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CFD Report Manual > Report Manual > Flashcards

Report Manual Flashcards

1
Q

Declaration of Municipality

A

Form 003

Must be submitted by new employees.

New form must be submitted with any/all change of address (F-31 Status Change)

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2
Q

Certificate of Military Training Pay

A

Form CS-8
Request for Military Leave With Pay Differential.

Submitted when military orders are received:
2 copies of the CS-8.
1 copy of F-25S listing the working days member will be absent.
1 copy of Military Training Orders signed by Commanding Officer.

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3
Q

Probationary Employees Progress Report

A

Form CS-11

Made out by immediate supervisor.
New employees: near the end of 6th month of probation
Newly promoted members below rank of Fire Chief: near the end of the 3rd month of probationary period.

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4
Q

Resignation

A

Form F-13
Rarely used.
If members turns in F-13 they should be counseled by their DC.

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5
Q

Application for Permit

A

Form F-15

References: CFPC Section Numbers spreadsheet in file folder

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6
Q

Interdepartment Correspondence Sheet

A

Form 17

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7
Q

Performance Appraisal Evaluation

A

Performance Appraisal Evaluation
F-21A (Non-Supervisory)
F-21B (Supervisory)
F-21C (Administrative)

Annual ratings due to Personnel Office by 4/1

References: Ratings Form Flow Chart, Performance Evaluation Appraisal Manual

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8
Q

Transfer Exchange Request/Notification Form

A

Form F-23

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9
Q

Application for Transfer

A

F-24

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10
Q

Application for Leave of Absence

A

F-25S

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11
Q

Requisition for Supplies

A

F-27

Due the first of each month (D1/D2 odd mos, D3/D4 even mos)

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12
Q

Outside Work Notice

A

F-28S

Prepare two copies. Submit 1 copy through normal channels to FC. Employee retains 2nd copy.

To withdraw, submit 2nd copy with “Cancel this Notification”, the date, and employee signature in the lower right hand corner of the form.

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13
Q

Change of Status Report

A

F-31
Change of address also requires a new Form 003 (Declaration of
Municipality)

Change of marital status requires a Medical Insurance Change Form

Change of withholding status requires new W-4

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14
Q

Equipment Repair Report

A

F-40
Accessible via shortcut on desktop, or CFDWEB
>Apparatus and Equipment Maintenance
>Central Stores
>Facility Maintenance
>Other Form F-40
*F-47 required with F-40 for lost or damaged equipment

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15
Q

Company Multiple Alarm Report

A

F-46C

Made out for: 3-Alarm or greater fires, serious injury or death to civilians or FF occurs, or at anytime requested by IC

Email to the suppression DC that had responsibility for the fire, Ops Administrative DC (Car 301), and AC of Ops.

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16
Q

Chiefs Report

A

F-47
Submit one copy.
Retain copy for company files.
Record in company diary.

*Anything unusual must be reported

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17
Q

Motor Vehicle Accident Response Form

A

F-54 MVA

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18
Q

Hydrant Report

A

F-57
Submit two copies.
Any defect requiring repairs by Water Works including hydrants or hydrant valves.

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19
Q

Notice of Official Reprimand

A

Form 66S
Filled out by LT and above

Prepare 4 Copies: 
White - employee
Pink - civil service
Canary - division head
Goldenrod - supervisor
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20
Q

Trade Request

A

F-76

Submitted 3 calendar days in advance for 1-2 tour trades, 6 calendar days for 3+ tour trades.

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21
Q

Application and Approval for Tuition Reimbursement

A

F-80

Submit signed original for to AC of HR

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22
Q

Supervisor’s Investigation of Vehicle Accident

A

F-90S

F-90S, F-90S WS, and F-92S (Driver’s Report of a Vehicle Accident) must be completed any time a FD vehicle is involved in an accident.

Submit one signed copy to DC of Health & Safety

References in folder: F-90S WS Vehicle Accident Worksheet
BMV 3303 (PDF Format) Dept of Public Safety and BMV Crash
Report

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23
Q

Supervisor’s Investigation of Employee Injury

A

F-91S/F
F-91S/F WS Employee Injury Work Sheet

Competed by assigned ALS Supervisor. Emailed, faxed, or personally delivered to DC where member was assigned at the time of the injury.

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24
Q

Driver’s Report of a Vehicle Accident

A

F-92S

Must be completed any time FD vehicle is involved in an accident.
Filled out by member driving apparatus at time of the accident.

