This field is required if
to
respond
Plug-in
3
Other
0
Required if detector failed to operate
3
There were no occupants
Hardwire
with battery
you checked
box (2) in L4 (Operated).
Undetermined
U4
4
Failed to alert occupants
Plug-in with battery
5
1 U Power
failure, shutoff, or disconnect
Detector
Operation
eat
Undetermined
Mechanical
6
L47
2
Improper
installation or placement
Multiple detectors & power
ion
Detector
Failure Reason
3
Defective
supplies
Fire
too small to activate
1
L6 Lack of maintenance, includes
4
Other
0
Required if detector failed to operate
Complete
not cleaning
Undetermined
2 U Operated
Block L5
Battery missing or disconnected
5
1
Powerdischarged
failure, shutoff,
or disconnect
Detector Operation Complete
Battery
or dead
6
heat 3
L4 Failed to operate
Block L6
2
Improper
installation
or
placement
Other
0
ction
3
Defective
Undetermined
U
Fire too small to activate
U1
Undetermined
nt
4
Lack of maintenance, includes
Complete
not cleaning
2
Operated
Block L5
Battery missing
5
Operation of Automatic
uishing System
Reason or
fordisconnected
Automatic
M
3
M
5 discharged
Battery
or dead
6
Complete
Extinguishing
System
Extinguishing
System Failure
3
Failed to operate
Block L6
Other Required if system failed or not effective
0
Required if fire was within designed range
Complete rest of
to M4) Undetermined
Operated/effective (go U
Section
M
1
U
t
Undetermined
1
System shut off
Operated/not effective (go to M4)
2
2
Not enough agent discharged
Fire too small to activate
3
3
but did not
shing
System
Operation
of Automatic
nguishing SystemIn Block
Reason
Automatic
6 mark
LFailed
box
that
best describesAgent
why discharged
thefordetector
failed to operate or did not operate
to the
operate
(go
to M5)
4
M
3
M
5 reach
fire
of AES
Extinguishing
System
Extinguishing
System
Failure
Other
0
properly.
This field is required if you checked
box
(3)
in
Block
4
Wrong type of systemL4 (Failed to operate).
if fire was within designed range
Undetermined
Required if system failed or not effective
U Required
Complete rest of
5
Fire not in area protected
Operated/effective (go to M4)
Section M
1
nt
1 System
System
shut off
6
components
damaged
Operated/not
effective
(go
to
M4)
Number of Sprinkler
2
M234 Fire
Not
enough
agent discharged
7
Lack of maintenance
tooOperating
small to activate
Heads
Agent intervention
discharged but did not
8 3 Manual
uishing System
Failed
operate (go to M5)
if systemto
operated
4Required
reach fire
e of AES
0
Other
Other
0
Wrong type of system
U 4 Undetermined
Undetermined
3-9
U
stem
5
Fire not in area protected
Number of sprinkler heads operating
stem
6
System components damaged
of Sprinkler
NFIRS–3 Revision 01/01/06
m
M4 Number
7
Lack of maintenance
Heads Operating
8
Manual intervention

