Building Fire Incident Data Collection Form

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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 zone

Auto-selected from incident country.

Town/city/municipality

Number of fatalities

Number of fatalities is unknown

Not collected

Age of fatalities

Not collected

Reported number also includes later deaths

Number of injuries

Number of injuries is unknown

Not collected

Above the ground

Below the ground

unknown

not collected

Select one primary causal factor

Intentional

Unintentional

Equipment failure

Natural phenomenon

Unknown

Not collected

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Type of building

Subtype of the building

Is it a mixed-use building?

Is the building under construction?

Additional building type details

Were the fire safety measures present at the area of origin?

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

Select one area of origin

Select one heat source from the corresponding group

Select one item that ignited first

Did fire spread further from the item first ignited?

If "yes", select items ignited

Select one primary causal factor

1. Incident date

2. Incident time

3. Incident location

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?

Additional building type details i

7. Number of floors

8. Fire safety measures

Were the fire safety measures present at the area of origin? i

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

9. Area of origin

Select one area of origin i

10. Heat source

Select one heat source from the corresponding group i

11. Item first ignited

Select one item that ignited first i

12. Articles contributing to fire development

Did fire spread further from the item first ignited? i

If "yes", select items ignited

13. Primary causal factor

Select one primary causal factor i

Type of building

Subtype of the building

Is it a mixed-use building?

Additional building type details

Were the fire safety measures present at the area of origin?

Select one area of origin

Select one heat source from the corresponding group

Select one item that ignited first

Did fire spread further from the item first ignited?

Select one primary causal factor