HomeMy WebLinkAbout106.069 - FD-69, Employee Issuance-Clearance Form
ADMINISTRATIVE MANUAL
FORMS
106.069 EMPLOYEE ISSUANCE / CLEARANCE FORM
(FD-69)
EFFECTIVE: APRIL 2007
Current Revision Date: 12-18-18 Next Revision Date: 12-18-22
Author’s Name/Rank: Bradley J Dandridge, Captain Review Level: 1
PURPOSE
Establish responsibilities and procedures regarding the tracking of items issued to
members and returned upon separation from the Fresno Fire Department (FFD or
Department).
APPLICATION
Completed by all members of FFD at issuance of items and at the time of separation
from the Department.
OPERATIONAL POLICY
Supervisors shall complete at time of issuance of items. A Battalion Chief,
supervisor, or senior storeskeeper is responsible for completing the form at the time
of member’s separation from the Department. Route completed form to the
Personnel Division for placement in the member’s personnel file.
OPERATIONAL GUIDELINE
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PROCESS
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INFORMATION
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Section 106.069
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DEFINITIONS
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CROSS REFERENCES
No cross references recognized.
Section 106.069
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FD-69
FRESNO FIRE DEPARTMENT
Employee Issuance / Clearance Form
NAME:
EMPLOYEE ID No.: RANK:
DATE OF HIRE: SEPARATION DATE:
Item Date
Issued Signature Issued By Date
Returned Signature Received
By
Helmet
Helmet Shield
(2) Turnout Coats
(2) Turnout Pants
Suspenders
Structure Boots
Structure Gloves
Nomex Hood
SCBA Facepiece
Wildland Helmet
Brush Suit Coat
Brush Suit Pants
Station Boots
Wildland Gloves
Blue Bag
Ear Protectors
Eye Protection
Hose Strap
Keys – C8 and Fuel
Section 106.069
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Item Date
Issued Signature Issued By Date
Returned Signature Received
By
Rules and Regulations
Book
*Uniform Badge
*Cap Badge
Identification Card
Airport Badge (if
applicable)
Plastic Name Tag
Metal Name Tag
Passports
iPad
iPad Charger
Radio
Radio Belt Clip
Other
* Member may keep, if desired.
Section 106.069
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