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DOCUMENTS WORTH READING
Common Errors, 1919 The Western Firefighters' Manual, 1919 lists the common errors in firefighting in 1919. Sounds surprisingly like today. Submitted by WP on 06/09/00. Referred to by DF on 02/07/03.
1993 SoCal Wildfire Siege AAR, a 94 page pdf file.
1957 Fire Task Force Report to the Chief Report of Task Force to Recommend Action to Reduce the Chances of Men Being Killed by Burning While Fighting Fire.
1977 Fatal and Near-Fatal Forest Fires: The Common Denominators Carl Wilson's classic 1977 paper.
Tony Petrilli's witness statement from the South Canyon Fire report (small 96 K pdf file) Tony Petrilli's witness statement from the South Canyon Fire report. May be used as pre-course reading (along with the IRPG) for S-130/190 classes.
Stand Down for Safety '94 Following the 1994 deaths on Storm King Mountain, firefighters were stood down. These are the things they thought about while they reflected on safety.
Firefighter Safety Awareness Study, Phase 1 A study resulting from the losses at South Canyon / Storm King in 1994.
A three part study to identify the organizational culture, leadership, human factors, and other issues impacting firefighter safety and to set and implement goals for improving safety. Part III, "Implementing Cultural Changes for Safety" is the roadmap for where we're going.
Firefighter Safety Awareness Study, Phase 2
Firefighter Safety Awareness Study, Phase 3
Firefighter Pay, 1998 Federal Firefighters Overtime Pay Reform Act of 1998.
Herger, 1998 Rep. Herger's testimony before the House Committee on Government Reform and Oversight Subcommittee on Civil Service, 1998.
Herger Again, 1998 CA Rep. Herger blasts USFS Region 5 Forest Service Conference 1998.
Lyle Shook, 1998 Quotes from Lyle Shook's retirement speech 11/98.
Dombeck 3/99 House Subcommittee on Appropriations for Interior and Related Agencies questions Dombeck policies.
Kentucky Fatalities, 1999 An insightful chronology regarding firefighters deaths in Kentucky, April 1999.
Recruitment Problems, 1999 A perspective regarding the difficulty of recruitment/retention of quality USFS employees, 04/99.
Sadler Entrapment Report Official report on the Sadler Fire fire shelter deployment, near Elko, Nevada, August 8, 1999 (pdf)
Dragon Tamers A paper on wildland firefighters from Tiny, The R5 Fire Pup, 04/05/00.
Ab Speaks, 2000 Original Abercrombie tells the story of how and when and why theysaid began, 04/00.
Kates Basin Report The Report of the fatal burnover on the Kate's Basin fire in Wyoming, 08/11/00.
Putnam on Human Factors "Fire Safety Up in Smoke" from the father of Human Factors Effects in Wildland Firefighting.
Thomas Addresses Congress, 2000 Jack Ward Thomas, Chief of the Forest Service, addresses Congress, 09/00.
Thomas Addresses Fire, 2000 Jack Ward Thomas, retired Chief of the Forest Service, addresses the Fire 2000 Conference in San Diego.
Cerro Grande Report pdf The Cerro Grande Investigative Report, 02/26/01, in pdf.
SenateCommittee 30-mi Investigation Senate Committee Thirtymile Fire Investigation, 09/26/01.
Brauneis' "Original Intent" Ten Standard Fire Orders, 2001 The logic in the way the Ten Fire Orders were originally conceived - as directions for engagement and disengagement of the fire... Authored by Karl Brauneis.
Crew Cohesion, Wildland Fire Transition, and Fatalities A paper that discusses the degree to which crew cohesion or lack thereof contributed the the 30mile tragedy, 03/07/02 in pdf.
American Indian Use of Fire in the Ecosystem A Bibliography, 2002.
Fire It Up, CDF Budget Issues, 2002 California's state budget has been cut drastically. This is a discussion of what shouldn't be cut in CDF Fire. Pay now or pay more later.
Daley Fire Disengagement, 2001 A description of timely and prudent action taken in the face of extreme fire behavior by meteorologist, dispatcher, and fire overhead to get firefighters to safety.
