Form 7630-11 UMATILLA INDIAN RESERVATION OFFICE OF AIR QUALITY PERMIT

Form Approved OMB 2060-0558 Approval Expires 5/31/2011
Permit Number:

United States Environmental Protection Agency (EPA)
Federal Air Rules for Reservations (FARR)
Region 10, OAWT 107
1200 6th Ave., Ste. 900
Seattle, WA 98101
Hotline: 1-800-424-4EPA
Fax: 206-553-0110
www.epa.gov/r10earth/FARR.htm

(To Be Assigned by CTUIR OAQ)

Confederated Tribes of the Umatilla Indian Reservation (CTUIR)
Office of Air Quality (OAQ)
CTUIR-DOSE
Office of Air Quality
46411 Timine Way
Pendleton, OR 97801
Phone: 541-429-7080
Fax: 541-429-7422
http://air.umatilla.nsn.us

UMATILLA INDIAN RESERVATION OFFICE OF AIR QUALITY PERMIT:
FORESTRY BURN PERMIT INSTRUCTIONS, TERMS & CONDITIONS
A forestry burn is the burning of vegetative debris from a forestry or silvicultural activity that is necessary for
disease or pest control, reduction of fire hazard, reforestation or ecosystem management. Agricultural, small
and large open burns require a different permit. Firefighter trainings require a large open burn permit. Permit
applicants are responsible for following all instructions, terms and conditions regarding forestry burning within
the exterior boundaries of the Umatilla Indian Reservation. After sending in the Air Quality Forestry Burn Permit
Application (pages 3-4) and receiving approval to burn, KEEP THIS SIGNED SHEET AS YOUR PERMIT
(pages 1-2). Have it available and provide it upon request to the CTUIR Office of Air Quality personnel or U.S.
EPA inspectors. 40 CFR 49.134 Forestry and Silvicultural Burning Permits
Printed Applicant Name:

General Terms and Conditions
1. Applicants must complete a permit application obtained from the CTUIR OAQ or online at
http://air.umatilla.nsn.us or www.epa.gov/r10earth/FARR.htm.
a. Applications must be submitted to the CTUIR OAQ via fax or received in the mail at least 3 business

days prior to desired burn date.
b. CTUIR Forestry burn permits cost $0.
c. Please apply early and ensure all documents are submitted to the OAQ prior to requesting permission

to burn.
2. Applicants must request and receive burn approval from the CTUIR OAQ Personnel at: 541-429-7080.
3. Applicants must shut down burns when requested to do so by the CTUIR OAQ or US EPA. CTUIR OAQ and
US EPA consider the following factors when deciding whether a burn should be shut down:
a. Wind speed, direction, or sudden shifts
b. Extended or extremely high levels of particulate matter in the atmosphere
c. Fire safety and control
d. Proximity to canyon rims, roadways, towns, houses, businesses, and other sensitive populations
e. Other relevant factors
4. Applicants are responsible for conducting test burns if requested by the CTUIR OAQ or EPA.
5. Applicants must make all required calls to the CTUIR OAQ as described in the instructions in this form.
Applicants must follow all procedures specified in this form and are responsible for following all procedures
and guidelines regarding forestry burning on the Umatilla Indian Reservation, including the CTUIR OAQ’s Best
Forestry Burn Practices Guidelines (Appendix K of the Outdoor Burning Management Plan and Procedures)
available through the CTUIR OAQ.
6. Smoke impacts on public roads, schools, daycares, medical facilities, elder homes and other sensitive people
or areas must be prevented as a condition of this permit. Applicants must have flaggers stationed for burns that
could potentially impact roadways.
7. Burning must be conducted in compliance with 40 CFR 49.131 General Open Burning and 49.134 Forestry
and Silvicultural Burning Permits. For a copy of these rules, please contact the CTUIR OAQ.
EPA Form 7630-11

THIS IS YOUR PERMIT: Keep Available While Burning

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Form Approved OMB 2060-0558 Approval Expires 5/31/2011

8. Burning conducted without authorization of the CTUIR OAQ and/or failure to follow the FARR permit
procedures are violations of the federal Clean Air Act and the FARR and are subject to penalties up to $37,500
per day of violation.
9. Applicants are responsible for compliance with any/all applicable burn safety requirements and must obtain any/all
fire safety permits. Contact the Oregon Department of Forestry (541-276-3491) for fire safety and permit information.
Instructions for Obtaining Authorization to Burn
Application Process
1. Obtain, fill out, and submit a permit application via fax or mail to the CTUIR OAQ office.
2. Application will be reviewed for completeness and assigned a permit number, which will be included at the top
of the permit section retained by applicant.
Procedures for the Day Prior to the Requested Burn Day
1. Applicant will be placed on the pending burn list once the application is submitted to CTUIR OAQ office and a
permit number is issued by CTUIR OAQ.
2. Applicant will be contacted by the CTUIR OAQ staff when a preliminary burn day and burn time is determined.
3 The CTUIR OAQ staff will review requested burns to determine recommendation for preliminary burn decisions.
Burn priority will be as follows:

a. Favorable conditions for sensitive areas (burns near towns, roads, canyons)

