DATE OES ENGINE # TYPE OF INVENTORY: (Check One ) STATE OF CALIFORNIA - GOVERNOR ' S OFFICE OF EMERGENCY SERVICES Fire and Rescue Branch FIRE APPARATUS INVENTORY AND RECORD CONVERSION WORKSHEET - OES ENGINE S 253 - 256 y ANNUAL TRANSFER: ASSIGNED DEPARTMENT ^ CA EXEMPT LICENSE # [ J FIRE : FIRE NAME: HOME REGION HOME LOCATION MILEAGE STRIKE TEAM #: HOME OPERATIONAL AREA SHORT # ISSUED # / ACTUAL # ISSUED # / ACTUAL # 2 / . SHORT # SHORT n ISSUED # / ACTUAL # 1 / ACCOUNTABLE PROPERTY & EQUIPMENT Passenger Side , Rear Compartment , cont 96 Chainsaw Kit ( see “ Tool Info Sheet " ) ACCOUNTABLE PROPERTY & EQUIPMENT Engineer ' s Compartment, cont . 51 Wrench , Wildland Spanner (1 * to 1 ' A ' Forestry ) Rope, 1/ 2 ” x 50 ’ , Utility in bag ACCOUNTABLE PROPERTY & EQUIPMENT Apparatus Cab 1 Radio , Mobile Serial # OES # DGS # 2 Radio , Handheld Serial # OES # DGS # 3 First Aid Kit ( DOT ) 4 Intercom Headset MI 100 101 Flotopump Serial # OES # 102 52 Wrench , Suction Hose Spanner 1 / 53 Wye , 214 " NH F x 2 - 1 Vf NH M 1 / 54 San Francisco Hydrant Adapler ( 3 ~ F x 2 W M) 1 / Driver' s Side , Compartment Above Rear Tires 55 Caribiner , Locking " D " , 11 mm 12 / 56 Edge Protection 2 / 58 Ffiction Device , Fig. 8 & Breaker Bar 1 ea / 59 Harness , Body , Commercial 21 1 / 1 / 1 / 4 / 5 Log Book , w / Credit Card 1 / 6 Hand Lantern , 12 - Volt 1 / Compartment , Cross -Thru w/ Slide Tool Tray 7 Axe , Pick Head 1 / 8 Axe , Flat Head 1 / 9 Chain , 25 ’ Tow w / Grab Hooks 1 / 10 Clamp , Hebert Hose 1 / 11 Bar , Claw , Wrecking , 3 ‘ 21 12 Bar , Pinch Point , 60 ' 13 Cutter , Bolt, 30 " 14 Extinguisher . 5 # A : B : C 4 / 1 / 1 / 15 Hammer , 3 - 4 lb. Sledge, Short 21 16 Hammer , 8 - 10 lb . Sledge 21 17 Hose , 5 " x 12 ’ Soft Suction 1 / 18 Jack , 8 - ton Hydraulic w / Handle 21 19 McLeod 20 Picket , Steel , 1 " x 4 1 / 6 / 21 Pulaski 1 / 22 Triangle Reflector Set 1 / 23 Shovel , Round Point , Long Handle 1 / 24 Shovel , Square Point , Long Handle 1 / 25 Strainer , 5 " Suction 1 / 26 Wrench . Hose Spanner ( i w to 21 / 2 * ) 4 / 27 Wrench , Adjustable Hydrant 21 Engineer ’ s Compartment 28 Adapter, 5 " x 2 DF , Hydrant 1 / 29 Adapter , 5 ” x 4 " , DF , Hydrant 1 / 30 Adapter , 5 " x 4 V / , DF , Hydrant 1 / . 34 Coupling, 2 Vi Double Female 35 Coupling, 2 Vz Double Male 37 Increaser , 1 " NPSH F x 1 NH M 1 / 38 Mallet , Rubber 1 / I 60 Litter Pre - Rig 1 / 63 Prusik Loop / Gibbs Ascender 6 / 64 Pulley , Rescue , 2 " / 4 " 3 / 65 Rope , Kernmantle , W x 150 ’ 21 66 Webbing Kit ( See “ Tool Info Sheet" ) Driver ' s Side , Rear Compartment 1 / . 