Hardwire with battery
4
Failed
to a
Plug-in with
battery
Detector
E
Detector
Power
Supply
,
,
Undeterm
Mechanical
LU5 Required
if dete
Total square feet
Multiple detectors & power
1
Alerted o
Battery only
Detector
F
supplies
L62 Alerted o
OR
Hardwire
only
Other
Required
if dete
to respon
Plug-in
Undetermined
3
There we
BY battery
,Hardwire with
,
14
Power
Detector
Operation
Failed fail
to
Length
in feet
Width in feet
Plug-in
with battery
2U
Improper
Undeterm
Mechanical
3
Defective
Multiple
detectors
& power
Fire
too small
to activate
Detector
4
of mF
supplies
L6 Lack
0
Other
Complete
not
cleani
Other Contributing Most
Fire Origin
Number1of Stories
Damaged by Flame
Type
0 of Material
Operated
Required if de
Smoke
Block L5
J3 Count the roof
K to2Flame
U as partUndetermined
Battery m
5
Undetermined
Spread
U
of the highest story.
2
Heat
Battery di
6
Below grade
Complete
3 if no flame
Failed
Check
spread to
OR operate
ifOperation
Number
w/minor damage
Power fai
Block L6 Skip to 1
3 of stories
Combination
smoke and heat same as MaterialDetector
Story of
Other
0
First Ignited (Block D4,
(1
to
24%
flame
damage)
L
4
fire origin
Improper
Section L 2
Fire Module) OR if unable to determine.
Undeterm
U
4
Sprinkler, water flow detection U
Undetermined
3
Defective
Fire too small to activate
Number
w/significant
1
5 of stories
More
than onedamage
type present
4
Lack of m
(25 to 49% flame damage)
Fire Spread
K1
0
Other
Complete
Item contributing most to flame spread
not clean
If fire spread was confined to object of origin,
2
Operation
of
Automatic
Operated
Presence
of Automatic
Extinguishing System
Block L5
Number of
w/heavy
damage
do not check a box (Ref. Block D3, Fire Module).
Undetermined
Battery
5
M
3
MU1 Nstories
M5m
Extinguishing
System
(50 to 74% flame
damage)
None Present
Battery
d
6
Confined to room of origin
Complete
3
Required if fire was within designed range
Failed to operate
Present
1
Re
K2 Complete
rest of
Block L6
Other
0
Confined to floor of origin
(go
to
M4)
Operated/effective
Section
M
Type
of material
contributing
Number of 2
stories w/extreme
damage Present
1
Required only if item
Partial System
1
most to flame spread
contributing code is 00
or <70. U (go toUndeterm
(75 to 100% flame damage)
Confined to building of origin
U
Operated/not
effective
M4)
2
Undetermined
Undetermined
U
2
Beyond building of origin
Fire too small to activate
3
3
Type of Automatic Extinguishing System
Failed to operate (go to M5)
4
M
2boxes
Operation
of
Automatic
Required
if fire
was
within
range
of AES
Presence
ofSupply
Automatic
Extinguishing
System
You must mark one of the
in Block
M1.designed
If no
automatic
extinguishing
system
was
present,
Detector
Effectiveness
Detector
Power
Presence of Detectors
0M3 Other
M1 N Wet-pipe
4M5
L3 box
5
Required if detector operated.
Extinguishing
None
sprinkler
Undetermined
1 and skip
check the None Present
the Present
rest
of SectionLM.
Complete
the other
of Section System
M
U parts
(In area of the fire)
5 R
Required
if
fire
was
within
designed
range
Present
Complete
restoccupants,
of
Dry-pipe
sprinkler
2 1 was
1
Alerted
occupants responded
Battery
only
1
only if an extinguishing
system
present.
Skip to
6
(go to M4)
Operated/effective
Section M
1
2
Partial
Number
of
Sprinkler
System
Present
N
None Present
Other
3
Section M
Alerted occupants,
failed
1
Hardwire
only sprinkler system 2
2
M
4 occupants
Operated/not
effective (go to M4) 7
2
Undetermined
U
Heads
Operating
4
Dry chemical system
to respond
Present
Plug-in
1
3
82
Fire
too small
3 Required
if system
operated to activate
5
Foam
system
3
There
were
no
occupants
Hardwire
with
battery
4
Type
of
Automatic
Extinguishing
System
Undetermined
03
U
Failed to operate (go to M5)
4
MPlug-in
26
Halogen-type
Failed to alert occupants
with
battery
5
Required
if fire was withinsystem
designed range of4AES
U
Other
0
7
Carbon dioxide (CO2) system
4
U
Undetermined
Mechanical
6
Detector Type
Wet-pipe sprinkler
Undetermined
1
U
Number
of sprinkler heads operating
0
Other
special
hazard system
5
Multiple
detectors
&
power
7
Dry-pipe sprinkler
Detector Failure Reason
U2
6
Undetermined
supplies
Number of Sprinkler
Other sprinkler system L6
3
M
4
7
Other
0
Heads
Operating
Required if detector failed to operate
Smoke
4
Dry chemical system
8
Undetermined
U
Required
if
system
operated
5
Foam system
Heat
0
6
Halogen-type system
1
Power failure, shutoff, or disconnect
Detector
Operation
Combination smoke and heat
U
L4
7
Carbon dioxide (CO2) system
2
Improper installation or placement
Sprinkler, water flow detection
Number of sprinkler heads operating
0
3
Defective
Other
hazard system
Fire too small
tospecial
activate
1
More than one type present
U
4
Lack of maintenance, includes
Undetermined
Other
Complete
not cleaning
2
Operated
Block L5
Undetermined
Battery missing
or disconnected
5 Extinguishment
In Block M2 mark the box indicating the type of Automatic
System
(AES) present. If
Battery
discharged
or dead
6
Complete
3
Failed
to
operate
multiple systems are present, indicate the system
designed
Block
L6
Other the area where the fire started.
0 to protect
The field is required
if
the
fire
was
within
the
designated
range
for the AES.
Undetermined
U
U
Undetermined
Enclosed building
Portable/mobile structure
Open structure
Air-supported structure
Tent
Open platform (e.g., piers)
Underground structure (work areas)
Connective structure (e.g., fences)
Other type of structure

1
2
3
4
5
6
7
0
U

4
highest story.
Undetermined
U
Under construction
5
Presence
of Detectors
Occupied &
operating
L
1
L
63
Detector
Type
Idle, not routinely
used
(In area of
the fire) Total number of stories at or
L
2
7
above grade
Under major renovation
1
Skip to
N
None
Present
NFIRS
5.0
Self-Study
Program
Vacant and secured
Section M
2
0
Vacant
1 andSmoke
Present
1unsecured
U3
Being
2 demolished
Heat
4
Undetermined
U
Total number of stories
Other
below grade
3
Combination smoke
and heat
L564
Undetermined
Detector Type
4
Sprinkler,
water flow detection
L
2
17
5
More than one type present

Section M: Presence of Automatic Extinguishing System,
Type of Automatic Extinguishing System,
Operation of Automatic Extinguishing System,
Number of Sprinkler Heads Operating,
Reason for Automatic Extinguishing System Failure

Presence of Automatic Extinguishing System
None Present
N
Present
1
Complete rest of
Section M
2
Partial System Present
Undetermined
U

1
2
3
4
5
6
7
0
U

Operation of Automatic
Extinguishing System

Required if fire was within designed range

1
2
3
4
0
U

Operated/effective (go to M4)
Operated/not effective (go to M4)
Fire too small to activate
Failed to operate (go to M5)
Other
Undetermined

