02601 MO 01 28 2020 2020-00000390 000 Delete BASIC FDID State Incident Date Station Incident Number Exposure Change

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MM DD YYYY NFIRS - 1 A 02601 MO 01 28 2020 2020-00000390 000 Delete BASIC FDID State Incident Date Station Incident Number Exposure Change

Location Type Check this box to indicate that the address for this incident is provided on the Wildland Fire Census Tract B Module in Section B, "Alternative Location Specification." Use only for wildland fires. Street address 500 MISSOURI BLVD Intersection Number/Milepost Prefix Street or Highway Street Type Suffix In front of Rear of Jefferson City MO - Adjacent to Apt./Suite/Room City State ZIP Code Directions

US National Grid Cross Street, Directions or National Grid, as applicable

Midnight is 0000 C IncidentType E1 Dates and Times E2 Shifts and Alarms Month Day Year Hour/Min Local option 350 Extrication, rescue, oth Check boxes if dates are ALARM always required Incident Type Alarm the same as C 1 F14 Alarm Date. 01 28 2020 1257 Shift or Alarms District Platoon D Aid Given or Received None Arrival ARRIVAL required, unless canceled or did not arrive 01 28 2020 1301 1 Mutual aid received Special Studies CONTROLLED optional, except for wildland fires E3 2 Auto. aid received Controlled Local option Their FDID Their 3 Mutual aid given State 4 Auto. aid given LAST UNIT CLEARED, required except for wildland fires Last Unit Special Special 5 Other aid given Their Incident Number Cleared 01 28 2020 1525 Study ID# Study Value

Actions Taken Resources Estimated Dollar Losses and Values F G1 Check this box and skip this block if an G2 Apparatus or Personnel Module is used. Required for all fires if known. LOSSES: Optional for non-fires. None 23 Extricate, disentangle Apparatus Personnel Primary Action Taken (1) Property $ Suppression 8 17 81 Incident command Contents $ EMS 0 0 Additional Action Taken (2) PRE-INCIDENT VALUE:Optional Other 2 2 Property $ Check box if resource counts include aid Additional Action Taken (3) received resources. Contents $

Casualties None Hazardous Materials Release None Mixed Use Not Completed Modules mixed H1 H3 I Property Fire-2 Deaths Injuries 10 Assembly use 1 Natural gas: slow leak, no evacuation or HazMat actions Structure Fire-3 Fire 20 Education use Service 0 0 2 Propane gas: < 21 - lb tank (as in home BBQ grill) Civilian Fire Cas.-4 33 Medical use 3 Gasoline: vehicle fuel tank or portable container Fire Service Cas.-5 Civilian 0 0 40 Residential use 4 Kerosene: fuel burning equipment or portable storage 51 Row of stores EMS-6 5 Diesel fuel/fuel oil: vehicle fuel tank or portable storage 53 Enclosed mall HazMat-7 Detector 58 Business & residential H2 Required for confined fires. 6 Household solvents: home/office spill, cleanup only Wildland Fire-8 59 Office use 7 Motor oil: from engine or portable container Apparatus-9 1 Detector alerted occupants 60 Industrial use 8 Paint: from paint cans totaling < 55 gallons Personnel-10 2 Detector did not alert them 63 Military use 0 Other: special HazMat action required or spill > 55 gal 65 Farm use Arson-11 U Unknown (Please complete the HazMat form.) 00 Other mixed use

J Property Use None 341 Clinic, clinic-type infirmary 539 Household goods, sales, repairs Structures 342 Doctor/dentist office 571 Gas or service station 131 Church, place of worship 361 Prison or jail, not juvenile 579 Motor vehicle/boat sales/repairs 161 Restaurant or cafeteria 419 1-or 2-family dwelling 599 Business office 162 Bar/tavern or nightclub 429 Multifamily dwelling 615 Electric-generation plant 213 Elementary school, kindergarten 439 Rooming/boarding house 629 Laboratory/science laboratory 215 High school, junior high 449 Commercial hotel or motel 700 Manufacturing plant 241 College, adult education 459 Residential, board and care 819 Livestock/poultry storage (barn) 311 Nursing home 464 Dormitory/barracks 882 Non-residential parking garage 331 Hospital 519 Food and beverage sales 891 Warehouse

Outside 936 Vacant lot 981 Construction site 124 Playground or park 938 Graded/cared for plot of land 984 Industrial plant yard 655 Crops or orchard 946 Lake, river, stream Look up and enter a 669 Forest (timberland) 951 Railroad right-of-way Property Use code and Property Use 807 Outdoor storage area 960 Other street description only if you Code have NOT checked a 919 Dump or sanitary landfill 961 Highway/divided highway Property Use box. 931 Open land or field 962 Residential street/driveway Property Use Description

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MM DD YYYY NFIRS - 1 A 02601 MO 01 28 2020 2020-00000390 000 Delete BASIC FDID State Incident Date Station Incident Number Exposure Change

Person/Entity Involved Schrimpf landscaping Inc 573 635-6300 K1 Local Option Business Name (if applicable) Area Code Phone Number

Check this box if same Mr., Ms., Mrs. First Name MI Last Name Suffix address as incident Location (Section B). then skip the three 2820 BRUSH CREEK CT duplicate address lines. Number Prefix Street or Highway Street Type Suffix JEFFERSON CITY

Post Office Box Apt./Suite/Room City MO 65109 - State ZIP Code

Owner Same as person involved? Then check K2 Local Option this box and skip the rest of this block. Business Name (if applicable) Area Code Phone Number

Check this box if same Mr., Ms., Mrs. First Name MI Last Name Suffix address as incident Location (Section B). then skip the three duplicate address lines. Number Prefix Street or Highway Street Type Suffix

Post Office Box Apt./Suite/Room City - State ZIP Code

M Authorization 3jn1804 Asst Chief Assistant Chi Check box if Officer in charge ID Signature Jay Niemeyer Position or rank Assignment Month Day Year same as Officer in charge. 3jn1804 Asst Chief Assistant Chi

Member making report ID Signature Jay Niemeyer Position or rank Assignment Month Day Year

MM DD YYYY NFIRS - 1 A 02601 MO 01 28 2020 2020-00000390 000 Delete BASIC FDID State Incident Date Station Incident Number Exposure Change

Remarks L Local Option

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MM DD YYYY NFIRS - 1S A 02601 MO 01 28 2020 2020-00000390 000 Delete SUPPLEMENTAL FDID State Incident Date Station Incident Number Exposure Change

Person/Entity Involved K1 Local Option Business Name (if applicable) Area Code Phone Number Jacob W Scrimpf Check this box if same Mr., Ms., Mrs. First Name MI Last Name Suffix address as incident Location (Section B). then skip the three 1319 RT C duplicate address lines. Number Prefix Street or Highway Street Type Suffix Russellville

Post Office Box Apt./Suite/Room City MO 65036 - State ZIP Code

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MM DD YYYY NFIRS - 2 FIRE A 02601 MO 01 28 2020 2020-00000390 000 Delete FDID State Incident Date Station Incident Number Exposure Change

Complete if there were any significant amounts of On-Site Materials None Property Details commercial, industrial, energy, or agricultural B C or Products products or materials on the property, whether or not they became involved Not Residential Enter up to three codes. B1 Check one box for each code On-Site Materials Storage Use Estimated number of residential living units in entered. building of origin whether or not all units 1 Bulk storage or warehousing became involved 2 Processing or manufacturing On-site material (1) 3 Packaged goods for sale 4 Repair or service B2 Buildings not involved U Undetermined Number of buildings involved 1 Bulk storage or warehousing 2 Processing or manufacturing On-site material (2) 3 Packaged goods for sale 4 Repair or service U Undetermined