67 Can . Fuel ( for generator) 1 / 68 Generator 1 / Serial # OES # Rear Compartment , Lower 69 Belt , Carpenter 21 70 Blade , Hacksaw , Package 3 / 71 Chisel, Cold , 1 " x 77/ 8 " 21 73 Hacksaw 21 74 Handsaw , Crosscut , 26 " 2 / 75 Hammer , 24 oz . Framini 2 / 79 Marking Kit , Building ( See ‘ Tool info Sheet ’ ) | 1 / 80 Nails @ 25 lb. ea , 16d , 8d , & 16d dpi 81 Shovel , Scoop w / UD " Handle 82 Square , TriorS | 84 Tape Measure , 25 ’ 85 86 Tape , Duct Rear Compartment , Upper 88 Backboard 89 Ladder , 10 ’ Attic 90 Ladder , 14 ’ Roof 91 Ladder , 24 ’ Extension 92 Pike Pole , 10 ’ Passenger Side , Rear Compartment 94 Can ( s ), Fuel ( Chainsaw & Flotopump) 103 104 Passenger Side, Compartment Above Rear Tires 105 106 Blanket, Disposable 21 . 107 Litter Cover (if not in use ) 1 / 108 Trauma Kit 1 / Passenger Side , Compartment Ahead of Rear Tires 109 Thermo Gel Concentrate , 5 gallons 2 / 110 Thermo Gel Backpack 1 / . 111 Thermo Gel Nozzle / Eductor / Hose 1 / 112 Thermo Gel Pick- Up Tube 1 / 113 Mount , Ground Deluge 1 / . Hosebed and Reel Line Area 115 Crbbing & Wedge Kit ( See ‘ Tool info Sheep n 116 Hose , 1 " NPSHx 50 ’ Wildland 8 / 117 Hose, 1 % " NHx 100 ’ Wildland 8 / 118 Hose , 1 V { NH x 50 ' Structural 12 / 119 Hose . 2 1 /2 " NH x 50 ' Structural 24 / 120 Hose , Booster , 1 " NPSH x 150 ’ 1 / 121 Litter , Stokes Basket 1 / 122 Deluge Monitor 1 / 123 Stream Straightener 1 / 124 Nozzles, Deluge ( 13f - 1 y / - 2 " ) 1 / 125 Nozzle , Deluge, 350 - 500 GPM Apparatus Exterior 1 / 126 Cap , 2 V / Discharge 5 / . 127 Chock Block 128 Hose, Hard Suction , 5 " x 10 ’ 129 Hose . 2 1 /2 " x 12 ’ Soft Suction 21 . 21 . 1 / 130 Plug , 21 / a " Suction Front Bumper 2 / 131 Hose , 1 x 35 ’ Truck Protection 1 L 132 Nozzle , 1 K " , Combo ( Wildland) 1 / NOTE : CELL SHADING indicates a DIFFERENCE in the items assigned to this engine vs. those on OES E314 - E359 . It may be the number of items or the configuration of the items . Note any equipment damage below : 21 21 21 1 / 39 Nozzle , 1 " NPSH Combo Wildland 40 Nozzle , 1 Vi Combo Structural 41 Nozzle , 1 Vi NH Combo Wildland 42 Nozzle , 1 Vi Foam , Air Aspirating 1 / . 21 43 Nozzle , 2 Vi Shutoff w / Fog tip 44 Nozzle , 2 Vi Shutoff w / 3 tips 45 Reducer , 1 NH F x 1 * NPSH M 1 / Recap All OES -Owned Special Equipment Carried: 46 Reducer . 2 W F x 1 Vi M 1 / 133 Lug wrench w / bars 1 / 47 Siamese , 2 Vi M x 2-2 % 9 F 1 / 134 Manuals : Engine , Chassis 1 ea ./ 48 Strap, Hose & Ladder 4 / 95 Chainsaw w/ 24" bar 1 / . Transmission , and Pump 49 Clamp, Wildland Hose 21 Serial # 135 Straps , Pickoff 21 50 Tee , Wildland Hose , 1 Vi NH x 1 “ NPSH CORRECT PER ACTUAL COUNT 3 / SIGNED : ASSIGNEE REPRESENTATIVE DISTRIBUTION: Original : OES . Sacramento TITLE: OES # 136 Cord , Electrical 21 . SIGNED : TITLE : OFFICE OF EMERGENCY SERVICES . FIRE & RESCUE BRANCH REPRESENTATIVE Yellow Copy : OES Field Assistant Chief Pink Copy : Assignee FORM F-157 A ( Revised 12 / 22/10 )