Florida Department of Agriculture and Consumer Services



|Florida Department of Agriculture and Consumer Services |

|Florida Forest Service |

| |

|RECOMMENDATION FOR CERTIFICATION |

|Florida Administrative Code 5I-2.006(2)(e) |

|Telephone: (850) 681-5900 |

| Broadcast Burner Pile Burner |

|Applicant Contact Information |

|Last Name       |First Name       |MI.       |

|Customer Number (if applicable, required for pile burner)       |

|Complete Home Mailing Address and Telephone Number |

|Street       |City       |

|State       |Zip Code       |Telephone Number with Area Code       |

|Complete Business Name, Address and Telephone Number |

|Business Name       |

|Street       |City       |

|State       |Zip Code       |Telephone Number with Area Code       |

|Burn Review Information |

|Date of burn       |Type       |Authorization Number       |

|Reviewer’s Name (please print) |Title |

|      |      |

| |

|(Reviewer: Please make sure that the attachments correspond with the type of burner certification needed for approval) |

| |

|Broadcast: ο Copy of the Florida Forest Service certificate of course completion |

|ο Copy of the Prescribed Burning Plan |

|ο Required Maps (burn area and smoke screen) |

| |

|Pile Burner: ο Copy of the Florida Forest Service letter mailed to Pile Burner |

|ο Copy of the Burn Plan for Pile Burners (DACS-11051), reviewed and approved |

|ο Smoke Screen Map |

|Center/District Manager (please print) |Signature |Date |

|      | |      |

INSTRUCTION FOR REVIEWER AND APPROVER:

Broadcast Burner: Applicants must successfully pass the Florida Certified Prescribed Burn Manager Training Course, complete three prescribed burns; the third one will be the one you review. Only one prescribed burn is required after successfully completing the Correspondence Course. Only one burn prescription is reviewed by the center/district personnel and approved by the center/district manager for both courses. (Reviewer must be a certified burner)

Pile Burner: A certification number will be issued after passing the Pile Burner course and completing one burn plan (prescription form FDACS-11051) reviewed, approved and executed. The burn plan will be reviewed by the center/district personnel and approved by the center/district manager. (Reviewer must have completed the certified pile burner course)

After approval, the center/district personnel will send the completed Recommendation for Certification Form (with the attachments) to the Forest Protection Bureau. A certificate number will be issued and mailed to the applicant. Information on the form is documented into the Fire Management Information System (FMIS).

FDACS-11477 Rev. 04/15

-----------------------

NICOLE “NIKKI” FRIED

COMMISSIONER

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download