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2. Date of Submission*
   Date of Submission
3. Person Submitting the Issue*
5. Select the Specific Category of the Issue

   1. Station Alerting
   2. AVL or CAD Recommendations
   3. EVP
   4. Dispatcher Related Issue
   5. Request a CAD Alert
   6. Radios
7. Station Involved*

   1. Station 1
   2. Station 2
   3. Station 3
   4. Station 4
   5. Station 5
   6. Station 6
   7. Station 7
8. Areas of the Station Involved*

   1. Apparatus Floor
   2. Bunk Room
   3. Day Room
   4. Kitchen
   5. Workout Room
   6. Entire Station
   7. Miscellaneous
9. Does the Issue Involve a Specific Item(s)?*

   1. Audio
   2. Signal Boards
   3. Light Indicators
   4. Bunk Room LED Lighting
   5. Toning Issue
   6. Other
11. Description of the issue(s) being submitted, please be specific*
13. CAD Number - this is different than the Run # and is located on the bottom right of the screen in RMS*
14. Run Number*
15. Date of Issue*
    Date of Issue
17. Description of the issue(s) being submitted, please be specific*
19. Apparatus ID*

    1. A1
    2. A2
    3. A4
    4. A5
    5. A6
    6. A7
    7. Q1

    1. Q2
    2. E3
    3. E4
    4. E5
    5. E6
    6. T7
    7. BC1

    1. BC2
    2. BT7
    3. 100
    4. 101
    5. 102
    6. TRT Squad
    7. Dive 2
21. Intersection or Location of Issue and Direction of Travel*
23. Was Issue Verified a Second Time before Submitting this Form*

    1. Yes
    2. No
25. Description of the issue(s) being submitted, please be specific*
27. Run Number (If Applicable)
28. Date of Issue*
    Date of Issue
30. Description of the issue(s) being submitted, please be specific*
32. Address or Location
34. Select issue:*

    1. Station Base Radio
    2. Portable Radio
    3. Vehicle Mobile Radio
    4. Battery
    5. Microphone
    6. Radio case / holster
36. Description of the issue(s) being submitted, please be specific*
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field