Forms Flashcards
Forms
F- 377
Name ______
Copies _____
Signed by _____
Retain (how long and where) ______
Forward _____
F- 377
Name - Preventive Maintenance Record Bi-Monthly
Copies - 2
Signed by - Station Commander and B/C
Retain - 6 copies in Log Book
Forward - One to B/C office first two weeks of even month
Note - Copy to arrive at B/C office no later than the day before inspection or the 15th of even month, whichever comes first
Forms
F- 701
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 701
Name - Statistical Information
Copies - 2
Retain - Permanently in Log Book
Forward - 1 at S and M
Forms
F- 702
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 702
Name - Assignment Record
Copies - 1
Retain - Permanently in Log Book
Forward - N/A
Forms
F- 704
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 704
Name - Apparatus Maintenance Record
Copies - 1
Retain - Retain until filled; one year after date of last entry may be discarded - In Log Book
Forward - N/A
Forms
F- 705
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 705
Name - Repair Record
Copies - 1
Retain - Permanently in Log Book
Forward - N/A
Forms
F- 706
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 706
Name - Battery Record
Copies - 1
Retain - Until Full, In Log Book
Forward - N/A
Forms
F- 709
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 709
Name - Inventory of Equipment Fire Fighting
Copies - 1
Retain - Permanently in Log Book
Forward - N/A
Forms
F- 710
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 710
Name - Tire Record
Copies - 1
Retain - Permanently in Log Book
Forward - N/A
Forms
F- 972
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 972
Name - Daily Pre-Trip Inspection Record
Copies - 1
Retain - 1 month after last entry, in Log Book
Forward - N/A
Forms
F- 974
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 974
Name - Reserve Apparatus Condition Inventory Record
Copies - 1
Retain - 1 year from last entry, in Log Book
Forward - N/A
Forms
F- 976
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 976
Name - Annual Ground Ladder Inspection Record
Copies - 1
Retain - Permanently in Log Book
Forward - To S and M when removed from service
Forms
F-977
Name ______
Copies _____
Signed by _____
Retain (how long and where) ______
Forward _____
F- 977
Name - Apparatus Inspection Checklist
(items to be checked during Bi-Monthly inspection)
Copies - 1
Signed by - Company Commander and B/C
Retain - 3 years in Log Book
Forward - N/A
Forms
F- 978A
Name ______
Copies _____
Signed by _____
Retain (how long and where) ______
Forward _____
F- 978A
Name - Heavy Apparatus Undercarriage Inspection Checklist
Copies - 1
Signed by - Company Commander and B/C
Retain - 3 years in Log Book
Forward - N/A
Forms
F- 978B
Name ______
Copies _____
Signed by _____
Retain (how long and where) ______
Forward _____
F- 978B
Name - LAFD Heavy Apparatus Undercarriage Inspection Form
Copies - 2
Signed by - Company Commander and B/C
Retain - 1 year in Log Book (per bottom of form)
Forward - 1 to S and M or hand carry to Annual Test
(old hard copies say 3 years)
Forms
F- 122
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 122
Name - Over Lay Hose and Salvage Cover
Copies - 1
Retain - Permanently in Book 55
Forward - N/A
Forms
F- 128
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 128
Name - Hose and Salvage Cover Record
Copies - 1
Retain - 6 months after last entry, in Book 55
Forward - N/A
Forms
F- 129
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 129
Name - Annual Hose Test Record
Copies - 2
Retain - For life of hose, in Book 55
Forward - 1 to S and M when test complete
Forms
F- 973
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 973
Name - Apparatus and Equipment Check Record
(W - Weekly and M - Monthly)
Copies - 1
Retain - I month after last entry, in Book 55
Forward - N/A
Forms
F- 975
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 975
Name - Lifeline and Rescue Kit Inspection
Copies - 1
Retain - Until Full, in Book 55
Forward - To S and M with lifeline when sent in for testing or repair
Forms
F- 979
Name ______
Copies _____
Signed by _____
Retain (how long and where) ______
Forward _____
F- 979
Name - SCBA Inspection Checklist
Copies - 1
Signed by - Company Commander and B/C
Retain - 3 years in Book 55
Forward - N/A
Forms
FG- 84B
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 84B
Name - Witness Card
Copies - 1
Retain - Permanently, in Station Files
Forward - Within 24 hours with FG 88 Bureau Commander to Personnel Services (Per Volume 5)
Forms
FG- 88
Name ______
Copies _____
Signed by _____
Retain (how long and where) ______
Forward _____
F- 88
Name - Automative Accident Report
Copies - 5
1 - Permanently - legal liability section, City Attorney Office
2 and 3 - Apparatus and Equipment Division
4 - Accident File
5 - Permanently member personal file
Signed by - Employee and Supervisor
Retain - Permanently
Forward - Within 24 hours with FG 88 Bureau Commander to Personnel Services (Per Volume 5)
Forms
DL 170
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
Dl 170
Name - Certificate of Driving
Copies - 2
Retain - Permanently
Forward - As needed - DMV and In-Service
Forms
F- 370
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 370
Name - Record of Drivers Training
Copies - 2
Retain - Permanently
Forward - As needed - Member and In-Service
Forms
F- 380
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 380
Name - Apparatus Yearly Mileage
Copies - 2
Retain - I year, Station File
Forward - To S and M, Original by concerned members by the 10th day after the end of the fiscal year. (July)
Forms
F- 392
Name ______
Copies _____
Retain (how long and where) ______
Forward _____
F- 392
Name - Monthly Gasoline and Diesel Fuel Report
Copies - 2
Retain - By Battalion for 1 year
Forward - Station to Battalion to Accounting Services Section
—No later than 5 days after end of each month