Pentagon Journal, Sept '01 Elizabeth Cavasso, member of CIIMT 3, went to provide support at the Pentagon following the terrorist attacks of 9/11. This is her journal. See also: the photos.
Final Thirtymile Investigation Report In pdf format, 106 pages. Photos here at wildlandfire.com.
Thirtymile Report Errata pdf file of changes made after the report was submitted by the Investigation team.
Thirtymile Legislation Hastings-Cantwell Bill, H. R. 3971, June 24.2002
Thirtymile Memorial Brochure A tribute to Tom, Karen, Devin and Jessica created for the opening of the Thirtymile Memorial at the one year anniversary of their deaths. In pdf format, 621 KB.
Lessons from the Thirtymile (training) Lesson suggestions from MTDC with accessible information including chronology, etc.
Thirtymile staff ride Thirtymile staff ride on the Fire Leadership website.
John Watt's Letter to the BRP on Aerial Firefighting, 2002 Following a number of air tanker accidents in 2001 and 2002, the Blue Ribbon Panel was convened to look into and make recommendations on how to deal with the aging air tanker fleet. John provided info to the panel and allowed us to post his letter. Here's the 60 page BRP Report itself (1.2MB pdf file). Other Docs Published in early Dec '02; [earlier from the AT Pilot's Board: Tony Kern on the Air Tanker Situation & John Watt's Reply]
Craig Goodell's "Better Way" Fire Orders, 2002 188K pdf Craig Goddell's dynamic way of thinking about the 10 Standard Fire Orders with description of how they apply to changing fire environment; also a discussion of the Situations that Shout Watchout that may be in conflict with some individual Orders. Take a look back at Brauneis' "Original Intent" Fire Orders above.
Guy Pence on Competitive Sourcing 03/03/03 Written to benefit the retention of the National Forest System, to keep professional land managers at all levels in the Forest Service, and to bring out the problems associated with competitive sourcing.
Dan Fiorito's Hotshots and Prescribed Fire 04/18/03 Tasking hotshots to tackle prescribed fire projects is too much to ask. This article was printed in Wildland Firefighter Magazine and is posted here at the request of the author.
 like the Swiss Cheese Model Hugh Carson on Accident Investigation 07/26/03 Specifically on a model like the "Swiss Cheese" Model of Accident Investigation (NB, Henry Reason's work stresses correcting the latent systemic holes in the Swiss Cheese; human factors, well you can work on those with training, but don't plan to avoid accidents at the last step)
like the Swiss Cheese Model The Human Factors Analysis and Classification System–HFACS, 2000 DOT, FAA, AM commissioned report (1242 K pdf) describes the logic behind the Swiss Cheese Model of accident causation and creates the HFACS. Report written by Scott Shappell and Doug Wiegmann, based on Reason's work on human error.
like the Swiss Cheese Accident Investigation Guide, 2003 USFS Accident Investigation Guide (3400 K pdf) contains aspects of the Swiss Cheese Model.
CDF Benefits, How and Why?  A commentary to remind us by "Another CDF BC"
Fire Behavior as it Relates to Firefighter Safety: Seven Key Points for Discussion  Discussion points presented by Martin Alexander, recipient of the 2003 International Award for Fire Safety.
Mission & Vision Statements - Revealing Firefighter Ethics Unless you know a wildland firefighter's ethics, how do you know their attitude toward safety? How do you gauge their situational awareness or understand how their leadership skills might come into play?
 Cramer Where Did All the ICs Go? An Opinion by Jeff Blackwood, following the Cramer Fire. 03/10/04
Fire Prediction using the Fire Signature Prediction Method - Focus on Cramer Hard questions from Mellie; Doug Campbell replies.
Another Way to Prevent a
Reoccurrence - Cramer

