Location/Address:  City:  Zip:  Incident Number:  Date:  Time:  Type of Occupancy:  Number of Stories:  Story of Origin:  Room of Origin:  Length of Room:  Width of Room:  Square Footage of Room:  Number of Sprinkler Heads in Room:  Number of Sprinkler Heads Activated:  Type of Sprinkler Heads Activated: Select Pendant Upright Concealed Sidewall Open Special Spray Select Standard Quick Response ESFR Extended Coverage Unknown Other Notes Reason For Activation: Select Fire Vandalism Broken Head Unknown Other Notes Smoke Detector Present: Select Yes No Smoke Detector Activation: Select Yes No Unknown Damage Structure: $ Contents: $ Estimated Money Saved: $ Estimated Number of Lives Saved:  System Put Back In Service: Select Yes No Name and Rank/Title of Person Providing Information: