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Captain Sori-Tech Volumes > Volume 5 - Form Name Memorization Only > Flashcards

Volume 5 - Form Name Memorization Only Flashcards

1
Q

What Form Name?

F-8

A

Roster Change (form on NSS)

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2
Q

What Form Name?

F-17

A

Pay Grade Advancement Special/Hazard Pay Application

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3
Q

What Form Name?

PGA-1

A

Pay Grade Advancement Application

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4
Q

What Form Name?

F-18A

A

Request for Transfer Uniformed Members (Form on NSS)

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5
Q

What Form Name?

F-18B

A

Request for Transfer Primary Vacancies (Form on NSS)

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6
Q

What Form Name?

F-23

A

LAFD Emergency Overtime Report (Form on NSS)

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7
Q

What Form Name?

F-70

A

Fire Hydrant Test Record

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8
Q

What Form Name?

FG-79

A

Notice of Commendation (Form on NSS)

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9
Q

What Form Name?

FG-84B

A

Witness Card

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10
Q

What Form Name?

F-86

A

Humanitarian Member Visitation

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11
Q

What Form Name?

FG-88

A

Automobile Accident Report

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12
Q

What Form Name?

F-95

A

Fire Hydrant Record

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13
Q

What Form Name?

F-100

A

What is Your Suggestion?

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14
Q

What Form Name?

F-101

A

Emergency Activity Record/Personnel

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15
Q

What Form Name?

F-101MULTI

A

Emergency Activity Record/Operations

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16
Q

What Form Name?

F-121

A

Hose Inventory Record

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17
Q

What Form Name?

F-128

A

Hose and Salvage Cover Record

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18
Q

What Form Name?

F-129

A

Annual Hose Test Record

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19
Q

What Form Name?

F-150

A

Accident Report

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20
Q

What Form Name?

F-215

A

Equipment Loan Receipt

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21
Q

What Form Name?

F-226A

A

Report of Informal Grievance Discussion

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22
Q

What Form Name?

F-226B

A

Formal Statement of Grievance

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23
Q

What Form Name?

F-226C

A

Grievance Reply

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24
Q

What Form Name?

F-392

A

Monthly Gasoline and Diesel Fuel Report

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25
Q

What Form Name?

F-666

A

Resource and Situation Status Record

(This is a two-sided form. One side is for multi-story incidents such as high-rise or ship incidents, the other side is for brush or one-story type incidents.)

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26
Q

What Form Name?

F-666W

A

Wildland Resource and Situation Status Record

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27
Q

What Form Name?

F-1106

A

Change of Status

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28
Q

What Form Name?

F-1109A

A

Waiver of Claims for Damages

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29
Q

What Form Name?

F-1109B

A

Indemnity Agreement

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30
Q

What Form Name?

F-1120

A

Notice of Intention to Apply for Service Pension

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31
Q

What Form Name?

F-1150

A

Outside Employment Activity Report

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32
Q

What Form Name?

F-351

A

Time Record Work Sheet

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33
Q

What Form Name?

F-351C

A

Time Record Worksheet FLSA Record

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34
Q

What Form Name?

F-96ML

A

Military Leave Timeoff/Compensation Form

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35
Q

What Form Name?

F-1104

A

Notice to Improve Performance

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36
Q

What Form Name?

F-1105

A

Reprimand

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37
Q

What Form Name?

F-1122

A

Performance Evaluation - Uniformed Personnel

38
Q

What Form Name?

F-1132

A

Performance Evaluation - Officer

39
Q

What Form Name?

F-1142

A

Probationary FF 10-Shift Performance Evaluation Report (Form on ERS Application)

40
Q

What Form Name?

F-1142A

A

Probationary FF Daily Observation Report (Form on ERG Application)

41
Q

What Form Name?

F-1142C

A

Probationary FF Performance Log (Form on ERS Application)

42
Q

What Form Name?

F-377

A

Bi-Monthly Preventive Maintenance Record (Form on NSS)

43
Q

What Form Name?

F-380

A

Apparatus Yearly Mileage

44
Q

What Form Name?

F-702

A

Assignment Record

45
Q

What Form Name?

F-704

A

Apparatus Maintenance Record

46
Q

What Form Name?

F-705

A

Repair Record

47
Q

What Form Name?

F-709

A

Inventory of Equipment Firefighting

48
Q

What Form Name?

F-710

A

Tire Record

49
Q

What Form Name?

F-972

A

Daily Pre-Trip Inspection Record

50
Q

What Form Name?

F-973M

A

Monthly Apparatus and Equipment Check Record (Engine and Truck have separate forms)

51
Q

What Form Name?

F-973W

A

Weekly Apparatus and Equipment Check Record (Engine and Truck have separate form)

52
Q

What Form Name?