None 1 Bulk storage or warehousing B3 2 Processing or manufacturing Acres burned Less than one acre On-site material (3) 3 Packaged goods for sale (outside fires) 4 Repair or service U Undetermined

Ignition Cause of Ignition Skip to Human Factors D E1 Section G Contributing to Ignition Check box if this is an exposure report. E3 Check all applicable boxes None D1 1 Intentional Area of fire origin Asleep 2 Unintentional 1 2 Possibly impaired by 3 Failure of equipment or heat source alcohol or drugs D2 4 Act of nature Heat source 3 Unattended person 5 Cause under investigation 4 Possibly mentally disabled U Cause undetermined after investigation 5 Physically disabled D3 Multiple persons involved Item first 1 Check box if fire spread was Factors Contributing to Ignition 6 ignited confined to object of origin. E2 None 7 Age was a factor D4 Estimated age of Type of material first ignited Required only if item first Factor contributing to ignition (1) ignited code is 00 or <70 person involved 1 Male 2 Female Factor contributing to ignition (2)

Equipment Involved in Ignition Equipment Power Source Fire Suppression Factors None If equipment was not involved, F1 None F2 G Enter up to three codes. skip to Section G

Equipment Power Source Fire suppression factor (1) Equipment Involved Equipment Portability Brand F3 1 Portable Fire suppression factor (2) Model 2 Stationary Serial # Portable equipment normally can be moved by one or two persons, is designed to be used in Fire suppression factor (3) Year multiple locations, and requires no tools to install.

Mobile Property Type and Make Local Use Mobile Property Involved None H2 H1 Pre-Fire Plan Available 1 Not involved in ignition, but burned Some of the information presented in Mobile property type this report may be based upon reports 2 Involved in ignition, but did not burn from other agencies: Involved in ignition and burned 3 Arson report attached Mobile property make Police report attached Coroner report attached Other reports attached Mobile property model Year

License Plate Number State VIN

Structure fire? Please be sure to complete the Structure Fire form (NFIRS-3).

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Structure Type Building Status Building Main Floor NFIRS-3 I1 I2 I3 I4 STRUCTURE If fire was in an enclosed building or a Height Size FIRE portable/mobile structure, complete the Count the roof as part of rest of this form. 1 Under construction the highest story. 1 Enclosed building 2 In Normal Use Portable/mobile structure 2 3 Idle, not routinely used Total square feet 3 Open structure 4 Under major renovation Total number of stories at or above grade Air-supported structure 4 5 Vacant and secured OR 5 Tent 6 Vacant and unsecured 6 Open platform (e.g., piers) 7 Being demolished 7 Underground structure (work areas) 0 Other Total number of stories BY below grade 8 Connective structure (e.g., fences) U Undetermined Length in feet Width in feet 0 Other type of structure

Fire Origin Number of Stories Damaged Type of Material Contributing Most J1 J3 by Flame K to Flame Spread Below grade Count the roof as part of the highest story. Check if no flame spread OR if Story of fire origin Skip to same as Material First Ignited (Block D4, Section L Number of stories w/minor damage Fire Module) OR if unable to determine. Fire Spread (1 to 24% flame damage) J2 Number of stories w/significant damage K1 If fire spread was confined to object of origin, Item contributing most to flame spread (25 to 49% flame damage) do not check a box (Ref. Block D3, Fire Module.) Number of stories w/heavy damage 2 Confined to room of origin (50 to 74% flame damage) 3 Confined to floor of origin K2 Type of material Required only if item Number of stories w/extreme damage 4 Confined to building of origin contributing most to contributing code is 00 or < 70. (75 to 100% flame damage) flame spread 5 Beyond building of origin

Presence of Detectors Detector Power Supply Detector Effectiveness L1 L3 L5 Required if detector operated. 1 Battery only (In area of the fire) 2 Hardwire only 1 Alerted occupants, occupants responded 3 Plug-in 2 Alerted occupants, occupants failed Skip to to respond N None Present Section M 4 Hardwire with battery 3 There were no occupants 1 Present 5 Plug-in with battery 6 Mechanical 4 Failed to alert occupants U Undetermined 7 Multiple detectors & power U Undetermined supplies 0 Other Detector Failure Reason Detector Type U Undetermined L6 L2 Required if detector failed to operated. Detector Operation 1 Power failure, shutoff, or disconnect 1 Smoke L4 2 Improper installation or placement 2 Heat 1 Fire too small to activate 3 Defective 3 Combination smoke and heat Complete 4 Lack of maintenance, includes 4 Sprinkler, water flow detection 2 Operated Block L5 not cleaning 5 More than one type present 5 Battery missing or disconnected 0 Other 3 Failed to operate Complete 6 Battery discharged or dead Block L6 U Undetermined 7 Other U Undetermined U Undetermined

Presence of Automatic Operation of Automatic Reason for Automatic M1 Extinguishing System M3 Extinguishing System M5 Extinguishing System Failure Required if fire was within designed range N None Present Required if system failed or not effective 1 Present Complete rest of 1 Operated/effective (go to M4) 1 System shut off 2 Partial System Present Section M U Undetermined 2 Operated/not effective (go to M4) 2 Not enough agent discharged 3 Fire too small to activate 3 Agent discharged but did not Type of Automatic Extinguishing reach fire M2 System 4 Failed to operate (go to M5) Required if fire was within designed range of AES 0 Other 4 Wrong type of system 1 Wet-pipe U Undetermined 5 Fire not in area protected sprinkler 2 Dry-pipe sprinkler 6 System components damaged 3 Other sprinkler system Number of Sprinkler Lack of maintenance 4 Dry chemical system M4 Heads Operating 7 5 Foam system Required if system operated 8 Manual intervention 6 Halogen-type system 0 Other 7 Carbon dioxide (CO2) system Undetermined 0 Other special hazard system Number of sprinkler heads operating U U Undetermined

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MM DD YYYY NFIRS-4 Civilian A 02601 MO 01 28 2020 2020-00000390 000 Delete Fire Casualty FDID State Incident Date Station Incident Number Exposure Change

B Injured Person Gender C Casualty 1 Male 2 Female Number

First Name MI Last Name Suffix Casualty Number

D Age or Date of Birth E1 Race F Affiliation H Severity 1 White 1 Civilian 2 Black, African American 2 EMS, not fire department 1 Minor Months (for infants) 3 Am. Indian, Alaska Native 4 Asian 3 Police 2 Moderate Age 5 Native Hawaiian, Other 0 Other Pacific Islander 3 Severe OR 0 Other, multiracial Date and Time of Injury 4 Life threatening Date of Birth U Undetermined G Midnight is 0000. 5 Death Etnicity Date of Injury Time of Injury U Undetermined Month Day Year E2 Month 1 Hispanic or Latino Month Day Year Hour Minute 0 Non Hispanic or Latino