Reason for Automatic
Extinguishing System Failure

Required if system failed or not effective

1
2
3

System shut off
Not enough agent discharged
Agent discharged but did not
Type of Automatic Extinguishing System
reach fire
Required if fire was within designed range of AES
4
Wrong type of system
Wet-pipe sprinkler
5
Fire not in area protected
Dry-pipe sprinkler
6
System components damaged
of Sprinkler
Other sprinkler system
M4 Number
7
Lacknot
of maintenance
3 mark the box that indicates Heads
In
Block
M
if
the
AES
operated
and
was
or
was
effective. Effective
Operating
Dry chemical system
8
Manual
intervention
Required
if
system
operated
does not necessarily mean complete extinguishment, but the system must at least contain and conFoam system
0
Other
Halogen-type
trolsystem
the fire until the fire department can complete extinguishment. U
Undetermined
Carbon dioxide (CO2) system
Number of sprinkler heads operating
If boxes
or 2 are marked in M3, use M4 to record the number of sprinkler heads that operated
Other special
hazard1system
NFIRS–3 Revision 01/01/06
Undetermined
(regardless of their effectiveness).

3-10

Complete
2 rest ofAlerted occupants, occupants failed
Hardwire only
2
Operated/effective (go to M4)
Section M
1
Partial System Present
to respond
1
Plug-in
3 2
Operated/not effective (go to M4)
Undetermined
3
There 2were no occupants
2
Hardwire
with battery
4 U
Fire too small to activate
4
Failed3to alert occupants
3
Plug-in
with battery
5 Type
of Automatic
Extinguishing System
Failed to operate (go to M5)
4
26 Required
U
Undetermined
Mechanical
NFIRS
5.0
Self-Study
Program
if fire was within designed range of AES
Other
0
4
Multiple detectors & power
7
Wet-pipe sprinkler
Undetermined
1
U Failure
Detector
Reason
5
supplies
L6
Dry-pipe sprinkler
2
6
Other
0
Number
of
Sprinkler
Required
if
detector
failed
to
operate
Other sprinkler system
3
M4 Heads Operating
7
Undetermined
U
4
Dry chemical system
8
Required shutoff,
if system operated
1
Power failure,
or disconnect
5
Foam system
Detector
Operation
0
L6 4 Halogen-type system
2
Improper installation or placement
U
3
Defective
Carbon
2) system
Fire
too dioxide
small to(CO
activate
17
Number of sprinkler heads operating
4
Lack of maintenance, includes
0
Other special hazard system
Complete
not cleaning
Undetermined
2U
Operated
Block L5
Battery missing or disconnected
5
discharged
or dead
6
Complete
In Block M4Block
fillL6in the total Battery
number
of sprinkler
heads that operated
3
Failed to operate
Other
0
required if the sprinkler
system
activated.
Undetermined
U
U
Undetermined

g System

omplete rest of
Section M

System

Operation of Automatic
Extinguishing System

Required if fire was within designed range

Operated/effective (go to M4)
Operated/not effective (go to M4)
Fire too small to activate
Failed to operate (go to M5)
Other
Undetermined

1
2
3
4
0
U

Number of Sprinkler
Heads Operating

Required if system operated

System shut off
Not enough agent discharged
Agent discharged but did not
reach fire
Wrong type of system
Fire not in area protected
System components damaged
Lack of maintenance
Manual intervention
Other
Undetermined
NFIRS–3

Revision 01/01/06

during the fire. This field is

Reason for Automatic
Extinguishing System Failure

Required if system failed or not effective

1
2
3
4
5
6
7
8
0
U

Number of sprinkler heads operating
Revision 01/01/06
In Block M5 mark the box that describes why the NFIRS–3
automatic
extinguishing system failed to operate
or did not operate properly. This field is required if the system failed to operate. If you indicated in
Block M3 that the system Operated/not effective, box 2, or Failed to operate, box 4, it is required to
record the reason for the problem in Block M5.

SUMMARY
The Structure Fire Module is used along with the Fire Module to gather detailed information about
larger fire incidents that involve building or portable/mobile structures. Given the information presented, you should know how to document an incident that requires the completion of the Structure
Fire Module.

3-11

NFIRS 5.0 Self-Study Program

EXAMPLE: Residential Fire
Directions: Read the call information in the example below. Then look at the completed Structure Fire Module form. Look at
each section and follow along with the proper use of the information as applicable to the Structure Fire Module.
A smoke detector in the first-floor hallway alerted the residents of a single-family dwelling of
a possible problem. They quickly exited out the front door and reported seeing smoke coming
from the basement. Children playing with matches started a fire in a small stack of newspapers
that were in the basement of a ranch-style home, 30 feet by 50 feet. Luckily they were uninjured.
There was fire damage in the basement and smoke damage on the first floor. The detector was
hardwired with a battery backup. There was a residential wet-pipe sprinkler system installed
throughout the home. One sprinkler head activated and extinguished the fire.

3-12

NFIRS 5.0 Self-Study Program
Structure Type

If fire was in an enclosed building or a
portable/mobile structure, complete the
rest of this form.

