Beaumont Fire/Rescue Dive Team

BEAUMONT FIRE/RESCUE DIVE TEAM WITNESS INTERVIEW FORM

Interview Questions Date: ______Incident # / Location: ______Time of Call: ______Time of Arrival: ______Time of Interview: ______

Witness name: ______Drivers License Number ______Witness address and phone numbers: ______How many people missing in the water?: ______What were they wearing?: ______Could you see anything beyond where they were?: ______What time did this happen?: ______Where were you at the time?: ______Show me – reenact the event: ______(OVER)

1 What was the victim doing when the accident happened? ______What was the witness doing when the accident happened? ______How far away was the witness from the victim: ______

Weather conditions at the time of the accident: ______

Was victim in: Car boat swimming other

When and what has the victim had to eat or drink? ______Description of victim: Name: ______Address: ______Sex ______Age: ______Hair color & length: ______Eye color: ______Was PFD on victim: ______Was injury prior to submergence possible? ______Distance of victim at “last scene point” to diver tender position: ______Compass reading from diver tender position to “last scene point” ______Distinctive Landmarks: ______

2 Rough Sketch of Scene Marking Witness Information:

PHOTOS / VIDEO Civilian Photos Available? ____Yes _____ No Photos Taken of Scene? ____Yes _____ No Photos Taken of Operation? ____Yes _____ No Photo Logs MUST be Submitted!

Possible Photo / Video Evidence from MEDIA TV News Crews On Scene?: _____Before ____During ____After Incident Station ______Reporter ______Contact Info: ______

******** 3 TV News Crews On Scene?: _____Before ____During ____After Incident Station ______Reporter ______Contact Info: ______

******** TV News Crews On Scene?: _____Before ____During ____After Incident Station ______Reporter ______Contact Info: ______

******** PRINT Media Reporter / Photographer On Scene?: _____Before ____During ____After Incident Newspaper ______Reporter ______Photographer ______Contact Info: ______

Reporter / Photographer On Scene?: _____Before ____During ____After Incident Newspaper ______Reporter ______Photographer ______Contact Info: ______

This form completed by: ______