Human Factors Factors Contributing None Cause of Injury None I 1 Exposed to fire products including flame J Contributing to Injury K to Injury heat, smoke, and gas Check all applicable boxes Enter up to three contributing factors 2 Exposed to toxic fumes other than smoke 1 Asleep 3 Jumped in escape attempt 2 Unconscious Contributing factor (1) 4 Fell, slipped, or tripped 3 Possibly impaired by alcohol 5 Caught or trapped 4 Possibly impaired by other drug Contributing factor (2) 6 Structural collapse 5 Possibly mentally disabled 7 Struck by or contact with object 6 Physically disabled Contributing factor (3) 8 Overexertion or strain 7 Physically restrained 9 Multiple causes 8 Unattended person 0 Other U Undetermined

Activity When Injured Location at Time of Incident Story at Start of Incident L M1 M3 Complete ONLY if injury occurred INSIDE 1 In area of origin and not involved Story at start of incident Below grade 1 Escaping 2 Not in area of origin and not involved 2 Rescue attempt 3 Not in area of origin, but involved Story Where Injury Occurred 3 Fire control 4 In area of origin and involved M4 0 Other Location 4 Return to fire before control Story where injury occurred, if Below grade different from M3 5 Return to fire after control U Undetermined 6 Sleeping General Location at Time of Injury Specific Location at Time 7 Unable to act M2 M5 of Injury Skip to 8 Irrational act 1 In area of fire origin Section N Complete ONLY if casualty NOT in area of origin

0 Other 2 In building, but not in area U Undetermined Skip to 3 Outside, but not in area Specific location at time of injury Block M5 U Undetermine d N Primary Apparent Symptom O Primary Area of Body Injured PDisposition 01 Smoke only, asphyxiation 1 Head Transported to emergency care facility 11 Burns and smoke inhalation 2 Neck and shoulder 12 Burns only 3 Thorax Local option 21 Cut, laceration Remarks 4 Abdomen 33 Strain or sprain 5 Spine 96 Shock 6 Upper extremities 98 Pain only 7 Lower extremities Look up a code only if the symptom is NOT found above 8 Internal 9 Multiple body parts Primary apparent symptom

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MM DD YYYY NFIRS - 5 FIRE A 02601 MO 01 28 2020 2020-00000390 000 Delete SERVICE FDID State Incident Date Station Incident Number Exposure Change CASUALTY

B Injured Person 1 Male 1 Career C Casualty Number Identification Number 2 Female 2 Volunteer Volunteer

First Name MI Last Name Suffix Casualty Number

D Age or Date of Birth E Date and Time of Injury Midnight is 0000. F Responses Age Date of Birth Date of Injury Time of Injury

OR Number of prior responses In years Month Day Year Month Day Year Hour Minute during past 24 hours

G1 Usual Assignment G2 Physical Condition Just Prior to Injury G4 Taken To Not transported 1 Rested 0 Other 1 Hospital 4 Doctor's office 1 Suppression 2 Fatigued U Undetermined 5 Morgue/funeral home 2 EMS 4 Ill or injured 6 Residence 3 Prevention Severity 7 Station or quarters 4 Training G3 1 Report only, including exposure 0 Other 5 Maintenance 2 First aid only 6 Communications 3 Treated by physician (no lost time) Activity at Time of Injury 7 Administration 4 Moderate (lost time) G5 8 Fire investigation 5 Severe (lost time)

0 Other 6 Life threatening (lost time) Activity at time of injury 7 Death

Primary Apparent Symptom Cause of Firefighter Injury Object Involved None H1 I1 I3 in Injury

Primary apparent symptom Cause of injury Primary Part of Body Injured Factor Contributing to Injury H2 None I2 None Object involved in injury

Primary injured body part Contributing factor

Where Injury Occurred Specific Location Where Vehicle Type Complete ONLY if J1 J3 J4 specific Location code Injury Occurred is >60 1 En route to FD location 1 Suppression vehicle 2 At FD location 65 In aircraft 2 EMS vehicle 3 En route to incident scene 64 In boat, ship, or barge Complete Block J4 3 Other FD vehicle 4 En route to medical facility 63 In rail vehicle 5 At scene in structure 61 In motor vehicle 4 Non-FD vehicle 6 At scene outside Remarks 7 At medical facility 54 In sewer In tunnel 8 Returning from incident 53 49 In structure 9 Returning from med facility 45 In attic 00 Other 0 Other 36 In water UU Undetermined U Undetermined 35 In well Story Where Injury 34 In ravine J2 Occurred 33 In quarry or mine 32 In ditch or trench 31 In open pit

1 Check this box and enter the story if the 28 On steep grade injury occurred inside or on a structure 27 On fire escape/outside stairs

Story of injury Below grade 26 On vertical surface or ledge 25 On ground ladder 2 Injury occurred outside 24 On aerial ladder or in basket If protective equipment failed and 23 On roof was a factor in this injury, please 22 Outside at grade complete the other side of this form.

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Did protective equipment fail and contribute to the injury? Yes Y Equipment NFIRS - 5 Fire Service K1 Please complete the remainder of this form ONLY if you answer YES. Sequence No N Number Casualty

K2 Protective Equipment Item K3 Protective Equipment Problem Head or Face Protection Coat, Shirt, or Trousers Check one box to indicate the main problem that occurred. 11 Helmet 21 Protective coat 11 Burned 12 Full face protector 22 Protective trousers 12 Melted 13 Partial face protector 23 Uniform shirt 21 Fractured, cracked or broken 14 Goggles/eye protection 24 Uniform T-shirt 22 Punctured 15 Hood 25 Uniform trousers 23 Scratched 16 Ear protector 26 Uniform coat or jacket 24 Knocked off 17 Neck protector 27 Coveralls 10 Other 28 Apron or gown 25 Cut or ripped 20 Other 31 Trapped steam or hazardous gas 32 Insufficient insulation Boots or Shoes 33 Object fell in or onto equipment item 31 Knee length boots with steel baseplate and steel toes 41 Failed under impact 32 Knee length boots with steel toes only 42 Face piece or hose detached 33 3/4 length boots with steel baseplate and steel toes 43 Exhalation valve inoperative or damaged 34 3/4 length boots with steel toes only 44 Harness detached or separated 35 Boots without steel baseplate and steel toes 36 Safety shoes with steel baseplate and steel toes 45 Regulator failed to operate 37 Safety shoes with steel toes only 46 Regulator damaged by contact 38 Non-safety shoes 47 Problem with admissions valve 30 Other 48 Alarm failed to operate 49 Alarm damaged by contact Respiratory Protection 51 Supply cylinder or valve failed to operate 41 SCBA (demand) open circuit 52 Supply cylinder/valve damaged by contact 42 SCBA (positive pressure) open circuit 53 Supply cylinder - insufficient air/oxygen 43 SCBA closed circuit 44 Not self-contained 94 Did not fit properly 45 Cartridge respirator 95 Not properly serviced or stored prior to use 46 Dust or particle mask 96 Not used for designed purpose 40 Other 97 Not used as recommended by manufacturer 00 Other equipment problem Hand Protection UU Undetermined 51 Firefighter gloves with wristlets 52 Firefighter gloves without wristlets 53 Work gloves 54 HazMat gloves 55 Medical gloves 50 Other Special Equipment K4 Equipment Manufacturer, Model and 61 Proximity suit for entry Serial Number 62 Proximity suit for non-entry 63 Totally encapsulated, reusable chemical suit 64 Totally encapsulated, disposable chemical suit