(link near the bottom of the page)
A powerpoint on solving the Cramer Fire Incident using Doug Campbell's Fire Signature Prediction Method. The Fire Signature Prediction method is a logical method for looking at current and expected fire behavior that allows groundpounders to determine safe firefighting tactics. Includes similarities between Cramer and South Canyon. 3/04. or download HERE
Comparing the deadly Cramer Fire and South Canyon Fires with the Dillon Fire (where all went home) (large ppt file 7 MB) Powerpoint demonstration of the Fire Signature Prediction method used with LCES. Compliments of Doug Campbell.
  • using wind, slope and solar preheat and recognizing when these Forces are In Alignment / Out of Alignment,
  • how to Time Tag a tactic,
  • set a Trigger Point, and
  • use Tracks on your map
  • in conjunction with LCES.

If you have trouble downloading this, do it early in the morning and/or find a broadband computer. Ab.

Why Agencies Should Support Their ICs An Opinion by SteveM on why the Federal Fire Agencies should support the Incident Commanders, 4/7/04, civil suits? ability to discipline their own? jury of your peers?
Similarities of Fatality Fires, Observations of Payne, 04/04 Some of the key similarities of three fatality fires: South Canyon, Thirtymile, and Cramer. Twenty firefighters lost their lives on these fires in the last decade. ppt is also available, check the site map under software.
Finger Pointing re AT Contract Cancellations With regard to the cancellation of 33 large AirTanker contracts following the NTSB Report by the Forest Service in May, 2004
Safety Protocol Review SoCal Fire Siege, 2003 A review of whether and how safety guidelines resulting from fatality fires (most recently the Cramer Fire) were followed in the SoCal Firestorm of 2003.