1
2
3
4
5
6
7
8
0

001

J2
2
3
4
5

Building Status

1
2
3
4
5
6
7
0
U

Under construction
Occupied & operating
Idle, not routinely used
Under major renovation
Vacant and secured
Vacant and unsecured
Being demolished
Other
Undetermined

J3
X Below grade

000

Number of stories w/heavy damage
(50 to 74% flame damage)

000

Number of stories w/extreme damage
(75 to 100% flame damage)

1
U

None Present

Detector Power Supply

L3
Skip to
Section M

Present
Undetermined

Detector Type

Count the roof as part of the highest story.

Number of stories w/significant damage
(25 to 49% flame damage)

Number of Stories Damaged by Flame

000

(In area of the fire)

1
2
3
4
5
0
U

Smoke
Heat
Combination smoke and heat
Sprinkler, water flow detection
More than one type present
Other
Undetermined

1
2
3
4
5
6
7

0
U

Detector Operation

Fire too small to activate

Operated

Complete
Block L5

Failed to operate

Complete
Block L6

Undetermined

1
2
3
4
5
6
7
0
U

Type of Automatic Extinguishing System
Required if fire was within designed range of AES

Wet-pipe sprinkler
Dry-pipe sprinkler
Other sprinkler system
Dry chemical system
Foam system
Halogen-type system
Carbon dioxide (CO2) system
Other special hazard system
Undetermined

0 , 030

0 , 050

Width in feet

Type of Material Contributing Most
to Flame Spread

if no flame spread OR if
X Check
same as Material First Ignited (Block D4,

Skip to
Section L

Fire Module) OR if unable to determine.

Item contributing most to flame spread

K2
Type of material contributing
most to flame spread

1
2

Detector Effectiveness

3
4
U

Alerted occupants, occupants responded
Alerted occupants, occupants failed
to respond
There were no occupants
Failed to alert occupants
Undetermined
Detector Failure Reason
Required if detector failed to operate

1
2
3
4
5
6
0
U

Power failure, shutoff, or disconnect
Improper installation or placement
Defective
Lack of maintenance, includes
not cleaning
Battery missing or disconnected
Battery discharged or dead
Other
Undetermined

Operation of Automatic
Extinguishing System
Operated/effective (go to M4)
Operated/not effective (go to M4)
Fire too small to activate
Failed to operate (go to M5)
Other
Undetermined
Number of Sprinkler
Heads Operating

Required if system operated

001

Required only if item
contributing code is 00 or <70.

Required if detector operated.

Required if fire was within designed range

1
2
3
4
0
U

,
Total square feet

Length in feet

Battery only
Hardwire only
Plug-in
Hardwire with battery
Plug-in with battery
Mechanical
Multiple detectors & power
supplies
Other
Undetermined

Presence of Automatic Extinguishing System
None Present
N
1 X Present
Complete rest of
Section M
2
Partial System Present
U
Undetermined

01
Total number of stories
below grade

Fire Spread

Presence of Detectors

NFIRS–3
Structure
Fire

Number of stories w/minor damage
(1 to 24% flame damage)

Confined to floor of origin
Confined to building of origin
Beyond building of origin

001
Total number of stories at or
above grade

001

X Confined to room of origin

Main Floor Size

Count the roof as part of the
highest story.

Story of
fire origin

If fire spread was confined to object of origin,
do not check a box (Ref. Block D3, Fire Module).

Building
Height

Reason for Automatic
Extinguishing System Failure

Required if system failed or not effective

1
2
3
4
5
6
7
8
0
U

Number of sprinkler heads operating
NFIRS–3

3-13

Revision 01/01/06

NFIRS 5.0 Self-Study Program

EXERCISE SCENARIO 3-1: Warehouse Fire
Directions: Read the call information in the exercise below. Use the information provided to complete the Structure Fire Module
form. Compare your work to the answers provided on the completed Structure Fire Module form. If your answers are different
from the ones provided, read over the Structure Fire Module again.
A fire occurred on the fifth floor of an eight-story, vacant and secured warehouse. The 200- foot
by 100-foot fifth floor was damaged by the fire. The sixth story was damaged by smoke. The warehouse was protected by a wet-pipe sprinkler system. Smoke detectors were hardwired through
the main power box on the building’s north end. Power to the warehouse was knocked out by
an electrical storm moving through the area. Because it was after eight in the evening, no one
was in the building to notice that the power was off or that a fire had started near where welders had been working on storage racks. Fortunately, two sprinkler heads activated and quickly
extinguished the fire.

3-14

NFIRS 5.0 Self-Study Program
Structure Type

If fire was in an enclosed building or a
portable/mobile structure, complete the
rest of this form.

1
2
3
4
5
6
7
8
0

Building Status

1
2
3
4
5
6
7
0
U

Under construction
Occupied & operating
Idle, not routinely used
Under major renovation
Vacant and secured
Vacant and unsecured
Being demolished
Other
Undetermined

Number of stories w/significant damage
(25 to 49% flame damage)

None Present

Present

Undetermined

Detector Type

1
2
3
4
5
0
U

Smoke
Heat
Combination smoke and heat
Sprinkler, water flow detection
More than one type present
Other
Undetermined

Number of stories w/extreme damage
(75 to 100% flame damage)

Detector Power Supply

1
2
3
4
5
6
7
0
U

0
U

Detector Operation

Fire too small to activate

Operated

Complete
Block L5

Failed to operate

Complete
Block L6

Undetermined

Type of Automatic Extinguishing System
Required if fire was within designed range of AES

Wet-pipe sprinkler
Dry-pipe sprinkler
Other sprinkler system
Dry chemical system
Foam system
Halogen-type system
Carbon dioxide (CO2) system
Other special hazard system
Undetermined

Width in feet

Type of Material Contributing Most
to Flame Spread
Check if no flame spread OR if
same as Material First Ignited (Block D4,
Fire Module) OR if unable to determine.