65 Partially encapsulated, reusable chemical suit Manufacturer 66 Partially encapsulated, disposable chemical suit 67 Flash protection suit 68 Flight or jump suit Model 69 Brush suit 71 Exposure suit 72 Self-contained underwater breathing apparatus (SCUBA) 73 Life preserver Serial Number 74 Life belt or ladder belt 75 Personal alert safety system (PASS) 76 Radio distress device Was the failure of more than one item of protective 77 Personal lighting equipment a factor in the 78 Fire shelter or tent injury? If so, complete an 79 Vehicle safety belt additional page of this form for each piece of 70 Special equipment, other failed equipment. 00 Protective equipment, other

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MM DD YYYY NFIRS - 6 A 02601 MO 01 28 2020 2020-00000390 000 Delete EMS FDID State Incident Date Station Incident Number Exposure Change

Number of Patients Patient Number Date/Time Month Day Year Hour/Min B C Check if same date Time Arrived at Patient as Alarm date Use a seperate form for each patient Time of Patient Transfer

None/no patient or refused treatment D Provider Impression/Assessment Check one box only 10 Abdominal pain 18 Chest pain 26 Hypovolemia 34 Sexual assult 11 Airway obstruction 19 Diabetic symptom 27 Inhalation injury 35 Sting/bite 12 Allergic reaction 20 Do not resuscitate 28 Obvious death 36 Stroke/CVA 13 Altered LOC 21 Electrocution 29 OD/poisoning 37 Syncope 14 Behavioral/psych 22 General illness 30 Pregnancy/OB 38 Trauma 15 Burns 23 Hemorrhaging/bleeding 31 Respiratory arrest 00 Other 16 Cardiac arrest 24 Hyperthermia 32 Respiratory distress 17 Cardiac dysrhythmia 25 Hypothermia 33 Seizure

E1 Age or Date of Birth F1 Race G1 Human Factors None G2 Other None 1 White Contributing to Injury Factors Check all applicable boxes Months (for infants) 2 Black, African American 3 Am. Indian, Alaska Native 1 Asleep If an illness, not an Age injury, skip G2 and Asian OR 4 2 Unconscious go to H3 5 Native Hawaiian, Other 3 Possibly impaired by alcohol Pacific Islander 4 Possibly impaired by drug

Month Day Year 0 Other, multiracial 5 Possibly mentally disabled 1 Accidental U Undetermined 6 Physically disabled 2 Self-inflicted 7 Physically restrained 3 Inflicted, not self E2 Gender F2 Ethnicity 8 Unattended person 1 Hispanic or Latino 1 Male 2 Female 0 Non Hispanic or Latino

Body Site of Injury Injury Type Cause of H1 List up to five body sites H2 List one injury type for each body site listed under H1 H3 Illness/Injury

Cause of Illness/Injury

Procedures Used Check all applicable boxes No treatment Safety None Cardiac Arrest I J Equipment K 01 Airway insertion 14 Intubation (EGTA) 15 Intubation (ET) Used or deployed by patient. Check all applicable boxes. 02 Anti-shock trousers Check all applicable boxes. 03 Assist ventilation 16 IO/IV therapy 1 Pre-arrival arrest? 17 Medications therapy 04 Bleeding control 1 Safety/seat belts If pre-arrival arrest, was it: 05 Burn care 18 Oxygen therapy 2 Child safety seat 06 Cardiac pacing 19 OB care/delivery 3 Airbag 1 Witnessed? 07 Cardioversion (defib) manual 20 Prearrival instructions 4 Helmet 2 Bystander CPR? 08 Chest/abdominal thrust 21 Restrain patient 5 Protective clothing 22 Spinal immobilization 2 Post-arrival arrest? 09 CPR 6 Flotation device Initial Arrest Rhythm 10 Cricothyroidotomy 23 Splinted extremities 0 Other 11 Defibrillation by AED 24 Suction/aspirate U Undetermined 1 V-Fib/V-Tach 12 EKG monitoring 00 Other 0 Other 13 Extrication U Undetermined

Initial Level of Highest Level of Care None Patient Status EMS Not transported L1 Provider L2 Provided On Scene M N Disposition 1 First Responder 1 Improved 1 FD transport to ECF 2 EMT - B (Basic) 1 First Responder 2 Remained same 2 Non-FD transport 3 EMT - I (Intermediate) 2 EMT - B (Basic) 3 Worsened 3 Non-FD trans/FD attend Check if: 4 EMT - P (Paramedic) 3 EMT - I (Intermediate) 4 Non-emergency transfer 0 Other provider 4 EMT - P (Paramedic) 1 Pulse on transfer 0 Other N No Training 0 Other provider 2 No pulse on transfer

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MM DD YYYY NFIRS - 7 A 02601 MO 01 28 2020 2020-00000390 000 Delete HAZMAT FDID State Incident Date Station Incident Number Exposure Change

HazMat ID Chemical Name B UN Number DOT Hazard CAS Registration Number Classification

C1 Container C2 Estimated Container Capacity D1 Estimated Amount Released Physical State Type None E1 When Released Capacity: by volume or weight Amount Released: by volume or weight 1 Solid C3 Units: Capacity Check one box D2 Units: Released Check one box 2 Liquid Container Type VOLUME WEIGHT VOLUME WEIGHT 3 Gas 11 Ounces 21 Ounces 11 Ounces 21 Ounces U Undetermined 12 Gallons 22 Pounds 12 Gallons 22 Pounds More hazardous 13 Barrels: 42 gal. 23 Grams 13 Barrels: 42 gal. 23 Grams Released Into materials? Use 14 Liters 24 Kilograms 14 Liters 24 Kilograms E2 additional sheets. 15 Cubic feet MICRO UNITS 15 Cubic feet MICRO UNITS 16 Cubic meters 16 Cubic meters Released Into Enter Code Enter Code

Population Density Area Evacuated None HazMat Actions Taken Complete the remainder F2 G2 H of this form only for the Enter up to three actions taken 1 Urban 1 Square feet first hazardous material Enter involved in this incident. 2 Suburban 2 Blocks measurement Primary action taken (1) 3 Rural 3 Square miles F1 Released From Area Affected Estimated Number of Additional action taken (2) Check all applicable boxes G1 G3 People Evacuated

1 Square feet Additional action taken (3) Below grade 2 Blocks If fire or explosion is 1 Inside/on structure 3 Square miles Estimated Number of I involved with a release, G4 Buildings Evacuated which occurred first? Story of release None 1 Ignition U Undetermined 2 Outside of structure Enter measurement 2 Release

Cause of Release Factors Contributing to Release Factors Affecting Mitigation None J K Enter up to three contributing factors L Enter up to three factors or impediments that affected the 1 Intentional mitigation of the incident 2 Unintentional release Factor contributing to release (1) 3 Container/containment failure Factor or impediment (1) 4 Act of nature Factor contributing to release (2) 5 Cause under investigation Factor or impediment (2) U Cause undetermined after Factor contributing to release (3) investigation Factor or impediment (3)

Equipment Involved None Mobile Property None HazMat Disposition M in Release N Involved in Release O 1 Completed by fire service only 2 Completed w/fire service present 3 Released to local agency Equipment involved in release Mobile property type 4 Released to county agency Brand 5 Released to state agency 6 Released to federal agency Mobile property make 7 Released to private agency Model 8 Released to property owner or Model Year manager Serial # HazMat Civilian Casualties License plate number State P Deaths Injuries Year

DOT number/ ICC number

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MM DD YYYY NFIRS - 8 A 02601 MO 01 28 2020 2020-00000390 000 Delete WILDLAND FDID State Incident Date Station Incident Number Exposure Change