SoCal Firestorm 2003, Lessons Learned

From fuels, interagency cooperation, command and control, evacuation, work/rest, strategy and tactics. Interesting read. Formerly posted here
Drinking on Fires This topic comes up on theysaid rather routinely so we're including TC's points here for reference. Ab.
Docs on the Cramer Fatality Investigation, 2003 Posted at the Colorado Firecamp Website. FS and OSHA investigations, including the Management Evaluation Report, and the un-redacted Findings section and Appendix E from the Factual Report; the OSHA investigation citations and the USFS response. The OIG report is not available to the public.
Cramer: Legal Process Involving the OIG Investigation With Reference to the Cramer Fire Fatalities, 2003. Researched by Mellie.
Aftragstaktik, or Commander's Intent a paper A paper related to doctrinal change.
Nuttall Fire Shelter Deployment After Action Review (234 K pdf file) Coronado National Forest, 7/2/04 (pdf file) Also Nuttall Fire Shelter Fact Sheet (pdf file); Map of Deployment Site (pdf file); deployment review (2121 K pdf file). important for lessons learned
Waterfall Fire Staging Area Burnover '04 -Lessons Learned
(HUGE 9.833 MB pdf file)
72 hr report 7/14/04 (77K pdf file)
Lessons learned powerpoint is by Pete Anderson, NV State Forester-Firewarden, Carson City NV Burned engine 1 picture; Burned engine 2 picture; KOLO TV article (or hotlist)
Cramer: Implications Of the changing the accountability level in fatality incidents, by DC. Stimulated by discussion of the Cramer Incident. From 12/3/04 theysaid.
Cramer: Accountability and Legal Outfall From theysaid 12/2/04. A dissertation on responsibility and accountability on the Cramer Incident, the changing litigious scene and Agency Support, by Misery Whip.
Cramer: Human Factors, Large Organizations & Accountability From theysaid 12/13/04. An exposť by Misery Whip on the Cramer Incident. Two more docs along the same thread: Accountability 3 and Unreasonable Expectations
John Wendt On Fire Reflections on a FS Fire Career: What was expected in the beginning and What's expected now. Centralizing fire is one suggestion for dealing with the burgeoning expectations placed on fire managers that can make fighting fire unsafe. 12/04
Thoughts in Times of Change Thoughts on Cramer, the professional wildland firefighter, the rule-bound system of so-called accountability, commander's intent (a better way), and ...district rangers and forest supervisors more and more at risk for criminal negligence when fires kill people. Mellie et al. 12/13/04.
Aftragstaktik, also known as Commander's Intent Commander's Expressed Intent (mission type orders) to accomplish a task in the face of complexity and uncertainty. Some other good readings listed in the Leadership Toolbox.
Argument for a Professional Firefighter Series Why a clearly designated professional wildland firefighter series makes more sense than IFPM's Series 0401, and tech series 462 and 455. Dozer, 1/6/05.
Forest Service Fire Organization Unreasonable Expectations? A Systemic Organizational Problem that Impacts Safety? Mellie's review of forest structure and how it might impact firefighter safety, from theysaid 2/8/05.
Forest Service Fire Organization: Facts, Issues, Suggestions A Safer Option? Centralization of Fire within Forests by "Concerned for the Future", from theysaid 2/8/05.
HR-408 Wage Comparison Fact Sheet comparing existing fed firefighter pay with portal to portal pay.
Wildland Firefighter -
Formal Education
What academic courses a professional wildland firefighter might need. Does not fulfill the Biology 0401 Series requirement, from theysaid 3/7/05.
Legal Deep Survival In the face of too many expectations, too many checklists, and the FS failure to back up its employees, from theysaid 3/8/05.
Incompetence Incompetence & Self-Awareness of Competence, by "Competent, I think"... from theysaid, by SteveM, 3/14/05.
Fire Law Mike Johns' paper lays it out... (186 K pdf)
Fire Behavior vs. Human Behavior: Why the Lessons from Cramer Matter (755 K pdf file) Kelly Close's paper, presented at the IAWF Human Factors Conference, Missoula MT, 4/26/05. Adds insight and lessons learned.
20 Minutes at H-2 – Linear Decision Making in an Exponential Fire Environment Kelly Close paper, adds insight and lessons learned on the Cramer Fire. (3363 K pdf file; large, 14 pages)
Novato Fire Department Report on the Cedar Fatality 5900K very large pdf file. Came out May, 2004.
CDF Cedar Fire Fatality Report 2750K pdf file. Came out 5/24/05. Discussed on Theysaid starting 5/25/05. Cedar Fire MAP
Fire Suppression: Foundational Doctrine (in html) Results of the Pulaski Conference Doctrinal Review, June 2005. Here's the draft in pdf with photos Fire Suppression: Foundational Doctrine (huge 6,476 K pdf). Also, go here for a link to the FS streaming video of the process.
Tuolumne Fire Report (LARGE 5.95 MB pdf file, 183 pages) For easier pieces, the CDF site has broken it down. CDF Greensheet/72hr USFS Report plus Map 1, Map 2, Map 3
