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Form 1 7.2A Revised August 2021 <br /> FIRE INCIDENT INFORMATION <br /> Incident Date Incident Number Police Incident Number <br /> June 7,2023 2023-00015078 N/A <br /> Incident Address <br /> 2039 Robins Ln SE <br /> City State Zip Code <br /> Salem Oregon 97302 <br /> Incident Type Estimated Dollar Loss <br /> Residential Structure Fire 5200,000 <br /> Shift Incident Commander <br /> A-Shift Battalion Chief Shawn Barnes <br /> Investigation Dale Investigator Dispatch Time Investigator Arrival Time Investigator Clear Time <br /> June 7,2023 2112 hours 2158 hours 2312 hours <br /> lead Investigator Assisting Investigator <br /> Deputy Fire Marshal,Justin Guinan,IAAI-FIT N/A <br /> Consent to Search Signed By Whom <br /> No—Pursuant to fire suppression N/A <br /> Other Agency Involved Name Incident Number <br /> N/A N/A N/A <br /> WEATHER INFORMATION <br /> General Conditions <br /> Fair-56%Humidity <br /> Temperature Wnd Direction Wind Speed <br /> 68°F SW 9 MPH <br /> FIREFIGHTING OPERATIONS <br /> Mode of Operation/Location of Suppression <br /> 1 ransitional—West side <br /> Method and Location of Ventilation <br /> Exterior—Positive,East door.Natural—Roof <br /> OWNER INFORMATION <br /> Name Date of Birth Gender <br /> Frank Norman Male <br /> Phone Number Email Address <br /> He could not recall Unknown at time of report <br /> Location at Time of Fire <br /> On the couch in the living room of the residence <br /> Comments <br /> I spoke with Mr.Norman on the night of the fire.Mr.Norman stated to me that he was lying on the couch with his dog just <br /> before the fire when he heard what he described as a"screeching"sound towards the back of the house.Mr.Norman got <br /> up and walked to his bedroom door at the back of the house on the structure's West side.He stated that he opened the <br /> door a couple of inches,and all he could see was fire.At this time,Mr.Norman closed the door and evacuated out of the <br /> front door. <br /> When asked if there were smoke detectors in the home,Mr.Nonnan noted that he could not think of any.When asked <br /> about smoking,Mr.Norman said he is a regular smoker.I asked him where he smokes and how he disposes of his <br /> cigarette materials.He told me that he smokes on the front porch and the porch outside of his bedroom on the back of the <br /> house.Mr. Norman took a while to try and recollect how he disposed of his cigarettes;he stated that he believes that he <br /> puts them all in jars and buckets. <br /> STRUCTURE INFORMATION <br /> Fixed Property Use/Oocupancy Type - Complex Name <br /> Single-Family Residential Structure—R3 Lake Terrace Mobile Home Park <br /> Total Square Feet Construction Type <br /> Approximately 1,900 ft2 V-B per OSSC 2019 Edition <br /> Investigator: Date: Incident Number: <br /> Page 2 of 8 <br /> Justin Guinan,DFM IAAI-FIT July 111e,2023 2023-00015078 <br />