Alternate Location Specification Wildland Fire Cause Factors Contributing None B D1 D3 to Ignition Enter Latitude/Longitude OR Township/Range/Section/ Subsection Meridian if Section B on the Basic Module 1 Natural source 8 Misuse of fire #1 #2 is not completed 2 Equipment 0 Other 3 Smoking U Undetermined Fire Suppression Factors 4 Open/outdoor fire D4 None Latitude Longitude 5 Debris/vegetation burn #1 OR 6 Structure (exposure) Enter up to #2 North East 7 Incendiary three factors #3 South West Human Factors Contributing Township Range D2 to Ignition None Heat Source Check as many boxes as are applicable. E

Section Subsection Meridian 1 Asleep 2 Possibly impaired by alcohol or drugs Mobile Property Type None C Area Type 3 Unattended person F 4 Possibly mentally disabled 1 Rural, farms > 50 acres 5 Physically disabled Equipment Involved None 2 Urban (heavily populated) 6 Multiple persons involved G in Ignition 3 Rural/urban or suburban 7 Age was a factor 4 Urban-wildland interface area

H Weather Information I1 Number of Buildings Ignited I4 Primary Crops Burned None Identify up to 3 crops if any crops were NFDRS Weather Station ID burned Number of buildings that were ignited in Wildland fire Weather Type Wind Direction I2 Number of Buildings Threatened Crop 1 None F° Check if negative Number of buildings that were threatened by Crop 2 Wind Speed (mph) Air Temperature Wildland fire but were not involved

Total Acres Burned % % I3 Crop 3 Relative Humidity Fuel Moisture Fire Danger Rating

Property Management NFDRS Fuel Model at Origin Type of Right-of-Way J K M Required if less than 100 feet None

Indicate the percent of the total acres burned for each owner- Enter the code and the descriptor corresponding Feet ship type then check the ONE box to identify the property owner- to the NFDRS Fuel Model at origin ship at the origin of the fire. If the ownership at origin is Federal, Horizontal Type of right-of-way enter the Federal Agency Code. distance from right-of-way Ownership % Total Acres Burned L1 Person Responsible for Fire N Fire Behavior

U Undetermined % 1 Identified person caused fire These optional descriptors refer to observations 2 Unidentified person caused fire made at the point of initial attack Private 3 Fire not caused by person

If person identified, complete the rest of Section L 1 Tax paying % Feet 2 Non-tax paying % L2 Gender of Person Involved Elevation Public 1 Male 2 Female 3 City, town, village, local % Relative position on slope Age or Date of Birth 4 County or parish % L3

5 State or province % Age in Years Date of Birth Aspect 6 Federal % OR Feet Federal Agency Code Month Day Year Flame length 7 Foreign % Activity of Person Involved L4 Chains per Hour 8 Military % Rate of spread

0 Other % Activity of Person Involved

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MM DD YYYY NFIRS - 9 A 02601 MO 01 28 2020 2020-00000390 000 Delete APPARATUS FDID State Incident Date Station Incident Number Exposure Change OR RESOURCES

Midnight is 0000 Apparatus Apparatus or Dates and Times Sent Number Actions B Use Taken Resources Check if same date as Alarm date on the Basic Module (Block E1) of Check ONE box for each apparatus to indicate its List up to 4 actions Use codes listed below People Month Day Year Hour / Min main use at this incident for each apparatus

1 ID Chief Dispatch 01 28 2020 1311 Suppression Arrival 01 28 2020 1311 01 EMS Type 92 Clear 01 28 2020 1513 Other

2 ID Chief Dispatch 01 28 2020 1311 Suppression Arrival 01 28 2020 1311 01 EMS Type 92 Clear 01 28 2020 1525 Other

3 ID Chief Dispatch 01 28 2020 1306 Suppression Arrival 01 28 2020 1306 01 EMS Type 92 Clear 01 28 2020 1456 Other

4 ID Chief Dispatch 01 28 2020 1300 Suppression Arrival 01 28 2020 1301 01 EMS Type 92 Clear 01 28 2020 1525 Other

5 ID E1 Dispatch 01 28 2020 1258 Suppression Arrival 01 28 2020 1301 03 EMS Type 11 Clear 01 28 2020 1513 Other

6 ID E4 Dispatch 01 28 2020 1258 Suppression Arrival 01 28 2020 1304 03 EMS Type 11 Clear 01 28 2020 1357 Other

7 ID L1 Dispatch 01 28 2020 1304 Suppression Arrival 01 28 2020 1308 02 EMS Type 12 Clear 01 28 2020 1400 Other

8 ID Rescu Dispatch 01 28 2020 1302 Suppression Arrival 01 28 2020 1303 01 EMS Type 71 Clear 01 28 2020 1511 Other

9 ID S2 Dispatch 01 28 2020 1312 Suppression Arrival 01 28 2020 1318 03 EMS Type 11 Clear 01 28 2020 1419 Other

Medical and Rescue Apparatus or Resource Type More Aircraft 71 Rescue unit Apparatus? Use additional Ground Fire Suppression 72 Urban search and rescue unit 41 Aircraft: fixed-wing tanker sheets. 11 Engine 73 High-angle rescue unit 42 Helitanker 12 Truck or aerial 75 BLS unit 43 Helicopter 13 Quint 76 ALS unit 40 Aircraft, other NN None 14 Tanker and pumper combination 70 Medical and rescue unit, other Marine Equipment UU Undetermined 16 Brush truck Other 17 ARFF (aircraft rescue and firefighting) 51 Fire boat with pump 91 Mobile command post 10 Ground fire suppression, other 52 Boat, no pump 92 Chief officer car 53 Marine equipment, other Heavy Ground Equipment 93 HazMat unit 21 Dozer or plow Support Equipment 94 Type 1 hand crew 22 Tractor 61 Breathing apparatus support 95 Type II hand crew 24 Tanker or tender 62 Light and air unit 99 Privately owned vehicle 20 Heavy ground equipment, other 60 Support apparatus, other 00 Other apparatus / resources

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MM DD YYYY NFIRS - 9 A 02601 MO 01 28 2020 2020-00000390 000 Delete APPARATUS FDID State Incident Date Station Incident Number Exposure Change OR RESOURCES

10 ID S5 Dispatch 01 28 2020 1300 Suppression Arrival 01 28 2020 1308 03 EMS Type 11 Clear 01 28 2020 1518 Other

11 ID Dispatch Suppression Arrival EMS Type Clear Other

12 ID Dispatch Suppression Arrival EMS Type Clear Other

13 ID Dispatch Suppression Arrival EMS Type Clear Other

14 ID Dispatch Suppression Arrival EMS Type Clear Other

15 ID Dispatch Suppression Arrival EMS Type Clear Other

16 ID Dispatch Suppression Arrival EMS Type Clear Other

17 ID Dispatch Suppression Arrival EMS Type Clear Other

18 ID Dispatch Suppression Arrival EMS Type Clear Other

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MM DD YYYY NFIRS - 10 A 02601 MO 01 28 2020 2020-00000390 000 Delete PERSONNEL FDID State Incident Date Station Incident Number Exposure Change

1 ID Chief Dispatch 01 28 2020 1311 Suppression Arrival 01 28 2020 1311 01 EMS Type 92 Clear 01 28 2020 1513 Other

Personnel Rank or Attend Action Action Action Action Name ID Grade Taken Taken Taken Taken 3ms9423 Matthew Donald Schofield Chief

