5800-066 Small Burn Annual Permit

SMALL BURN ANNUAL

PART “A”

SMALL BURN ANNUAL

For burns 10 ft or less in diameter or 60 ft or less of ditch
bank or fence line vegetation.

Fill Out and Return to the

AIR QUALITY PERMIT APPLICATION

AIR QUALITY PERMIT
for the

for the
Reservation

Reservation

Applicant Name (must be owner or lessee of property):

Owner

Lessee

Signature of Applicant / Date:

Fire Safety Methods: Please
indicate the measures you will take
to prevent escaped burns:
water availability
hand tool availability
heavy equipment availability

Applicant Mailing Address:

fire breaks or safety zones
flaggers

Email Address of Applicant:

Phone Number(s) of Applicant:

Burn Location (street address or, if none, legal
description):

Owner/Lessee Information (if applicable):

other:

The Permittee is responsible for
all fire safety requirements.
By applying for this permit, you agree
that burning shall be conducted in
accordance with the Small Burn
Permit terms and conditions, including
restrictions on the location, quantity
and type of materials burned.

Name of Owner or Lessee (if different from Applicant):

Owner

Lessee

Owner/Lessee Mailing Address:

Detach, Fold and Return Part A : Part A is your permit application. Retain Part B : Part B is your permit.

Office of Air Quality

Applicant Information:

PART “B"

Check
each
day you want to burn to find out if it is a
burn day. Burn only on BURN DAYS and
ONLY DURING ALLOWED BURN HOURS.

THIS IS YOUR PERMIT
for calendar year 202X
Keep available at site while burning.

Q: Why do I need approval?
A: Smoke from open burning contains air pollutants
that affect air quality and public health (especially for
children and the elderly).

Applicant Name (print clearly):

Signature of Applicant / Date:

Burn Location (street address or, if none, legal
description):

For more information, contact:

Tribe

Q: What are some alternatives to outdoor burning?
A: Chipping and shredding vegetation for composting.
Household paper and cardboard can be recycled.
Q: How can I burn more cleanly?
A: Make sure your fuel is as dry as possible, separate
the fire from damp ground and be sure there is enough
draft to keep the fire burning hot.
Q: Q: Are there exceptions from the Small Open
Burn Annual Permit Rule?
A: Cultural, traditional, recreational, outdoor cooking
and certain other fires are exempt and do not require
approval. See 440 CFR 49.142 Rule for Small Open
Burning Annual Permits..

U.S. Environmental Protection Agency
Federal Air Rules for Reservations (FARR)

Owner/Lessee Email Address:

Region 10, Air and Radiation Division
1200 6th Ave, Ste. 155 Mail Code: 15-H13

Owner/Lessee Phone Number(s):

Seattle, Washington 98101-3144
EPA Form 5800-066
OMB Control No. 2060-NEW
Approval Expires XX/XX/XXXX

www.epa.gov/FARR
Hotline: 800-424-4EPA
Email: [email protected]

For more information about the health effects
of outdoor burning visit: www.epa.gov/FARR
Burning must be conducted in compliance with 40 CFR
49.131 General Open Burning and 49.142 Rule for Small
Burning Annual Permits.

SMALL BURN ANNUAL PERMIT
TERMS & CONDITIONS

This permit is part of a federal air quality program administered by the
Tribe
to control emissions of air pollutants and manage smoke for air quality purposes. These rules apply within the
Reservation (both formal and informal reservation lands).

2.

This permit applies to the owner and lessee (if any) of the property and to any person conducting a small open
burn on the property (collectively, “the Permittee”).

3.

Only the following materials may be burned: (a) natural vegetation and untreated wood; (b) paper, paper
products, or cardboard generated on site at a single-family residence or residential building with four or
fewer dwelling units; and (c) paper and manufactured fire starters to start the fire. BURNING ANY OTHER
MATERIALS IS PROHIBITED.

4.

Before initiating a small open burn, the person conducting the burn must call
to
check whether burning is allowed for the area on that day and conduct and complete the burn during the hours
that burning is allowed on that day. BURN ONLY ON BURN DAYS AND ONLY DURING ALLOWED HOURS..

5.

The Permittee must ensure that the person conducting the small open burns is familiar with the requirements of
the permit and that the permit is available on the property during the open burn and provided on request to the
Tribal personnel or U.S. EPA.

6.

Open burning is not permitted (and shall not be initiated) during burn bans or air pollution episodes, or when the
Tribe or U.S. EPA determines that burning will cause or contribute to an
exceedance of any NAAQS orany other adverse impact to air quality.

7.

All small open burning is subject to the following requirements: (a) all materials to be openly burned must
bekept as dry as possible through the use of a cover or dry storage; (b) before igniting a burn, dirt and stones
mustbe separated from the materials to be openly burned to the greatest extent practicable; (c) natural or
artificiallyinduced draft must be present; (d) to the greatest extent practicable, materials to be openly burned
must beseparated from the grass or peat layer; (e) a fire must not be allowed to smolder; (f) a person 18 years
of age orolder must be in attendance at all times during the burn; (g) there must be a means available for
extinguishingthe fire, such as water or chemical fire suppressants; and (h) the fire must be extinguished, if safe
to do so, when requested to doso by the
Tribe or U.S. EPA based on a
determination that burning willcause or contribute to an exceedance of any NAAQS or any other adverse impact
to air quality.

8.

This permit expires at the end of the calendar year in which it is issued unless it is revoked after written notice to
the applicant prior to that time.

9.

If the owner or lessee of the property changes, a new permit is required in order to conduct small open burns on
the property.

10. Nothing in this section exempts or excuses any person from complying with any applicable laws and ordinances
of Tribal governments, local fire departments, and other governmental entities. The Permittee is responsible for
compliance with any applicable burn safety requirements and must also obtain applicable fire safety permits.
Contact your local fire district or sheriff’s office for fire safety permit information.

This collection of information is approved by OMB
under the Paperwork Reduction Act, 44 U.S.C. 3501
et seq. (OMB Control No. 2060-NEW). Responses
to this collection of information are mandatory (40
CFR 49.142). The public reporting and record
keeping burden for this collection of information is
estimated to average 0.5 hour per response. An
agency may not conduct or sponsor, and a person is
not required to respond to, a collection of
information unless it displays a currently valid OMB
control number. 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 to the
Regulatory Support Division Director, U.S.
Environmental Protection Agency (2821T), 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.

First
Class
Postage
Required

11. All open burning under this permit must be conducted in compliance with this permit (including instructions and
procedures), 40 CFR 49.131 (General rule for open burning) and 49.142 (Rule for small open burning annual
permits). Burning conducted without permission from the
Tribe Air Quality
Program and/or failure to follow the FARR permit terms and conditions, including instructions and procedures,
violates the FARR and the federal Clean Air Act and is subject to penalties up to $
per day of

Address

1.