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Incident Report – 12/16/2021
1111 Samuelson Rd, Rockford, IL 61109

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Summary

On December 16, 2021, Rockford Fire Department responded to an EMS call at 1111 Samuelson Rd, Rockford, IL 61109, a manufacturing/processing facility.

The alarm was received at 8:48 PM, 4 suppression and 2 EMS personnel arrived at 8:54 PM, and the last unit was cleared at 9:16 PM. The time to arrive was 6 minutes and the total incident time was 28 minutes.

The following actions were taken during the incident: provide basic life support (BLS), provide advanced life support (ALS), and transport person.

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Location

Type Street address
Address 1111 Samuelson Rd, Rockford, IL 61109
County Winnebago County
State IL
City ROCKFORD
Zip Code 61109
Property Use Manufacturing, processing

Timeline

  • Alarm

    Alarm received at

  • Arrived

    Arrived at

    Alarm to arrival: 6 minutes

  • Last Unit Cleared

    Last unit cleared at

    Alarm to last unit cleared: 28 minutes

Response

Incident Type EMS call, excluding vehicle accident with injury
Department Station 007
Mutual Aid Given/Received None
Resources Include Mutual Aid No
Alarms 1
District 002

Personnel

Support Personnel 4
EMS Personnel 2
Other Personnel 0

Fire Department

Name Rockford Fire Department
Department Type Career
Address 204 S 1ST St
Rockford, IL 61104
Phone (779) 500-6501
Website https://rockfordil.gov/city-departments/fire/

Actions Taken

First Action Taken Provide basic life support (BLS)
Second Action Taken Provide advanced life support (ALS)
Third Action Taken Transport person

Metadata

Incident Key IL_WJ111_12162021_0030108_0
State Illinois
Fire Department ID WJ111
Incident Date 12/16/2021
Incident Number 0030108
Exposure Number 0
NFIRS Version 5.0
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