2 ID Chief Dispatch 01 28 2020 1311 Suppression Arrival 01 28 2020 1311 01 EMS Type 92 Clear 01 28 2020 1525 Other

Personnel Rank or Attend Action Action Action Action Name ID Grade Taken Taken Taken Taken 3jb3049 Jerry Paul Blomberg Chief

3 ID Chief Dispatch 01 28 2020 1306 Suppression Arrival 01 28 2020 1306 01 EMS Type 92 Clear 01 28 2020 1456 Other

Personnel Rank or Attend Action Action Action Action Name ID Grade Taken Taken Taken Taken 3jt7870 Jason D Turner Chief

4 ID Chief Dispatch 01 28 2020 1300 Suppression Arrival 01 28 2020 1301 01 EMS Type 92 Clear 01 28 2020 1525 Other

Personnel Rank or Attend Action Action Action Action Name ID Grade Taken Taken Taken Taken 3jn1804 Jay Niemeyer Assistant

5 ID E1 Dispatch 01 28 2020 1258 Suppression Arrival 01 28 2020 1301 03 EMS Type 11 Clear 01 28 2020 1513 Other

Personnel Rank or Attend Action Action Action Action Name ID Grade Taken Taken Taken Taken 3AM5091 Andrew J Mallow Firefighte 3rb2589 Ryan Edward Back Fire Capta 3js8045 Joel Swader Firefighte

6 ID E4 Dispatch 01 28 2020 1258 Suppression Arrival 01 28 2020 1304 03 EMS Type 11 Clear 01 28 2020 1357 Other

Personnel Rank or Attend Action Action Action Action Name ID Grade Taken Taken Taken Taken 3jm9717 Jonathan William Moe Firefighte 3ch9279 Clint Joseph Hays Fire Drive 3dp8919 Dirk Protzman Fire Capta

Page: 14 of 23 Page 15 of 17

7 ID L1 Dispatch 01 28 2020 1304 Suppression Arrival 01 28 2020 1308 02 EMS Type 12 Clear 01 28 2020 1400 Other

Personnel Rank or Attend Action Action Action Action Name ID Grade Taken Taken Taken Taken 3cw5009 Colin W Wright Firefighte 3jk8304 Jason Ryan Karr Fire Drive

8 ID Rescu Dispatch 01 28 2020 1302 Suppression Arrival 01 28 2020 1303 01 EMS Type 71 Clear 01 28 2020 1511 Other

Personnel Rank or Attend Action Action Action Action Name ID Grade Taken Taken Taken Taken 3mg5336 Matthew Gauthier Firefighte

9 ID S2 Dispatch 01 28 2020 1312 Suppression Arrival 01 28 2020 1318 03 EMS Type 11 Clear 01 28 2020 1419 Other

Personnel Rank or Attend Action Action Action Action Name ID Grade Taken Taken Taken Taken 3ck7736 Clint A Kempker Firefighte 3ch4238 Casey M. Hughes Fire Capta 3gh4645 Greg John Heckemeyer Fire Drive

10 ID S5 Dispatch 01 28 2020 1300 Suppression Arrival 01 28 2020 1308 03 EMS Type 11 Clear 01 28 2020 1518 Other

Personnel Rank or Attend Action Action Action Action Name ID Grade Taken Taken Taken Taken 3bm4521 Brendan L Martin Firefighte 3lb3993 Lisa Layton-Brinker Fire Drive 3pm4872 Philip E McKee Fire Capta

Page: 15 of 23 Page 16 of 17

MM DD YYYY NFIRS - 11 A 02601 MO 01 28 2020 2020-00000390 000 Delete ARSON FDID State Incident Date Station Incident Number Exposure Change

B Agency Referred To None Agency name Their case number

Number Prefix Street or Highway Street Type Suffix Their ORI

Post Office Box Apt./Suite/Room City Their Federal Identifier (FID) - State ZIP Code Agency phone number Their FDID

C Case Status D Availability of Material First Ignited 1 Investigation open 4 Closed with arrest 1 Transported to scene 2 Investigation closed 5 Closed with exceptional 2 Available at scene 3 Investigation inactive clearance U Unknown

Suspected Motivation Factors Check up to three factors E 42 Vanity/recognition 54 Burglary 11 Extortion 22 Hate crime 43 Thrills 61 Homicide concealment 12 Labor unrest 23 Institutional 44 Attention/sympathy 62 Burglary concealment 13 Insurance fraud 24 Societal 45 Sexual excitement 63 Auto theft concealment 14 Intimidation 31 Protest 51 Homicide 64 Destroy records/evidence 15 Void contract/lease 32 Civil unrest 52 Suicide 00 Other suspected motivation 21 Personal 41 Fireplay/curiosity 53 Domestic violence UU Unknown motivation

None No container Apparent Group Involvement Incendiary Devices CONTAINER F Check up to three factors H Select one from each category 1 Terrorist group 11 Bottle (glass) 14 Pressurized container 17 Box 2 Gang 12 Bottle (plastic) 15 Can (not gas or fuel) 00 Other Container 3 Anti-government group 13 Jug 16 Gasoline or fuel can UU Unknown 4 Outlaw motorcycle organization 5 Organized crime IGNITION/DELAY DEVICE No device 6 Racial/ethnic hate group 11 Wick or fuse 17 Road flare/fuse 7 Religious hate group 12 Candle 18 Chemical component 8 Sexual preference hate group 13 19 0 Other group Cigarette and matchbook Trailer/steamer U Unknown 14 Electronic component 20 Open flame source 15 Mechanical device 00 Other delay device G1 Entry Method 16 Remote control UU Unknown FUEL None Entry Method 11 Ordinary combustibles 16 Pyrotechnic material G2 Extent of Fire Involvement on Arrival 12 Flammable gas 17 Explosive material 14 Ignitable liquid 00 Other material 15 UU Extent of Fire Involvement Ignitable solid Unknown

Other Investigative Information Property Ownership Initial Observations I Check all that apply J Check all that apply K Check all that apply 1 Code violations 1 Private 1 Windows ajar 5 Fire department forced entry 2 Structure for sale 2 City, town, village, local 2 Doors ajar 6 Entry forced prior to FD arrival 3 Structure vacant 3 County or parish 3 Doors locked 7 Security system activated 4 Other crimes involved 4 State or province 4 Doors unlocked 8 Security system present (not activated) 5 Illicit drug activity 5 Federal 6 Change in insurance 6 Foreign Laboratory Used Check all that apply None 7 Military 7 Financial problem L 1 Local 3 ATF 5 Other 6 Private 0 Other Federal 8 Criminal/civil actions pending 2 State 4 FBI

Page: 16 of 23 Page 17 of 17

MM DD YYYY NFIRS - 11 A 02601 MO 01 28 2020 2020-00000390 000 Delete Juvenile FDID State Incident Date Station Incident Number Exposure Change Firesetter

M2 Age or Date of Birth M4 Race M6 Family Type 1 White 2 Black, African American Complete this section Age (in years) 3 American Indian, Alaska 1 Single parent if the person involved in OR Native the ignition of the fire 2 Foster parent(s) was a child or Juvenile 4 Asian under the age of 18 5 Native Hawaiian, Other 3 Two-parent family Pacific Islander Month Day Year 0 Other, multiracial 4 Extended family U Undetermined N No family unit

Subject Number Ethnicity 0 Other family type M1 M3 Gender M5 Complete a separate Section M U Unknown form for each juvenile 1 Male 2 Female 1 Hispanic or Latino 0 Non Hispanic or Latino Subject Number

Motivational/Risk Factors Check only one of codes 1-3 Disposition of Person Under 18 and then all others (4-9) M8 M7 that apply 1 Mild curiosity about fire 1 Handled within department 2 Moderate curiosity about fire 3 Extreme curiosity about fire 2 Released to parent/guardian 3 Referred to other authority 4 Diagnosed (or suspected) ADD/ADHD 5 History of trouble outside school 4 Referred to treatment/counseling program 6 History of stealing or shoplifting 5 Arrested, charged as adult 7 History of physically assaulting others 6 Referred to firesetter intervention program

8 History of fireplay or firesetting 0 Other 9 Transiency U Unknown 0 Other U Unknown

Remarks N Local Option

Page: 17 of 23 Page: 18 of 23

CAD Narrative

01/28/2020 12:57:47 ssmith Narrative: CONSTRUCTION WORKERS ADV WALL COLLAPSED 01/28/2020 12:57:50 fvolmert Narrative: Call #: 938 - WALL COLLAPSED 01/28/2020 12:58:05 ssmith Narrative: 1 PERSON TRAPPED 01/28/2020 12:58:09 ssmith Narrative: CAN HEAR HIM IS ALIVE 01/28/2020 12:58:16 fvolmert Narrative: Call #: 938 - SOMEONE IS TRAPPED 01/28/2020 12:58:21 naston Narrative: EMS ADVISED 01/28/2020 12:58:34 jswader Narrative: Dispatch received by unit E1 01/28/2020 12:58:42 fvolmert Narrative: Call #: 938 - AT OLD ST MARYS 01/28/2020 12:58:45 alenart Narrative: Dispatch received by unit 10 01/28/2020 12:58:46 nkerman Narrative: Dispatch received by unit 47 01/28/2020 12:59:20 jlehman Narrative: Dispatch received by unit 82 01/28/2020 13:01:09 pmccutchen Narrative: Dispatch received by unit 5 01/28/2020 13:01:52 dheislen Narrative: Dispatch received by unit 4 01/28/2020 13:02:48 ssmith Narrative: RESCUE1 REQ 01/28/2020 13:03:39 pmckee Narrative: Dispatch received by unit S5 01/28/2020 13:09:49 alindsey Narrative: PER 10-MEDIA RELEASE-500 BLK MO BLVD IS CLOSED 01/28/2020 13:14:12 ewilde Narrative: Dispatch received by unit 2 01/28/2020 13:14:25 jambler Narrative: Dispatch received by unit 90 01/28/2020 13:14:46 alindsey Narrative: DETECTIVE NEEDED AT THE SCENE 01/28/2020 13:16:19 ssmith Narrative: E3 MOVING TO STATION 1 01/28/2020 13:23:04 ssmith Narrative: PAGE SENT TO A & B SHIFTS TO RESPOND TO STATION 1 01/28/2020 13:35:10 sweaver Narrative: Dispatch received by unit 8 01/28/2020 13:40:57 ssmith Narrative: PAR 23 01/28/2020 14:39:11 ssmith Narrative: EXTRICATION AT 1418 01/28/2020 14:58:27 alenart Narrative: Dispatch received by unit 10 01/28/2020 15:09:10 dervine Narrative: Dispatch received by unit 58 01/28/2020 15:31:35 ssmith Narrative: SCENE RELEASED TO CONTRACTORS (Narrative added to cleared call.) 01/28/2020 15:34:30 ssmith Narrative: COMM TERMINATED 1533 (Narrative added to cleared call.) Page: 19 of 23

Fire Narrative

500 Missouri Blvd January 28, 2020

Engine 1 and Engine 4 were dispatched to the report of a medical emergency with entrapment, a report of a brick wall that had fallen at a construction site. Chief 7 responded and requested Squad 5 to respond. Rescue 1 also responded.

Chief 7 and Chief 4 arrived on the scene and Chief 7 established Missouri Boulevard Command. Chief 7’s initial assessment found an approximately 7 foot high pre-cast block wall that had partially collapsed. The pre-cast blocks were large in size, with multiple sizes and with weights estimated between 250 and 1000 pounds. The wall started on the Southwest end of the construction site along the sheer faced rock wall and continued a considerable distance to the collapsed section. Construction workers were on top of the block wall at the collapsed section and they were frantically waving to fire department units.

Chief 7 went to the area of the collapse and made contact with the construction workers and examined the area. At Chief 7’s arrival construction workers were using a medium size excavator to try to remove pre-cast blocks around the area of the victim. It was confirmed with workers that only 1 person was trapped and all other workers were accounted for. Chief 7 told them to stop all action so he could survey the area and assess the patient.

A quick risk assessment was completed showing very minor risk to responders including falling debris (from the work area above or from the rock face) and the unsupported pre-cast block wall near the collapse site that was over 5 ft in height. Both were mitigated with proper PPE (helmets) and exclusion from the non-collapsed area.

The patient was at risk from continued entrapment, further collapse due to unstable blocks (both on the patient and near the patient that could fall on the patient as blocks were moved), and risk of using the excavator near the patient causing additional crush injury while attempting to move the large blocks. Additionally, the attachment points to move the blocks were not accessible due to the positioning of the blocks post collapse.

Chief 7 found one male victim pinned between the collapsed pre-cast block wall and the sheer faced rock wall. The top pre-cast block had impacted the patient at the mid scapular line and the patient’s left hand was above his head. The patient was upright, his body was faced towards the rock face and his back was towards the pre-cast block wall that had collapsed. His head was turned to the right. The patient was having some head movements and lip movements upon initial contact. The patient had a weak carotid pulse; his skin around his face slightly red and was warm and dry. The patient was not breathing, alert or talking. Due to the position of the large pre-cast block it appeared that the patient would be unable to breathe.

Based on the presentation of the patient, the amount of time the patient had already been trapped, the presumed injury that occurred to the patient by the impact of the large block, and the limited length of survivable time Chief 7 chose to start moving blocks in an attempt to quickly rescue the patient. Page: 20 of 23

Chief 7 advised the operator of the excavator to start removing pre-cast blocks approximately 3 to 5 feet to the southwest of the patient (near the small excavator behind the collapse) and start working down the pre-cast block wall to help relieve pressure in the area and get the pre-cast block wall to fall away. Chief 7 also asked members of the construction crew to get any wood cribbing that they had available. As the operator moved the large pre-cast blocks Chief 7 monitored the movement of the pre-cast blocks near the patient and the patient’s condition.

After removing 3 or 4 pre-cast blocks Chief 7 could see that the blocks near the patient were starting to move and place more weight on the patient and Chief 7 asked the operator to stop removing blocks. Two nylon load straps were attached to the excavator bucket to stabilize the largest block that was in direct contact with the patient. At this time the patient’s head and neck were a deep red to purple color, the patent was still not breathing and was not responsive and there was no movement of the patient.

E1 arrived at the location of the patient and Chief 7 assigned the E1 Captain to take over the rescue operation and Chief 7 could continue Incident Command responsibilities. Engine 1 was directed to continue to stabilize the blocks from further movement and to work to remove the blocks from the victim.

Engine 4 was assigned to E1 to assist with rescue operations. Rescue 1 arrived and was assigned to E1. L1 was requested to respond to the incident. All fire units on scene were moved to fire ground 1 tactical channel.