Skip to
Section L

Item contributing most to flame spread

K2
Type of material contributing
most to flame spread

Battery only
Hardwire only
Plug-in
Hardwire with battery
Plug-in with battery
Mechanical
Multiple detectors & power
supplies
Other
Undetermined

1
2
3
4
5
6
7

Presence of Automatic Extinguishing System
None Present
N
Present
1
Complete rest of
Section M
2
Partial System Present
U
Undetermined

Length in feet

Number of stories w/heavy damage
(50 to 74% flame damage)

L3
Skip to
Section M

,
Total square feet

Total number of stories
below grade

Fire Spread

(In area of the fire)

NFIRS–3
Structure
Fire

Number of stories w/minor damage
(1 to 24% flame damage)

Presence of Detectors

Total number of stories at or
above grade

Story of
fire origin

Confined to room of origin
Confined to floor of origin
Confined to building of origin
Beyond building of origin

Main Floor Size

Count the roof as part of the
highest story.

Count the roof as part of the highest story.

If fire spread was confined to object of origin,
do not check a box (Ref. Block D3, Fire Module).

2
3
4
5

Building
Height

Number of Stories Damaged by Flame

Below grade

1
2
3
4
U

Detector Effectiveness
Required if detector operated.

1
2
3
4
5
6
0
U

Operation of Automatic
Extinguishing System

Required if fire was within designed range

Operated/effective (go to M4)
Operated/not effective (go to M4)
Fire too small to activate
Failed to operate (go to M5)
Other
Undetermined

1
2
3
4
0
U

Number of Sprinkler
Heads Operating

Required if system operated

Required only if item
contributing code is 00 or <70.

Reason for Automatic
Extinguishing System Failure

Required if system failed or not effective

1
2
3
4
5
6
7
8
0
U

Number of sprinkler heads operating
NFIRS–3

3-15

Revision 01/01/06

NFIRS 5.0 Self-Study Program
Structure Type

If fire was in an enclosed building or a
portable/mobile structure, complete the
rest of this form.

X Enclosed building

1
2
3
4
5
6
7
8
0

Portable/mobile structure
Open structure
Air-supported structure
Tent
Open platform (e.g., piers)
Underground structure (work areas)
Connective structure (e.g., fences)
Other type of structure
Fire Origin

005

J2
2
3
4
5

Building Status

1
2
3
4
5
6
7
0
U

Under construction
Occupied & operating
Idle, not routinely used
Under major renovation
Vacant and secured
Vacant and unsecured
Being demolished
Other
Undetermined

000

Number of stories w/significant damage
(25 to 49% flame damage)

000

Number of stories w/heavy damage
(50 to 74% flame damage)

000

Number of stories w/extreme damage
(75 to 100% flame damage)

Presence of Detectors
N
1
U

None Present

Skip to
Section M

Present
Undetermined

Detector Type

Smoke
Heat
Combination smoke and heat
Sprinkler, water flow detection
More than one type present
Other
Undetermined

1
2
3
4
5
6
7

Detector Operation

Fire too small to activate

Operated

Complete
Block L5

Failed to operate

Complete
Block L6

M2
1
2
3
4
5
6
7
0
U

Type of Automatic Extinguishing System
Required if fire was within designed range of AES

Wet-pipe sprinkler
Dry-pipe sprinkler
Other sprinkler system
Dry chemical system
Foam system
Halogen-type system
Carbon dioxide (CO2) system
Other special hazard system
Undetermined

0 , 200

Width in feet

Type of Material Contributing Most
to Flame Spread
Skip to
Section L

Fire Module) OR if unable to determine.

Item contributing most to flame spread

K2
Type of material contributing
most to flame spread

Detector Effectiveness

1
2
3
4
U

Alerted occupants, occupants responded
Alerted occupants, occupants failed
to respond
There were no occupants
Failed to alert occupants
Undetermined
Detector Failure Reason

Required if detector failed to operate

1
2
3
4

5
6
0
U

Required if system operated

002

Required only if item
contributing code is 00 or <70.

Required if detector operated.

Required if fire was within designed range

1
2
3
4
0
U

0 , 100

if no flame spread OR if
X Check
same as Material First Ignited (Block D4,

Undetermined

Presence of Automatic Extinguishing System
None Present
N
1 X Present
Complete rest of
Section M
2
Partial System Present
U
Undetermined

,
Total square feet

Length in feet

Battery only
Hardwire only
Plug-in
Hardwire with battery
Plug-in with battery
Mechanical
Multiple detectors & power
supplies
Other
Undetermined

0
U

Detector Power Supply

(In area of the fire)

Count the roof as part of the highest story.