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25
Q

Inspection Request (Copy of Form)

A

Form F-107 ✏️

26
Q

Complaint Slip (Copy of Form)

A

Form F-108 ✏️

27
Q

Inspection Form (Copy of Form)

A

Form F-109 ✏️

28
Q

Inspection Card (Copy of Form)

A

Form F-110✏️

29
Q

Monthly Company Summary

A

Form F-112 🖥

Due on the 4th of every month

30
Q

New Construction Inspections Form

A

Form F-119 🖥

31
Q

Places of Assembly Posting Record (Copy of Form)

A

Form F-120 ✏️

32
Q

Fire Fighting Equipment Inventory

A

Form F-141B (Eng) and F-141C (Lad) 🖥

Due Annually on the 2nd of January

33
Q

Annual Fire Hydrant Inventory Report

A

Form F-201 🖥

Due annually on the 15th of November

34
Q

Quarterly Certification Status Report

A

Form F-207C🖥

Due on the 1st of the Month in Jan, April, July, October

35
Q

Roster for Fire College

A

Form F-211 🖥

36
Q

Pay Request for Overtime Work-Above-Grade

A

Form F-212 🖥

37
Q

Request for Retirement and Election of Lump Sum

A

Form F-214 🖥

38
Q

Progress Sheet Utility Operator

A

Form F-215A, F-215B, F-215C ✏️

39
Q

Permission to Flow Test Private Hydrant

A

Form F-222 🖥

40
Q

Vacation and Holiday Grants

A

Form F-234 🖥

41
Q

Quarterly Qualification Status Report

A

Form F-207Q 🖥

Due on the 1st of the Month Jan, April, July, October

42
Q

Fire Company Annual Report

A

Form F-236 🖥

Due on the 3rd of January each year.

43
Q

Record of Hydrant Spanner Loaned

Temporary Use of Fire Hydrants (Information Sheet)

A

Form F-238 🖥

Form F-238A 📄

44
Q

Water Usage Report

A

Form F-241 🖥

Due on the 3rd of each month.

45
Q

Accident Information to Vehicle Operator

A

Form F-251 ✏️

46
Q

Premise History Entry

A

Form F-272 🖥

47
Q

Citizen Complaint Report

A

Form 273B ✏️

48
Q

Juvenile Firesetter Program Authorization for Release of Information (Copy of Form)

A

Form F-289 ✏️

49
Q

Juvenile Firesetter Program (Copy of Form)

A

Form F-289✏️

50
Q

Certification of Healthcare Provider

A

Form WH-380 ✏️

51
Q

Employee Request for Family Medical Leave Form
Conditional Notification to Employee
Response to FMLA 48 Hour
Response to FMLA 40 Hour

A 
Form F-406🖥
   Form F-406A 📄
   Form F-406B 📄
   Form F-406C 📄
          FMLA Clarification
          Your FMLA Rights
          FMLA FAQs
52
Q

Fire Dept Minor Injury Report

A

Form F-500🖥 (✏️)

53
Q

Firefighter Exposure to Infectious Disease Report

A

Form F-501 🖥 (✏️)

54
Q

Narcotic Usage Report

A

Form F-502 🖥 (✏️)

55
Q

Basic Incident Report

A

Form 902 🖥

56
Q

Quarterly Reports

A

Community Relations Report (F-47 on the 1st)
Hydrant Report (F-47 on the 1st)
Place of Assembly Report (F-47 on the 1st)
Company Cerification Report (F-207C on the 1st)
Company Qualification Report (F-207Q on the 1st)

57
Q

Monthly Reports

A

Requisition for Supplies (F-27 on the 1st)
Water Usage Report (F-241 on the 3rd)
Company Summary (F-112 on the 4th)

58
Q

Annual Reports

A 
Engine Inventory (F-141B due on January 2nd)
Truck Inventory (F-141C due on January 2nd)

Annual Hydrant Inventory Report (F-201 due on November 15th)

59
Q

Forcible Entry Form

A

Form F-05

F-05 is to be left behind at premises when forcible entry is required due to emergency and no key holder response within reasonable amount of time.

To be carried on all apparatus and hand written at the scene.
Date, Time, Company, Run #.

F-47 submitted anytime forcible entry is required.

60
Q

Probationary period for Fire Chief and Fire Fighter is _____________.
For all other classes,______________.

A

1 year

6 months

61
Q

Recommendation for Commendation Report

A

F-22

Prepare two copies, submit one copy. Retain on copy for company file.
Submitted through normal channels to Ops AC.

Reference Procedures Section 507

62
Q

Three instances that require a F-21 to be made out:

A
  1. Annual Rating - made out yearly and due 4/1
  2. Probationary Rating - completed approx 1 mo before end of probationary period
  3. Special Ratings - consult PAEM as to when these ratings are to be made out nothing found in PAEM

CFD Report Manual (1 decks)

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