EMS had arrived on the scene and assumed patient care. EMS stated that they had requested a helicopter, but the helicopter would not fly due to weather conditions. EMS was advised to reposition their ambulance for quicker departure.

PD was on the scene controlling access to the site and controlling traffic around the fire apparatus that were staged on Missouri Boulevard.

Squad 5 arrived on the scene and was assigned to E1 to assist with rescue operations.

Chief 1 and Chief 3 arrived on the scene. Chief 3 was assigned to relieve E1 Captain and direct rescue operations. Chief 1 assumed Liaison and PIO duties. Squad 2 was requested to respond.

PD was assigned to make contact with the contractor to ensure all work was stopped above the rescue operation.

Captain McKee (Squad 5) was removed from rescue operations and assigned to take photographs of the scene and rescue operations for documentation. A request was made to JCPD to dispatch a detective to begin an accident investigation, PD stated a detective was already responding,

It was confirmed by representatives from Schrimpf Landscaping that both the injured worker’s family and the owners of the company had been contacted about the accident. JCPD was working with the company to ensure family members were contacted. Page: 21 of 23

S2 arrived and were assigned to Chief 3 to assist with rescue operations. Call back procedures were started to get JCFD Special Operations Response Team (SORT) members to respond, to supplement and support extended operations.

At approximately1326 hours Chief 3 and the IC discussed the length of the incident, the time that the patient had been trapped with no respirations and pulse, and the estimated time to extricate the victim. Rescue operations continued, but a plan was started to move to investigation and recovery mode.

JCPD was advised of the pending move to recovery operations and requested to place officers near the collapse site, for scene security and responder safety.

At approximately 1338 hours the largest block trapping the patient was removed using the excavator exposing the victim’s torso. Cole County EMS confirmed that the patient remained pulseless and apneic. The rescue operations stopped and the incident moved to an investigation and recovery operation. FD members assisted PD detectives with securing and documenting the scene. JCPD again had to make contact with the contractor and request the crews above the site stop all work.

Cole County EMS remained on the scene to provide care for responders if needed.

While the investigation process started, JCFD units began securing equipment and returning trucks to service. As SORT team members arrived they were assigned to Chief 3.

Once the PD advised the initial documentation phase was completed, JCFD continued recovery operations, accessed the victim, removed the victim from the collapsed area and moved the victim to the transport vehicle. JCPD continued their investigations during the recovery process.

Once recovery operations were complete, Cole County EMS was released from the scene and FD units secured rescue equipment and returned fire apparatus to service. Fire line tape was place around the collapse site.

Chief 7 remained on the scene until representatives of F& F Development (general contractors), Pat Mingucci and Curtis Neuenswander arrived on the scene and the incident scene was turned over to them. Mr. Mingucci confirmed that OSHA had been advised of the incident.

Chief 7 cleared the scene and command was terminated.

Submitted, M. Jay Niemeyer

Page: 22 of 23

Rescue group supplemental

1/28/2020 Medical Emergency 500 Missouri Blvd. Rescue Group Supplement

Engine 1 and Engine 4 dispatched for a Medical Emergency at 500 Missouri Blvd. Dispatch advised wall collapse with one person trapped. Engine 1 Captain assigned Ladder 1 firefighter to respond Rescue 1. Chief 7 arrived on scene and established command. Engine 1 arrived on scene. Upon Engine 1’s arrival, JCPD, Chief 4, Chief 7, and construction crews were on scene. Engine 1 Captain observed a partially collapsed wall constructed of Rosetta type blocks. The collapse was located approximately 5 feet above ground level. Engine 1 met with Chief 7 on the rubble pile of the collapsed blocks. Chief 7 confirmed one male patient trapped. Engine 1 Captain and Firefighter and Rescue 1 Firefighter gained access to the patient. Patient presented in the upright position, pinned between the collapsed block wall and the interior wall of natural rock. Patient was assessed by Engine 1 Firefighter and presented as unresponsive, not breathing and had no pulse. Engine 1 Captain performed an assessment and confirmed patient was pulseless, not breathing, and unresponsive. Patient’s lips were cyanotic. Cribbing was placed on each side of the patient to prevent any further collapse. Two 52.7t airbags were placed, one on each side of the patient and inflated, moving the collapsed blocks approximately 6 inches away from the patient. Further cribbing was placed as movement was achieved to capture progress. An excavator already on site had been positioned close to the collapse and two straps were already wrapped around a large block in a basket configuration and attached to the bucket of the excavator. Engine 1 Captain instructed the excavator operator to maintain tension on the straps as movement was achieved with the airbags. Once the airbags were inflated to their maximum inflation pressure, Engine 1 Captain requested the excavator operator to attempt to lift the large stone up and away from the patient. The excavator operator advised the Engine 1 Captain that the excavator was already applying significant force and he did not feel comfortable applying more force. The excavator operator also expressed concern with one of the straps referring to its worn condition. Engine 1 Captain acknowledged the excavator operator’s concern and instructed him to continue to utilize the excavator for stabilization of the large stone. Engine 1 Captain and Firefighter placed an E-draulic Spreader rescue tool between the natural rock wall and the large stone in attempt to move the large stone in an upward and outward direction away from the patient. The spreader was opened until the tool’s maximum pressure was applied. This operation resulted in no additional movement of the large stone. The movement achieved by the airbags gave Engine 1 personnel a better visual of the patient’s lower extremities. Patient’s waist and lower extremities were pinned underneath the large block with an estimated weight of 800 pounds and a smaller block with an estimated weight of 250 pounds. Patient still presented as unresponsive with no pulse and not breathing. Cole County EMS arrived on scene and performed a patient assessment and confirmed patient was pulseless, not breathing, and unresponsive. Chief 3 arrived on scene and the Engine 1 Captain advised Chief 3 of the status and progress made thus far. The operator of the excavator on site was instructed to utilize the straps that were already wrapped around the large block in a basket configuration and attached to the bucket of the excavator. A chain from Squad 5 was also secured around the stone and attached to the bucket of the excavator by Engine 1 Captain and Squad 2 Captain. All personnel were removed from the hazard zone. The excavator operator was instructed by Chief 3 to lift the large block off of the patient. While lifting the block, the excavator’s track opposite of the bucket left the ground at least two feet, making the excavator very Page: 23 of 23

unstable. The block was lifted in an uncontrolled manner and quickly set on the ground next to the excavator away from the block wall. Cole County EMS Supervisor performed an assessment of the patient and confirmed the patient was unresponsive, pulseless, and not breathing. The Engine 1 Captain and Squad 2 Captain manually lifted the small block off of the patient. Squad 2 Captain gained a visual of the patient’s lower extremities and confirmed the patient was no longer pinned. Personnel were instructed by Chief 3 to stand by while JCPD started their investigation. 6 personnel from the JCFD Special Operations Team arrived on scene. Once JCPD gave clearance to proceed, Engine 1 Captain, Driver, Firefighter and the 6 JCFD SORT team members proceeded to remove the patient from the collapse zone. Patient was lifted via two person lift, up on top of the remaining collapsed blocks and was placed and secured to a long spine board, then lowered down a ladder to the ground. Patient was carried to and placed in the funeral home’s transportation. Engine 1 personnel and JCFD SORT members removed tools and accessible cribbing from the collapse zone. Personnel returned equipment to service. Engine 1 was released by command. Engine 1 cleared the scene and returned to service.

Submitted by: Captain Ryan Back