Fire Spread

Confined to building of origin
Beyond building of origin

1
2
3
4
5
0
U

00
Total number of stories
below grade

Number of stories w/minor damage
(1 to 24% flame damage)

Confined to room of origin

NFIRS–3
Structure
Fire

001

X Confined to floor of origin

008
Total number of stories at or
above grade

Number of Stories Damaged by Flame

Below grade

Main Floor Size

Count the roof as part of the
highest story.

Story of
fire origin

If fire spread was confined to object of origin,
do not check a box (Ref. Block D3, Fire Module).

Building
Height

Reason for Automatic
Extinguishing System Failure

Required if system failed or not effective

1
2
3
4
5
6
7
8
0
U

Number of sprinkler heads operating
NFIRS–3

3-16

Revision 01/01/06

NFIRS 5.0 Self-Study Program

EXERCISE SCENARIO 3-2: Cary Street Fire
Directions: Read the call information in the exercise below. Use the information provided to complete the entire Structure Fire
Module form and the other required forms. Compare your work to the answers provided in Appendix A. If your answers are different from the ones provided, read over the Structure Fire Module again.
The Alberta Fire Department (FDID #92188) received a call for a reported house fire at 5 East
Cary Street, Brunswick, Virginia 23351, on May 1, 2005. The dispatcher assigned the incident
(#5433) to Engine 1, Engine 2, and Truck 1 from Shift A. The units received the alarm at 12:53
p.m. and arrived at the scene at 1:05 p.m. Each unit was staffed with four firefighters.
The owner of the single-family dwelling, Mrs. Christy Gordon, said that she was warming her
lunch on the stove when the grease from the pan began to burn. The gas stove was a Whirlpool,
Model RF330PXVN, Serial Number F925888840, Year 2000. The fire spread from the pan to
the curtains. She had fallen asleep upstairs and was alerted when the hardwired smoke detector
activated. The flame damage was confined to the kitchen. The 2,000-square-foot, two-story
home was filled with smoke in the other rooms. She called 911. The firefighters extinguished the
fire and removed smoke from the other rooms. The fire was brought under control at 1:25 p.m.
There was $24,000 fire loss to property and $9,600 content loss. The value of the property was
$161,000 and the content value was $80,400. The last unit cleared the scene at 2:40 p.m. FF1
Adam C. Wallner, Badge No. 224, completed the report after returning to Station No. 2. Captain
Tonya S. Gordon, Badge No. 105, was the officer in charge. The incident was in Census Tract
5011-12, District A12.

3-17

NFIRS 5.0 Self-Study Program
MM

Delete

Incident Date

State

Location Type

Station

Incident Number

Exposure

NFIRS–1

Number/Milepost

Prefix

Basic

No Activity

Check this box to indicate that the address for this incident is provided on the Wildland Fire
Module in Section B, “Alternative Location Specification." Use only for wildland fires.

Street address
Intersection
In front of
Rear of
Adjacent to
Directions
US National Grid

Census Tract

Street or Highway

Street Type

Suffix

Apt./Suite/Room

City

State

ZIP Code

Cross Street, Directions or National Grid, as applicable

Incident Type

YYYY

Change
FDID

Aid Given or Received

None

Dates and Times

Midnight is 0000

Month

Check boxes if
dates are the
same as Alarm
Date.

Day

Year

Hour

Min

Shifts and Alarms
Local Option

ALARM always required

Shift or
Platoon

Alarm

Alarms

District

ARRIVAL required, unless canceled or did not arrive

1
2
3
4
5

Mutual aid received
Auto. aid received
Mutual aid given
Auto. aid given
Other aid given

Their FDID

Last Unit
Cleared

Resources

Primary Action Taken (1)

Apparatus

Personnel

Suppression
Additional Action Taken (2)

Civilian Fire Cas.–4
Fire Service Cas.–5
EMS–6
HazMat–7
Wildland Fire–8
Apparatus–9
Personnel–10
Arson–11

Check box if resource counts include aid
received resources.

Casualties

None

Deaths Injuries
Fire
Service
Civilian

H2
1
2
U

Detector
Required for confined fires.

Detector alerted occupants
Detector did not alert them
Unknown

H3
1
2
3
4
5
6
7
8
0

Special
Study Value

Estimated Dollar Losses and Values

LOSSES:

Required for all fires if known.
Optional for non-fires.

Property

Contents

None

PRE-INCIDENT VALUE: Optional

EMS
Other
Additional Action Taken (3)

Special
Study ID#

LAST UNIT CLEARED, required except for wildland fires

Check this box and skip this block if an
Apparatus or Personnel Module is used.

Fire–2
Structure Fire–3

Local Option

Controlled

Actions Taken

Completed Modules

Special Studies

CONTROLLED optional, except for wildland fires

Their
State

Their Incident Number

Arrival

Property

Contents

Hazardous Materials Release

None

Natural gas: slow leak, no evacuation or HazMat actions
Propane gas: <21-lb tank (as in home BBQ grill)
Gasoline: vehicle fuel tank or portable container
Kerosene: fuel burning equipment or portable storage
Diesel fuel/fuel oil: vehicle fuel tank or portable storage
Household solvents: home/office spill, cleanup only
Motor oil: from engine or portable container
Paint: from paint cans totaling <55 gallons
Other: special HazMat actions required or spill > 55 gal
(Please complete the HazMat form.)

