FORMS INDEX

East Lake Tarpon Special Fire Control District

FORMS

updated 01/04/12

ADMINISTRATION

Advantica Reimbursement Form

Application for Employment

Application Interview Eval.

Appraisal - Executive Managerial
(Chief, Division/Deputy, DC)

Appraisal - Supervisory
(Lt's)

Appraisal - General Employee
(FF, DE, Office Manager, Financial Admin.)

Auto Accident Procedures

Bomb Threatening Call

Compensatory Time Sheet

Computer List Sign Out

Computer Problem Form

CPR Course Pre Registration

CPR Course Evaluation Form

Credit Card Purchases

Department Issued Equipment

Employee/Interview form

Employee Orientation Skills

Employee Right-to-Know Act

Exchange of Duty

Exchange of Duty (Acting Duty)

Firefighter Bill of Rights

Insurance Information & Release

Inter-Departmental Comm.

Leather Helmet Agreement

Local Traveling Expenses

Mutual of Omaha Beneficiary update form

Mutual Aid/Automatic Aid Reimb.

Notary Affidavit

Notice of Eligibility and Rights & Resp.

Overtime Pay Request

Permission Form to Ride on Vehicles

Personnel Maintenance Request (County 911)

Physical Agility Test

Quality Assurance letter

Receipt for Copies

Request for EMS run report

Request for Leave–Absence Rept (Admin)

Request for Leave–Absence Rept (Non-Admin)

Request for Records

Special Pay Time Sheet

Supervisor’s Check List

Third Party Billing

Threat Incident Report

Tour of Duty - What not to bring

Tour of Duty - Schedule

Tour of Duty - Permission Form

Training / Community Room Contract and Usage (Day Use)

Training / Community Room Contract and Usage (Evening Use)

Uniform Order form-Allways McCafferty’s

Uniform Order form – Image Depot

Uniform Order form – Misc

Waiver Employee Photos

APPARATUS

Accident/Damage Report

Accord Automobile Loss Notice

Accord General Liability Notice

Apparatus / Vehicle #s

Compartment of the Day

Daily Fire App Maint Cklst

Daily Non-Fire App Maint Cklst

DC 57 (543) Daily Veh. Inventory

E56 (529) Daily Vehicle Inventory

E57 (526) Daily Vehicle Inventory

E58 (528) Daily Vehicle Inventory

S57 (525) Daily Vehicle Inventory

W58 (548) Daily Vehicle Inventory

B58 (549) Daily Vehicle Inventory

Proposed Equipment Movement

Weekly Vehicle Maint

Monthly Vehicle Maint

Work Request Form

BUNKER GEAR

Bunker Gear Washing Log

Monthly P.P.E. Inspection

Surviveair Skills Checklist

EMS

Ambulance / Hospital Incident Report

BLS Hurricane Shelter Bag E56

Blue Respiratory Bag for E58(monthly)

Blue Respiratory Bag for E56 & S57(monthly)

Certification Requirement Checklist

Comm Disease Exp. Report

EMS County Supply Order form

Infection Control Exposure Report

Lifepak 1000 Defibrillator User's Checklist

Medications Expiring Next Month

Medication Inventory Sheet

Pediatric Bag Inventory (monthly)

Medical Box & Monitor (monthly)

Run Report Review

Spare Blue Respiratory Bag

Spare Medical Box

Staff Vehicle BLS Trauma Bag Inventory

Sunstar Medication Return Form

Trauma Box Inventory 57 + 58 (monthly)

Trauma Box Inventory 56 (monthly)

Waste Management Compliance Daily Checklist

FIRE PREVENTION

Fire Inspection for Occup. w/ Kitchen

Inspection Detail Report

Investigation Report

Monthly Extinguisher Log

Notice of Vacant Occupancy Sticker

Pinellas County Juvenile
Fire-Setters Coalition

Private Hydrant Letter

Public Hydrants Out Of Service

HOSE TESTING

1.75 Hose Chart

3 inch Hose Chart

5 inch Hose Chart

Hose Service Testing

NEW EMPLOYEE

General Safety Rules

OPERATIONS

Activity Report

Daily Training Report

Dispatching Errors

Rotation of New Employees

7.5 Minute Response Form

STATIONS

Air Filter Replacement Sched. 57

Cleaning Supplies Inventory

Monthly Maint. Support Services Cksht

Station Duties - Sta 57

Station Duties Sta 56 / 58

Supply Order form Non-Sani Chem

Supply Order form Sani Chem

TRAINING

Basic Company Evolution Eval. (1410) Drill

WORKERS COMP FORMS

Accident/Damage Report

First Report (DWC-1)

Line of Duty Injury Protocol

Infection Control Exposure Report

Injury Report

Post Exposure Protocol