LOS ANGELES COUNTY - DEPARTMENT OF HEALTH SERVICES
Radio Days Communication Failure Report
 
Date of Incident : mm/dd/yyyy    Time of Incident : hh:mm    Sequence # :
 Agency :  Unit :
 
 Location Address :
 City :  Cross Streets :
 
 Base Hospital :
 Channel(s) Attempted :  Radio Type :
 Problem Transmitting :  Garbled Transmission :
 Problem Receiving :  Static :
 No Response :  Other(see below) :
 Problem Description :
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