SOUTHERN AFRICAN EMERGENCY SERVICES INSTITUTE NPC Registration No. 2014/162285/08. Interior Industrial Fire Brigade Member- NFPA 1081, 2007

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SOUTHERN AFRICAN EMERGENCY SERVICES INSTITUTE NPC Registration No. 2014/162285/08 Contact Details: Phone: 011-660 5672 Fax2Email: 086 544 0008 Fax: 011 660 1887 Email: info@saesi.com Website: www.saesi.com Addresses: No. 295 Jorissen Street Monument KRUGERSDORP, 1739 PO Box 613, KRUGERSDORP, 1740 APPLICATION: RECOGNITION OF PRIOR LEARNING ACC 125 Interior Industrial Fire Brigade Member- NFPA 1081, 2007 First Name/s: Surname: ID Number: Employer: Postal Address: (Where result and certificate/s should be sent) Tel No: Cell No: Age: Postal Code: Fax No: Membership No. PURPOSE: The purpose of this procedure is to assess your academical qualification in combination with your experience to determine if Quality Assurance for the Interior Industrial Fire Brigade Member qualification is appropriate. Any person with an Industrial Fire Brigade Qualification or equivalent (Portfolio of evidence) and 18 months Fire or Rescue Department service and an acceptable CV of appropriate experience can apply. 1

PROCEDURE: - Submit a certified copy of training attended which satisfy the requirements of NFPA 1081, chapter 7. - Submit a certified copy of the course content and curriculum of course attended - The decision of the Quality Assurance Committee will be final. - After evaluation of the application, the applicant will be informed in writing of the outcome of the assessment and of what will be required for full Quality Assurance, if applicable. - If an application is made with any other qualification, not presented by SAESI, the curriculum of the qualification and Portfolio of Evidence of the student should be included. - Application with regards to experience should be completed on annexure A & B. (No other CV will be accepted) - Proof of Payment MUST ACCOMPANY application Experience/ history. Date 1 st appointed in the Fire Dept. Highest Fire Qualification (Now) Position held.(now) Designation (Now) (Ops/Training/Admin Etc.) Duration From: to: The application and proof should be marked "Quality Assurance Committee" and submitted to: SAESI P.O. Box 613 KRUGERSDORP 1740 Fax: 011 660 1887 Fax2Mail: 086 544 0008 Email: info@saesi.com An administrative fee of R135.00 for members and R265.00 for non-members for each RPL application will be payable to SAESI before evaluation of the application. Proof of the payment should accompany the application. The administration fee DOES NOT INCLUDE Certification/Seal fee. Direct deposits can be made to: The Southern African Emergency Services Institute. (SAESI) Bank: ABSA Account number: 310 810 045 Branch Krugersdorp 632005 or the SAESI Branch Account to which you belong. 2

ANNEXURE A Employing Service (Where you have worked/are working) Position/Rank (Held or are holding) From Date To Primary Functions (What you were / are doing) ANNEXURE: B C.V. - Interior Industrial Fire Brigade Member, NFPA 1081, 2007 Standard for Industrial Fire Brigade Member Professional Qualifications This Annexure B should accompany your application for Quality Assurance on the grounds of Recognition of Prior Learning for Interior Industrial Fire Brigade Member [Form: ACC 125]. Briefly describe your Roll as Interior Industrial Fire Brigade Member in the following activities. Use all the headings listed below in your CV. The purpose of this is to be able to have a realistic impression of your experience to be able to assess your application fairly. If you attended any courses related to the Criteria described in the CV, copies of the certificates can be attached. This CV is required in addition to a certified copy of your Interior Industrial Fire Brigade Member Qualification or higher qualification. 3

Note: Please use additional paper if the space provided is not adequate. 1. General. Discuss your roll in the using of thermal protective clothing during structural firefighting operations, so that the clothing is correctly donned, worn, and doffed, as per NFPA 1081, 7. 1.2.1 Discuss your roll in the use of SCBA and PASS device/s during interior firefighting operations, so that the SCBA and PASS device is correctly donned and activated, the equipment is correctly worn, controlled breathing techniques are used, emergency procedures are enacted if the SCBA fails, all low-air warnings are recognized, respiratory protection is not intentionally compromised, and hazardous areas are exited prior to air depletion, as per NFPA 1081, 7. 1.2.2 Discuss your roll in utilizing a pre-incident plan at an emergency incident, so that the industrial fire brigade member implements the pre-incident plan, as per NFPA 1081, 7. 1.2.3 2. Manual fire Suppression. Discuss your roll in attacking an interior structural fire operating as a member of a team at an emergency incident, so that team integrity is maintained, the handline is deployed for advancement, access is gained into the fire area, correct application practices are used, the fire is approached safely, attack techniques facilitate suppression given the level of the fire, hidden fires are located and controlled, the correct body posture is maintained, hazards are avoided or managed, and the fire is brought under control, as per NFPA 1081, 7.2.1 4