Mixed Use
Property
10
20
33
40
51
53
58
59
60
63
65
00

Not mixed

Assembly use
Education use
Medical use
Residential use
Row of stores
Enclosed mall
Business & residential
Office use
Industrial use
Military use
Farm use
Other mixed use

Property Use
None
Structures
Church, place of worship
131
Restaurant or cafeteria
161
Bar/tavern or nightclub
162
Elementary school, kindergarten
213
High school, junior high
215
College, adult education
241
Nursing home
311
Hospital
331

341
342
361
419
429
439
449
459
464
519

Clinic, clinic-type infirmary
Doctor/dentist office
Prison or jail, not juvenile
1- or 2-family dwelling
Multifamily dwelling
Rooming/boarding house
Commercial hotel or motel
Residential, board and care
Dormitory/barracks
Food and beverage sales

539
571
579
599
615
629
700
819
882
891

Household goods, sales, repairs
Gas or service station
Motor vehicle/boat sales/repairs
Business office
Electric-generating plant
Laboratory/science laboratory
Manufacturing plant
Livestock/poultry storage (barn)
Non-residential parking garage
Warehouse

Outside
Playground or park
124
Crops or orchard
655
Forest (timberland)
669
Outdoor storage area
807
Dump or sanitary landfill
919
Open land or field
931

936
938
946
951
960
961
962

Vacant lot
Graded/cared for plot of land
Lake, river, stream
Railroad right-of-way
Other street
Highway/divided highway
Residential street/driveway

981
984

Construction site
Industrial plant yard

3-18

Look up and enter a
Property Use code and
description only if you
have NOT checked a
Property Use box.

Property Use
Code
Property Use Description
NFIRS–1 Revision 01/01/05

NFIRS 5.0 Self-Study Program
Person/Entity Involved

Local Option

Check this box if same
address as incident
Location (Section B).
Then skip the three
duplicate address
lines.

Business Name (if applicable)

Mr., Ms., Mrs.

First Name

Number

Prefix

Post Office Box

State

Area Code

Phone Number

Last Name

Suffix

Street or Highway

Street Type

Apt./Suite/Room

Suffix

City

ZIP Code

More people involved? Check this box and attach Supplemental Forms (NFIRS–1S) as necessary.

Owner

Local Option

Check this box if same
address as incident
Location (Section B).
Then skip the three
duplicate address
lines.

Same as person involved?
Then check this box and skip
the rest of this block.

Mr., Ms., Mrs.

Business Name (if applicable)

First Name

Number

Prefix

Phone Number

Last Name

Suffix

Street or Highway

Street Type

Apt./Suite/Room

Post Office Box

State

Area Code

Suffix

City

ZIP Code

Remarks:

Local Option

Fire Module Required?
Check the box that applies and then complete the Fire Module
based on Incident Type, as follows:
Complete Fire & Structure Modules
Complete Fire Module &
Section I, Structure Module
Basic Module Only
Confined 113–118
Complete Fire Module
Mobile property 120–123
Complete Fire Module
Vehicle 130–138
Complete Fire or Wildland Module
Vegetation 140–143
Outside rubbish fire 150–155 Basic Module Only
Complete Fire or Wildland Module
Special outside fire 160
Special outside fire 161–163 Complete Fire Module
Complete Fire or Wildland Module
Crop fire 170–173
Buildings 111
Special structure 112

ITEMS WITH A

MUST ALWAYS BE COMPLETED!

More remarks? Check this box and attach Supplemental Forms (NFIRS–1S) as necessary.

Authorization

Check box if
same as
Officer in
charge.

Officer in charge ID

Signature

Position or rank

Assignment

Month

Day

Year

Member making report ID

Signature

Position or rank

Assignment

Month

Day

Year

3-19

NFIRS 5.0 Self-Study Program

MM
FDID

YYYY

Incident Date

State

Station

Property Details

C
Not Residential

Incident Number

On-Site Materials
or Products

Change

Exposure

None

Enter up to three codes. Check one box for each code
entered.

On-Site Materials
Storage Use

On-site material (1)

1
2
3
4
U

Bulk storage or warehousing
Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

On-site material (2)

1
2
3
4
U

Bulk storage or warehousing
Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

1
2
3
4
U

Bulk storage or warehousing
Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

Buildings not involved
Number of buildings involved

None

Less than one acre

Acres burned (outside fires)

On-site material (3)

D
D1
D2

Ignition

Area of fire origin

Heat source

D3
Item first ignited

Check box if fire spread was
confined to object of origin.

Cause of Ignition
Skip to
Section G

Check box if this is an exposure report.

Intentional
Unintentional
Failure of equipment or heat source
Act of nature
Cause under investigation
Cause undetermined after investigation

Factors Contributing to Ignition

3
4
5
None
6

Estimated age of
person involved

Required only if item first
ignited code is 00 or <70

Equipment Involved in Ignition
None

Age was a factor

Factor contributing to ignition (2)

None

Asleep
Possibly impaired by
alcohol or drugs
Unattended person
Possibly mentally disabled
Physically disabled
Multiple persons involved

1
2

Factor contributing to ignition (1)
Type of material first ignited

Human Factors
Contributing to Ignition

Check all applicable boxes

1
2
3
4
5
U

Fire

Complete if there were any significant amounts of
commercial, industrial, energy, or agricultural products or
or materials on the property, whether or not they became involved

Estimated number of residential living units in
building of origin whether or not all units
became involved

NFIRS–2

Delete

Equipment Power Source

Male

Fire Suppression Factors

Female

None

Enter up to three codes.