Executive Summary (5 pages)
CDF Site has broken the Tuolumne Fire Report down into parts for easier download.
Article from Fire Engineering (Note: based only on minimal information released.)
Potential Entrapment, Rivera Mesa Fire (doc file) June 18, 2006, Las Vegas, New Mexico, Santa Fe Interagency Hotshot Crew
Balls Canyon NearMiss, Peer Review (html file) June 27th, 2006, HumboldtToiyabe National Forest near Cold Springs, NV. This document is a Peer Review, which bridges the gap between After Action Reviews and Investigations. Discussion of the rationale for a Peer Review is presented in addition to review of the incident.
72 Hr Report Sawtooth Complex Entrapments, 3 Incidents July 11, 2006, Wildland Fire Entrapment, Minor Burn Injuries and Smoke Inhalation, Fire Engine Damage, Command Vehicle Damage; Southern CA; Joint investigation: BLM, San Bernardino Co Fire, CDF
Little Venus Entrapment, Peer Review (1,327 K pdf file) July 24, 2006, Shoshone National Forest in Wyoming.
New York Peak 72 Hour Report July 25, 2006 Eldorado Hotshots were hit by a firewhirl on the New York Peak Fire near Winnemucca NV. 3 were burned, 2 seriously.
New York Peak Factual Report (3076 K pdf file) 7/25/06, Eldorado IHC was hit by a firewhirl on the New York Peak Fire
Mudd Fire Deployment/Burnover August 26,2006, Wildland Fire Deployment, Elko, Nevada. Bakersfield BLM engine crew. 2 firefighters were burned over and burned.
What Was He Thinking?
Decision Making and Judging
137K doc file. Researched and written by Mike Johns, Assistant US Attorney and Senior Litigation Counsel and former wildland firefighter. This is a "brief summary of concerns about and solutions to inherent problems associated with decision making and judgment. This paper was prepared for the Serious Accident Investigation course." Discussed on theysaid 9/26/06.
Roadmap to a Just Culture
Enhancing the Safety Environment
546K pdf file. Please read the copyright information. This paper is prepared by: GAIN Working Group E, Flight Ops/ATC Ops Safety Information Sharing, September 2004. It was prepared by the worldwide aviation community to improve aviation safety, but the principles are relevant to safety in our wildland fire learning environment. Ab.
Map of Esperanza Site with Risks 10/26/06 Wind driven fire blows the flames into the fuel in front of the advancing line of fire. Spotfires introduce radiant heat in the fuel in advance of the line of fire. Under high fire danger conditions, the spot fires become can so numerous and preheating fuel so intense that the area seems to ignite all at once. This situation is one of these with the potential for area ignition. The burn pattern signature seems to indicate this is what happened. The fire and observations of the fire behavior are the ground truth. The fire models are ill equipped to account for all the variations in this scenario. Doug Campbell
Esperanza Green Sheet (559K doc)
Spread Map (1509 K pdf file)
Labeled Contour Map (665 K pdf file)
Site Map (82 K pdf file)
Site Map Detail (320 K pdf file)
72 hour report on the 5 burnover fatalities of Engine 57 on the Esperanza Fire, 10/26/06; also 24 hour Report: Esperanza Blue Sheet (91K pdf)
Free Ellreese.htm Theysaid posts relating to the criminal incitement of Ellreese Daniels, Incident Commander, for decisions and actions on the 30 Mile Fire.
30 Mile: Hindsight Bias & Conflicting Witness Statements Analysis by Misery Whip rebuts the contention that Ellreese was lying. December 31, 2006
2006 Fire Season – What Went Wrong and How Do We Learn From It? (3481K pdf file) pdf of a powerpoint keynote presentation delivered by Assistant U.S. Attorney Mike Johns at the Wildland Urban Interface Conference in Reno Feb, 2007.
30 Mile Charges 70 page pdf file Charges brought by the DOJ against Ellreese Daniels more than 5 years after the burnover and deaths on the 30mile fire.
Rod Altig on 30 Mile Criminal Prosecution 30 Mile Criminal Prosecution, an Agency Slippery Slope, January 7, 2007
R6 Chief Snell on Issues Re: 30 Mile Criminal Prosecution R6 FAM Chief Snell's White Paper on Issues surrounding 30 Mile Criminal Prosecution
IAWF Online Survey Results of 30 Mile Criminal Prosecution (removed from their server) in News Releases section. A survey of 3,362 firefighters (2/07) shows that 36% of the full-time wildland firefighters surveyed will make themselves less available to be assigned to wildland fires as a direct result of manslaughter charges filed recently against a firefighter in Washington state. [The next fire season 25-33% let their red cards lapse or did not take assignments.]
Esperanza Investigation Report (pdf files in downloadable pieces) At the CAL FIRE site.
Esperanza Action Plan (23k pdf file) The FS chief's response for what will be done to mitigate the findings of the Esperanza Report.
ESPERANZA FACTUAL REPORT ANALYSIS
September 10, 2007

