Abstract: On July 30, 2012 Employee, #1, a 49-year-old male firefighter with Contra Costa County Fire Protection District, was a member of a three man crew that was extinguishing a fire that was located up a steep hill. Employee #1 stated that it was difficult to ascend the hill with his fire hose. Employee #1 stated that he had to exert lot of energy to go up the hill to the location of the fire. The supervisor of the crew noticed that Employee #1 was having trouble and assisted him in pulling his fire hose up the hill. After approximately ten-minutes fighting the fire, Employee #1 told his supervisor that he needed to "take a knee." Employee #1 went and sat under a tree away from the fire. After approximately ten-minutes, the supervisor asked a coworker to check on Employee #1. Employee #1 appeared to be very ill; his condition was not getting better. The supervisor summoned Emergency Medical Services, and Employee #1 was hospitalized for heat illness/exhaustion. Water was available in the Fire House and in the Fire Truck. Employee #1 was wearing a Camelbak Hydration Pack at the time of the incident. Employee #1 stated that he only remembered drinking about two 16-ounce bottles of water that morning. Employee #1 was fighting the fire between 2:00 p.m. and 4:00 p.m. that afternoon. Drinking a small amount of water coupled with the heat from the fire and an outside air temperature of ninety-four-degrees Fahrenheit and his protective gear probably were factors in this event.