Discuss your roll in forcing entry into a structure at an emergency incident, given personal protective equipment, tools, and an assignment, so that the tools are used, the barrier is removed, and the opening is in a safe condition and ready for entry, as per NFPA 1081, 7.2.2 Discuss your roll in performing ventilation on a structure operating as a member of team at an emergency incident, so that a sufficient opening is created, all ventilating barriers are removed, structural integrity is not compromised, and products of combustion are released from the structure, as per NFPA 1081, 7.2.3 Discuss your roll in overhauling a fire scene, given personal protective equipment, attack line, hand tools, a flashlight, and an assignment, so that structural integrity is not compromised, all hidden fires are discovered, fire cause evidence is preserved, and the fire is extinguished, as per NFPA 1081, 7.2.4 Discuss your roll in exiting a hazardous area as a team at an emergency incident during vision-obscured conditions, so that a safe haven is found before exhausting the air supply, others are not endangered, and the team integrity is maintained, as per NFPA 1081, 7.2.5 Discuss your role in establishing a water supply for fire-fighting operations at an emergency incident, so that a water supply is established and maintained, as per NFPA 1081, 7.2.6 5

Discuss your roll in the interface with outside mutual aid organizations, so that a unified command is established and maintained, as per NFPA 1081, 7.2.7 Discuss your roll in conducting search and rescue operations as a member of a team at an emergency incident, given an assignment, obscured vision conditions, personal protective equipment, a flashlight, forcible entry tools, handlines, and ladders when necessary, so that all equipment is correctly used, all assigned areas are searched, all victims are located and removed, team integrity is maintained, and team members safety, including respiratory protection, is not compromised, as per NFPA 1081, 7.2.8 Discuss your roll in conserving property operating as a member of a team at an emergency incident, so that exposed property and the environment are protected from further damage, as per NFPA 1081, 7.2.9 Discuss your roll in operating as member of a rapid intervention crew at an emergency incident, so that strategies to effectively rescue the brigade member(s) are identified and implemented; hazard warning systems are established and understood by all participating personnel; incident-specific personal protective equipment is identified, provided, and utilized; physical hazards are identified; and confinement, containment, and avoidance measures are discussed, as per NFPA 1081, 7.2.10 3. Site-Specific Requirements. Discuss your roll interpreting alarm conditions, given an alarm signaling system, a procedure, and an assignment, so that the alarm condition is correctly interpreted and a response is initiated in, as per NFPA 1081, 7.3.1 6

Discuss your roll in activate a fixed fire protection system at an emergency incident, so that the procedures are followed and the system operates, as per NFPA 1081, 7.3.2 Discuss your roll in, utilizing master stream appliances at an emergency incident, so that the appliance is set up correctly and the agent is applied as assigned as per NFPA 1081, 7.3.3 Discuss your roll in extinguishing an ignitable liquid fire operating as a member of a team at an emergency incident, so that the correct type of foam concentrate is selected for the given fuel and conditions, a correctly proportioned foam stream is applied to the surface of the fuel to create and maintain a foam blanket, fire is extinguished, re-ignition is prevented, and team protection is maintain, as per NFPA 1081, 7.3.4 Discuss your roll in controlling a flammable gas fire operating as a member of a team at an emergency incident, so that team integrity is maintained, contents are identified, the flammable gas sources is controlled or isolated, hazardous conditions are recognized and acted upon, and team safety is maintained, as per NFPA 1081, 7.3.5 Discuss your roll in extinguishing a fire using special extinguishing agents other than foam operating as a member of a team at an emergency incident, so that fire is extinguished, re-ignition is prevented, and team protection is maintained, as per NFPA 1081, 7.3.6 7

Discuss your roll in utilizing tools and equipment assigned to the industrial fire brigade at an emergency incident, so that tools are selected and correctly used under adverse conditions in accordance with manufacturer s recommendations and the policies and procedures of the brigade, as per NFPA 1081, 7.3.7 Discuss your role in setting up and use portable ladders at an emergency incident, so that hazards are assessed, the ladder is stable, the angle is correct for climbing, extension ladders are extended to the correct height with the fly locked, the top is placed against a reliable structural component, and the assignment is accomplished, as per NFPA 1081, 7.3.8 Discuss your roll in interfacing with outside mutual aid organizations at an emergency incident, so that a unified command is established and maintained, as per NFPA 1081, 7.3.9 Discuss your roll in perform a fire safety survey in a facility, so that fire and life safety hazards are identified, recommendations for their correction are made, and unresolved issues are referred to the proper authority., as per NFPA 1081, 7.3.10 8

Declaration of Applicant & Management Representative/s I, (initials and surname of applicant) hereby confirm that the information is true and that I will accept the decision of the Quality Assurance Committee with regards to my application. Sign: Date =================== I, in my capacity as the Head of Training for hereby confirm that the above mentioned information, provided above is correct to the best of my knowledge. Sign: Date (Head of Training) =================== I, in my capacity as the Head of Organization / Department / Section herby confirm that the above mentioned information, provided above is correct to the best of my knowledge. Sign: (Head of Organization / Department / Section) =================== 9