Seltzner Perspective on Esperanza

Corrections and Clarifications made to the official Esperanza Investigation Report by firefighters that were on the ground. Report from firefighters on the ground.

 

A perspective worth reading.

What Was He Thinking? (4854K doc file) by Mike Johns, Assistant U.S. Attorney
The Human Factors Context to help in assessing the Esperanza Report; also important in decisions involving judgment.
Misery Whip's Critique of the Esperanza Report & Action Plan Thoughtful evaluation, taken from Theysaid discussion 6/6/07.
Rick Halsey on Fire Suppression, Science, and Richard Minnich. In response to a June 16,2007 San Bernardino County Sun news article "Forests Need to Burn". Rick is Director of the California Chaparral Institute.
Shari Downhill on The Media Good tips on what to expect and how to work with the Media.
Fed OSHA Report on Esperanza   Came out on 7/19/07 (290 K pdf file)
Q's Perspective on Forest Service 1.5 Years after Retirement I was recently asked my perspective of the Forest Service since my retirement a year and a half ago. Without being a “side line quarter-back,” what would I change? ... What Q thinks...
Cascade Complex Accident Prevention Analysis APA - Formerly called "Peer Review" (huge 8,241K pdf file); In the spirit of Lessons Learned.
Pie chart: Cause of death of Federal FF from 1990-2006 (3,927 K pdf file) from the NWCG Safety and Health Working Team: Federal Employees by Cause of Death 1990-2006 (73 employees) 29 or 39.7% died from burnover; Table of Data
Entire Document: Wildland Firefighter Fatalities in the United States: 1990–2006 (5838 K pdf file); A publication of the NWCG Safety and Health Working Team, PMS 841, August 2007
Research on Recruitment, Retention and Pay A problem in California and other Wildland Urban Interface areas with extremely high cost of living.
2008 Retention Draft 22 p. draft following a week long meeting of Fire Professionals,12/10/07; no action resulted...
R5 Module Configuration If R5 were staffed at levels budgeted by Congress, these are the resources we'd expect on each of the R5 Forests. R5 Forest Unit Identifiers
FWFSA Response to the FS Recruitment & Retention Analysis (112 K doc file); FS Recruitment & Retention Analysis was presented at the Senate Hearing on Appropriations on 4/1/08, Black Tuesday.
VIDEO: Doug Campbell using CPS on the '88 Fayette Fire (WY) Historical 1/2 hr footage showing the fireground logic of the Campbell Prediction System, now called the Fire Signature Prediction Method
Centralized Fire Organization & Firefighter Retention Exposť by "Never Forget Black Tuesday". Pertinent, meaty, a strong argument for reorganization, 5/24/08.
The Art of Wildland Firefighting (3425 K doc file download) by Doug Campbell and Bruce Schubert lays out the logic and vocabulary of Doug's "Campbell Prediction System" (also known as "The Fire Signature Prediction System"). This paper describes Doug's body of work, the only fire behavior training in which you can find a distillation of and a focus on the "old firefighting wisdom" of the past for groundpounders of the present. It's truly valuable training, a "force multiplier" for safety. Part science and part art, it provides terminology to communicate tactics based on what the fire is telling you, given wind, slope and solar preheating of fuels. USFS Trainer Will Spyrison's comments. Documentation of European training: EU Training Plan; Marc News; Countries using CPS; EU Grant
The AAR Process - Army (138 K ppt file) Major R. L. Kennedy (2002); The After Action Review Process: intent, key elements and the application of the process to training and operations; compare with Organizational Learning Tools and quick table: From AAR to SAI. The AAR focuses on what was done correctly, incorrectly, and how to do better next time around.
Australian Bushfire Management: a case study in wisdom versus folly The issues leading up to Black Saturday. (66 K pdf file) It is one person's view, Roger Underwood's, and was a talk that he recently delivered to the Stretton Group (of influential business leaders etc) in Melbourne. Underwood is a forester with 50 yr experience in bushfire management and bushfire science. He's worked as a firefighter, a district and regional manager, a research manager and senior government administrator. He is Chairman of The Bushfire Front, an independent professional group promoting best practice in bushfire management. Sent by Alan Thompson, New Zealand.
USFS Wildland Fire Risk Management 2009 (482 K pdf file) Based on data through 2008; graphs, charts, fatality and accident trends
The True Cost of Wildfire in the Western US (2864K pdf file, 17p) Western Forestry Leadership Coalition: examines the data from six large wildland fires across the west to explore beyond the costs of suppression to give a more accurate telling of the cost to communities and the environment form large wildland fires.
Comments on the FS Redesign From theysaid 6/19/09
Fire Behavior Tuneup for Structural Firefighters A review of Doug Campbell's method of wildland fire prediction (1/22/10) Nice...
Campbell Prediction System Language: Glossary of Terms (html version) For those who need a print copy, here is a very large (6,519 K doc file) download: Campbell Prediction System Language: Glossary of Terms. (please do not download unless you need it in print; has imbedded google language translation utility)
Doug says: "The use of the CPS language was to promote communication of fire behavior potential. A language promotes clear thinking and situational awareness. Describing a fire situation is an important safety factor. Without language thoughts and unease about situations on the fireline cannot be communicated. Practice describing fire scenes to gain experience using the language, or create some phrases of your own. Without some method of describing the changes in fire behavior safe practices are compromised." Doug Campbell, 2010
2010 Accident Prevention Analysis Guide (411 K pdf file) 5th edition (draft) of the APA guide. (Five Years of pushing Just Culture!)
CPS Prescribed Fire Book (711K pdf file) Doug's latest book on fire behavior and Rx.
Site Map There may be more documents, please see the Site Map.

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