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Muscatine Fire Department Fire/EMS Standby Request
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Muscatine Fire Department Fire/EMS Standby Request
Today's Date
*
Date of Event
*
Start Time:
*
End Time:
*
Contact Person
*
Contact Phone and email
*
Location of Event
*
Reason for EMS/Fire Standby
*
Is Fire/EMS Standby Required for your Event to Function?
*
Yes
No
Staffing Requested
*
Engine with 3
Ambulance with 2
EMS ATV with 1
Please list if you are a non profit or governmental agency
*
Approve/Deny Officer:_________________________________Date:_____________________
Decision provided to contact:____________________________________
* indicates required fields.
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