Office Fire Permit

MOJAVE DESERT AIR QUALITY MANAGEMENT DISTRICT RULE 444 BURN PERMIT
THIS PERMIT IS VALID FOR THE MATERIALS LISTED BELOW AND WITHIN THE APPLE VALLEY FIRE PROTECTION DISTRICT ONLY ON “BURN DAYS”
PERMITTEE'S INFORMATION
Issued To:*

Full Name
Telephone:*
Email
Billing Address*
Street Address City State ZIP Code
Burn Location*

Street, Road, Cross Street or other description
BURN INFORMATION
BURN HOURS 6:00 AM TO 12:00 NOON
(TREE TRIMMINGS NO LARGER THAN 2” IN DIAMETER)
- Tumbleweeds
- Piled Trimming Waste/Brush
- Agricultural Burn
(TREE TRIMMINGS NO LARGER THAN 2” IN DIAMETER)
BURN HOURS FOR AGRICULTURAL BURN: 6:00AM TO ONE HOUR PRIOR TO SUNSET

An agricultural operation is growing crops or raising fowl or animals for profit, livelihood, or education (444(B)(2)). Name of crop type required (i.e. alfalfa)
Property Size:*

Acres
By checking this box you accept these rules*
I accept these rules
PERMIT EXPIRES: ONE YEAR FROM TODAY’S DATE

APPLICANT AGREES TO THE FOLLOWING CONDITIONS:
• Before burning call: 1-800-472-2376 or 909-356-3805 (Rule 444(C)(8-9) and (E)(2))
• All material must be piled/stacked in a maximum size of 5’ X 5’ in such a manner as to promote drying and insure combustion with a minimum of smoke. For minimum drying times see Rule 444(C)(6)(b)(i-v).
• Before ignition remove all trash, tires, oil filters, construction/demolition debris, plastics, rubber, motor vehicle bodies, tar, shop and household debris, etc., as provided in Rule 444 (C)(1) and (C)(6)(c).
• Permittee must not burn during very hot, dry periods when winds are strong enough that burning would be unsafe.
• The fire shall be attended at all times by a responsible person. Fire control tools, (shovel and water are required) must be on-site and available until the fire is completely extinguished. CFC 307.5
• All fires shall be confined within cleared firebreaks or barriers to prevent it from escaping control. If permittee allows a fire to escape, maybe found civilly or criminally negligent or in violation of the law, and held liable for All Fire Suppression Costs incurred by the Fire Department. (H&S Code §13009).
• Permittee shall conform to all conditions of this permit and all applicable local and state rules and regulations. (Rule 444(C)(7))
• Permittee shall curtail burning when informed by the issuing agency, or Air District, that such burning is causing, or contributing to the creation of, a public nuisance (H&S Code §41700).
• This permit must be in possession of the responsible person at the burn site during the burn.
• If all conditions on this permit are not met, this permit shall automatically terminate.

I own or legally control the above-described land and I agree to comply with all fire and air quality management laws, ordinances, regulations, and terms of the permit. I certify that I have read, understand and agree to comply with the conditions on this permit. The information on this permit is true to the best of my knowledge.
IMPORTANT GUIDELINES
BY INITIALING EACH BOX, YOU ARE ACKNOWLEDGING THAT YOU UNDERSTAND THE PARAMETERS OF THIS BURN PERMIT.
CFC 307.4: The location for open burning shall not be less than 50 feet from any structure, and provisions shall be made to prevent the fire from spreading to within 50 feet of any structure and or living vegetation.*

Initials
YOU must call before burning to make sure it is a burn day. Burning Time is 0600 to 1200 hours. The fire must be completely extinguished by 12 noon.*

Initials
Size: There may only be one burn pile no more than 5’ x 5’, branches may be no larger than 2” in diameter and the burn pile should have a 50’ clearance.*

Initials
Must have a shovel and a water hose within 10-0’ of burn area*

Initials
It is incumbent on the permit holder to follow the directions of the burn permit and immediately extinguish any fire should the weather conditions change while burning. (i.e. the increase of wind)*

Initials
Make sure the fire is completely extinguished when burning is done. Douse with water and rake through the embers until the fire is completely out.*

Initials
I understand I can’t burn trash/papers, tires, carpet, furniture, plastics, rubber, oil filters, construction/demolition debris, and household debris, etc.,*

Initials
Signature*
Date*
MM slash DD slash YYYY
PLEASE BE FIRE SAFE READ AND ACKNOWLEDGE ADDITIONAL RULES ON THIS FORM
OFFICIAL USE ONLY APPLE VALLEY FIRE PROTECTION DISTRICT
Permit Number

Office Fire Permit

PERMITTEE'S INFORMATION

BURN INFORMATION

PLEASE BE FIRE SAFE READ AND ACKNOWLEDGE ADDITIONAL RULES ON THIS FORM

OFFICIAL USE ONLY APPLE VALLEY FIRE PROTECTION DISTRICT

Board Meeting

Regular Board Meeting