F-974

A

Reserve Apparatus Condition Inventory Record

53
Q

What Form Name?

F-975

A

Lifeline and Rescue Kit Inspection

54
Q

What Form Name?

F-976

A

Annual Ground Ladder Inspection Record

55
Q

What Form Name?

F-977

A

Bi-Monthly Apparatus Inspection Checklist

56
Q

What Form Name?

F-978A

A

Heavy Apparatus Undercarriage Inspection Checklist

57
Q

What Form Name?

F-978B

A

Heavy Apparatus Undercarriage Inspection Report

58
Q

What Form Name?

F-979

A

Self Contained Breathing Apparatus Inspection Checklist

59
Q

What Form Name?

F-63

A

Fire Prevention Summary (Form on NSS)

60
Q

What Form Name?

F-63A

A

Record of Fire Prevention Activities (Form on NSS)

61
Q

What Form Name?

F-290

A

Request for Legal Action

62
Q

What Form Name?

F-315

A

Special Permit

63
Q

What Form Name?

F-334

A

Complaint of Hazard

64
Q

What Form Name?

F-340 A,B,C

A

Fire/Life Safety Violation

(F-340C is blank to fill in items not listed in form A or B)

65
Q

What Form Name?

F-340D

A

Fire Protection Equipment Performance Certification (Chief’s Reg 4 Test)

66
Q

What Form Name?

F-340E

A

Fire/Life Safety Violation - Overcrowding

67
Q

What Form Name?

F-340FW

A

Fire Watch

68
Q

What Form Name?

F-341

A

Non-Compliance Reinspection Fee Form

69
Q

What Form Name?

F-903

A

Control Medication Inventory Record

70
Q

What Form Name?

F-1000

A

Injury Status Form

71
Q

What Form Name?

F-1000 MRSA

A

MRSA Injury Status Form

72
Q

What Form Name?

F-1001

A

NIOD/Family Illness Status Form

(Physician’s Work Status/Limitation Notification)

73
Q

What Form Name?

State DWC Form 1

A

Workers’ Compensation Claim Form

74
Q

What Form Name?

F-1107

A

Report of Injury Notification to Medical Liaison Unit

75
Q

What Form Name?

F-3

A

Hazardous Substance Exposure Report (Form on NSS)

76
Q

What Form Name?

F-420

A

Communicable Disease Exposure and Notification Report (Form on NSS)

77
Q

What Form Name?

F-166B

A

NIOD Injury or Illness Report for Uniform Personnel (aka Employer’s Report of Occupational Injury or Illness)

(Form on NSS)

78
Q

What Form Name?

Form 5020

A

Occupational Injury or Illness Report

79
Q

What Form Name?

F-620 Packet

A

Accident Procedure Packet

80
Q

What Form Name?

F-223

A

Red Letterhead (No Boxes) - Used for intradepartmental correspondence NOT “Through Channels”

81
Q

What Form Name?

F-225

A

Red Letterhead, Through Channels (with boxes) - Used for intradepartmental correspondence “Through Channels”

82
Q

What Form Name?

F-228

A

Black Letterhead - Used for correspondence to governmental agencies, organizations, business, general public etc., and for Letters of Appreciation and/or Invitation within the Dept. Also used for correspondence to elected City officials with the exception of joint communications.

83
Q

What Form Name?

Form Gen. 160

A

Inter-Departmental Correspondence - used to correspond with all other City departments. May also be used to correspond with City officials IF IT IS a joint COMMUNICATION from Fire Chief and head of one or more departments.

84
Q

What Form Name?

FG-16

A

Personal Expense Statement

85
Q

Form name and use?

F-666A?

F-666B?

A

RESOURCE AND SITUATION STATUS RECORD

F-666A is for use at multi-level incidents such as high-rise or ship fires.

The F-666B is for use at single-level incidents such as one-story structures or brush fires.

86
Q

Form Name and use?

F-666C

A

HAZARDOUS MATERIAL INCIDENT DATA SHEET

(used by the Incident Commander at Hazardous Material Incidents. Each emergency sedan is provided with four copies of the F-666C)

87
Q

Form Name and Use?

F-666E

A

MULTI-PATIENT INCIDENT WORKSHEET (MCI)

88
Q

Form Name?

F-3000

A

Supervisor’s Report of Employee’s Physical Characteristics/Behavior

89
Q

Form name?

F-3001

A

Order for Urine Sample

90
Q

Form Name?

F-3002

A

Employee’s Voluntary Urine Sample

91
Q

Form Name?

Cal/OSHA 300

A

Log of Work-Related Injuries and Illnesses

92
Q

Form name?

Cal/OSHA 300A

A

Annual Summary of Work-Related Injuries and Illnesses

Captain Sori-Tech Volumes (10 decks)

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