Building Fire Incident Data Collection Form

Cancel

Building fire incident data collection form

Incident ID: Q7MK-2VP-9XR

Data collection point

This field is mandatory.

Incident country

This field is mandatory.

Incident reference number

Expand all sections

Incident date

This field is mandatory.

Incident time

Time is unknown

Time zone

Auto-selected from incident country.

Town/city/municipality

Address

ZIP

Street

Number

Address is unknown

Coordinates

Latitude

Longitude

Coordinates are unknown

Number of fatalities

Number of fatalities is unknown

Age of fatalities

Reported number also includes later deaths

Number of injuries

Number of injuries is unknown

Above the ground

Below the ground

Select one primary causal factor

Intentional

Unintentional

Undetermined intent

Equipment failure

Natural phenomenon

Undetermined

Unknown

You've reached the end of the Building fire incident data collection form. Save it from the toolbar above.

Address

Coordinates

Type of building

Subtype of the building

Is it a mixed-use building?

Is the building under construction?

Additional building type details

Were fire safety measures present?

If "yes", check all safety measures and their status

Select one area of origin

Select one item that ignited first

Did fire spread further from the item first ignited?

If "yes", select items ignited

Select one heat source from the corresponding group

Select one primary causal factor

1. Incident date

2. Incident time

3. Incident location

Address

Coordinates

4. Fatalities and age of fatalities

5. Injuries

6. Type of building

Type of building i

Subtype of the building i

Is it a mixed-use building? i

Is the building under construction? i

Additional building type details i

7. Number of floors

8. Fire safety measures

Were fire safety measures present? i

If "yes", check all safety measures and their status

9. Area of origin

Select one area of origin i

10. Item first ignited

Select one item that ignited first i

11. Articles contributing to fire development

Did fire spread further from the item first ignited? i

If "yes", select items ignited

12. Heat source

Select one heat source from the corresponding group i

13. Primary causal factor

Select one primary causal factor i

Type of building

Subtype of the building

Is it a mixed-use building?

Is the building under construction?

Additional building type details

Were fire safety measures present?

Select one area of origin

Select one item that ignited first

Did fire spread further from the item first ignited?

Select one heat source from the corresponding group

Select one primary causal factor