b. The preferred area to be burned (in terms of forecasted conditions)

c. The order of burn requests received from the applicants
Procedures for the Burn Day
1. Applicants will be called by the CTUIR OAQ by 9:00 AM to verify final burn decisions.
2. Applicants must be reachable by phone or other means of communication during the day of the burn, should
there be a change in the burn decision and it is necessary to cease all burning.
NOTE: If applicants are not reachable and continue burning, they are in violation of this permit.
3. All fires must be ignited and must be completely out within approved burn duration times.
Post-Burn Procedures
1. As a condition of this permit, within 24 hours after completing the burn, the applicant must contact the CTUIR
OAQ with post-burn information and may leave a telephone message, email or fax with the following post-burn
information:

a. Name, as it is on application

b. Date, time and durations of the burn(s)

c. How the burn went and if it was completed

d. Number of acres or amount actually burned

e. The size of any remaining unburned material (if burn was not completed)
NOTE: If an applicant does not submit the post-burn information, then the applicant will be out of compliance with
permit conditions, and subject to enforcement action.
Applicant’s Signature
I certify that I have read, understand and have followed the instructions on this form and agree to abide by the
permit’s instructions, terms and conditions.

Applicant’s Signature is required for permit to be valid.

Date

The public reporting and recordkeeping burden for this collection of information is estimated to average 0.35 hour
per response. Send comments on the Agency’s need for this information, the accuracy of the provided burden
estimates, and any suggested methods for minimizing respondent burden, including through the use of automated
collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T),
1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence.
Do not send the completed form to this address.
EPA Form 7630-11

THIS IS YOUR PERMIT: Keep Available While Burning

pg 2 of 4

Form Approved OMB 2060-0558 Approval Expires 5/31/2011
For Internal Use Only
Permit Number:

United States Environmental Protection Agency (EPA)
Federal Air Rules for Reservations (FARR)
Region 10, OAWT 107
1200 6th Ave., Ste. 900
Seattle, WA 98101
Hotline: 1-800-424-4EPA
Fax: 206-553-0110
www.epa.gov/r10earth/FARR.htm

Date:

Initials of CTUIR Staff:

Confederated Tribes of the Umatilla Indian Reservation (CTUIR)
Office of Air Quality (OAQ)
CTUIR-DOSE
Office of Air Quality
46411 Timine Way
Pendleton, OR 97801
Phone: 541-429-7080
Fax: 541-429-7422
http://air.umatilla.nsn.us

UMATILLA INDIAN RESERVATION OFFICE OF AIR QUALITY PERMIT:
FORESTRY BURN PERMIT APPLICATION
Complete this application and submit it at least three business days prior to the proposed burn date. Submit
completed forms to: CTUIR-DOSE, Office of Air Quality, 46411 Timine Way, Pendleton, Oregon 97801.
Phone: 541-429-7080, Fax: 541-429-7422.
Contact Information

1. Company Name

2. Date

3. Applicant Name

4. Primary Phone

5. Physical Address

6. Additional Phone

7. Mailing Address (if different from above)

8. Fax and Email

9. City, State, Zip Code

10. County of Burn

11. Name of Person Conducting Burn (if different from applicant)

12. Phone of Person Conducting Burn
(if different from applicant)

Proposed Burn: You may attach an approved burn plan. If one is available, please reference the page numbers
where the requested information can be located.
13. Purpose of the Burn:

14. Requested Burn Date:

15. Fuel Conditions:

16. Burn Location:

17. Township:

EPA Form 7630-11

18. Range:

19. Section:

20. Quartersection:

THIS IS YOUR APPLICATION: Return to the CTUIR OAQ

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Form Approved OMB 2060-0558 Approval Expires 5/31/2011

Burn Information
21. Map: Attach a printout or draw a map of the locations listed on this application to be burned, which shows
local access roads, highways, residences, businesses or other areas that have potential to be impacted by the
burning to be conducted. Indicate distance and direction. A tract map, GPS map or other similar map may also be
used.

22. Fuel Type (Ex: Slash Pile) and size of burn (Ex: Pile dimensions (height x width x length) in feet,
number of piles, number of acres or tons):

23. Burning Methods: Describe the burning method(s) to be used:
Method:
Propane Torch
Other ______________________________________________
Pattern:
Strip Burn
Circle Burn
Other ____________________
24. Estimated duration of flaming stage?

25. Estimated duration of smoldering stage?
26. Fire Safety Methods: Please indicate the measures you will take to prevent escaped burns and smoke danger:
water availability
hand tool availability
heavy equipment availability
fire breaks or safety zones
flaggers
other_______________________
other ___________________________
Applicants must also obtain applicable fire safety permits.
27. Indicate the Safety Measures or Safety Routes:

28. Remarks:
APPLICANT’S STATEMENT (To be signed by the applicant): I certify that the information provided as part of this
application is true and accurate to the best of my knowledge and that I have read, understand and agree to abide
by the permit’s terms and conditions.

Signature of Applicant

Printed Applicant Name

Date

For Internal Use Only
Approved by:
EPA Form 7630-11

THIS IS YOUR APPLICATION: Return to the CTUIR OAQ

Date:
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