If equipment was not involved, skip to
Section G
Equipment Power Source

Equipment Involved

Brand
Model
Serial #

Equipment Portability
1

Portable

Stationary

Portable equipment normally can be moved by
one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

Year

Mobile Property Involved

Not involved in ignition, but burned

Involved in ignition, but did not burn

Involved in ignition and burned

None

Fire suppression factor (1)

Fire suppression factor (2)

Fire suppression factor (3)

Mobile Property Type and Make

Local Use
Pre-Fire Plan Available
Some of the information presented in this report may be
based upon reports from other agencies:

Mobile property type

Mobile property make

Mobile property model

License Plate Number

Year

State

Arson report attached
Police report attached
Coroner report attached
Other reports attached

VIN

Structure fire? Please be sure to complete the Structure Fire form (NFIRS–3).
NFIRS–2 Revision 01/01/05

3-20

NFIRS 5.0 Self-Study Program
Structure Type

If fire was in an enclosed building or a
portable/mobile structure, complete the
rest of this form.

1
2
3
4
5
6
7
8
0

Building Status

1
2
3
4
5
6
7
0
U

Under construction
Occupied & operating
Idle, not routinely used
Under major renovation
Vacant and secured
Vacant and unsecured
Being demolished
Other
Undetermined

Number of stories w/significant damage
(25 to 49% flame damage)

None Present

Present

Undetermined

Detector Type

1
2
3
4
5
0
U

Smoke
Heat
Combination smoke and heat
Sprinkler, water flow detection
More than one type present
Other
Undetermined

Number of stories w/extreme damage
(75 to 100% flame damage)

Detector Power Supply

1
2
3
4
5
6
7
0
U

0
U

Detector Operation

Fire too small to activate

Operated

Complete
Block L5

Failed to operate

Complete
Block L6

Undetermined

Type of Automatic Extinguishing System
Required if fire was within designed range of AES

Wet-pipe sprinkler
Dry-pipe sprinkler
Other sprinkler system
Dry chemical system
Foam system
Halogen-type system
Carbon dioxide (CO2) system
Other special hazard system
Undetermined

Width in feet

Type of Material Contributing Most
to Flame Spread
Check if no flame spread OR if
same as Material First Ignited (Block D4,
Fire Module) OR if unable to determine.

Skip to
Section L

Item contributing most to flame spread

K2
Type of material contributing
most to flame spread

Battery only
Hardwire only
Plug-in
Hardwire with battery
Plug-in with battery
Mechanical
Multiple detectors & power
supplies
Other
Undetermined

1
2
3
4
5
6
7

Presence of Automatic Extinguishing System
None Present
N
Present
1
Complete rest of
Section M
2
Partial System Present
U
Undetermined

Length in feet

Number of stories w/heavy damage
(50 to 74% flame damage)

L3
Skip to
Section M

,
Total square feet

Total number of stories
below grade

Fire Spread

(In area of the fire)

NFIRS–3
Structure
Fire

Number of stories w/minor damage
(1 to 24% flame damage)

Presence of Detectors

Total number of stories at or
above grade

Story of
fire origin

Confined to room of origin
Confined to floor of origin
Confined to building of origin
Beyond building of origin

Main Floor Size

Count the roof as part of the
highest story.

Count the roof as part of the highest story.

If fire spread was confined to object of origin,
do not check a box (Ref. Block D3, Fire Module).

2
3
4
5

Building
Height

Number of Stories Damaged by Flame

Below grade

1
2
3
4
U

Detector Effectiveness
Required if detector operated.

1
2
3
4
5
6
0
U

Operation of Automatic
Extinguishing System

Required if fire was within designed range

Operated/effective (go to M4)
Operated/not effective (go to M4)
Fire too small to activate
Failed to operate (go to M5)
Other
Undetermined

1
2
3
4
0
U

Number of Sprinkler
Heads Operating

Required if system operated

Required only if item
contributing code is 00 or <70.

Reason for Automatic
Extinguishing System Failure

Required if system failed or not effective

1
2
3
4
5
6
7
8
0
U

Number of sprinkler heads operating
NFIRS–3

3-21

Revision 01/01/06

NFIRS 5.0 Self-Study Program

Structure Module Test
1. What is the building height of a house with two stories, full unfinished attic (two rooms), and a full
basement?

(a) Two stories.

(b) Three stories.

(d) Two stories above grade; one story below grade.

2. The main floor size of a building is calculated by

(a) Multiplying the number of stories by the building length.

(b) Multiplying the building width by the building height.

(d) Multiplying the building length by the building width.

3. Battery and hardwire are examples of this data element.

(a) Equipment Involved in Ignition.

(b) Detector Operation.

(d) Detector Type.

4. Under construction and being demolished are examples of these data element.

(a) Actions taken.

(b) Building status.

(d) Cause of ignition.

5. A fire on a pier needs these modules.

(a) Basic and Fire.

(b) Basic, Fire, and only Structure Type on the Structure Module.

(d) Basic.

3-22

File Type	application/pdf
File Modified	2008-02-12
File Created	2008-02-12