7630-12 Large Open Burn Permit and Application

OMB Control No. 2060-NEW Approval Expires XX/XX/XXXX

[Tribe Name]
[Address]
United States Environmental Protection Agency, Region 10 ARD [Contact Information]
1200 Sixth Ave, Suite 155 MS: 15-H13
[Insert tribe logo in box to the
Seattle, WA 98101
right]
Federal Air Rules for Reservations (FARR)
Hotline: 800-424-4EPA
Website: www.epa.gov/FARR
Email: [email protected]

RESERVATION OFFICE OF AIR QUALITY:
LARGE OPEN BURN PERMIT AND APPLICATION
A large open burn is a burn of specified materials that is greater than 10 feet in diameter or more than 60 feet of ditch bank or fence line vegetation.
Firefighter training fires and fires for the disposal of fireworks require a large open burn permit if they meet the size criteria of a large open burn. After
sending in the Air Quality Large Open Burn Permit Application (pages 3-4) and receiving approval to burn, KEEP THIS SIGNED SHEET AS YOUR
PERMIT (pages 1-2). 40 CFR 49.132 Rule for Large Open Burning Permits

Printed Applicant Name (applicant must be owner or lessee of property):
General Terms and Conditions
1. This permit is part of a federal air quality program administered by the

2.
3.

4.
5.

Tribe to control emissions of air

pollutants and manage smoke for air quality purposes. These rules apply on the
Reservation (both formal
and informal reservation lands).
The owner and lessee, if any, of the property on which the open burn is conducted and the person conducting the burn (collectively, “the
Permittee”) must comply with all terms and conditions of this permit, including instructions and procedures.
Except for firefighter training fires and fires for the disposal of fireworks, 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.
Before igniting a burn that could significantly impair visibility on roadways, the Permittee must contact relevant safety authorities and take
any transportation safety measures during the burn required by such authorities.
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 or any
other adverse impact on air quality..
6. The person conducting the burn must be reachable by phone during the burn.
7. The Permittee must ensure that the person conducting the burn 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
personnel or U.S. EPA
inspectors.
8. The Permittee must conduct open burning as follows: (a) all materials to be openly burned must be kept as dry as possible through the
use of a cover or dry storage; (b) before igniting a burn, dirt and stones must be separated from the materials to be openly burned to the
greatest extent practicable; (c) natural or artificially induced draft must be present; (d) To the greatest extent practicable, materials to be
openly burned must be separated from the grass or peat layer; (e) a person 18 years of age or older must be in attendance at all times
during the burn; (f) there must be a means available for extinguishing the fire, such as water or chemical fire suppressants.
9. A fire must not be allowed to smolder unless: (a) it is a multiday burn; (b) the burn is actively managed to complete the burn in the shortest
possible time within the time period allowed by this burn permit; and (c) all other terms and conditions of this permit are met while the fire
is smoldering.
10. The Permittee must immediately extinguish the fire if safe to do so, discontinue lighting the fire, and withhold additional materials from
the fire so the fire burns down, as applicable, when the permit is revoked by either the
Tribe or U.S. EPA
Regional Administrator.
11. 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.
12. Burning must also be conducted in compliance with 40 CFR 49.131 General Open Burning and 49.132 Large Open Burning 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, are violations of the FARR and the federal Clean Air Act and are
subject to penalties up to $
EPA Form 7630-12

per day of violation.
THIS IS YOUR PERMIT: Keep Available While Burning

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OMB Control No. 2060-NEW Approval Expires XX/XX/XXXX

INSTRUCTIONS FOR OBTAINING AUTHORIZATION TO BURN
Burn Approval Process
Step 1. Complete permit application, pages 3-4.
Step 2. Submit completed permit application to the
business day(s) prior to the proposed burn date.

Tribe Air Quality Program at least

Step 3. Call
to request to burn no later
than
business day(s) prior to the day of the requested burn. The Permittee must leave a message
providing the following information:
a. Name and phone number.
b. Burn name(s) or number(s).
c.

Date(s) of each requested burn.

d. Type and size of burn (Large Open Burn, number of acres, footage or piles).
NOTE: Permittee is not guaranteed a next day burn approval.
Step 4. If the request to burn is approved, the Permittee will receive a preliminary burn decision and ignition time. Approvals
given the day before the desired burn are considered preliminary and are subject to Step 5. If the request to burn is not
approved, the Permittee will not receive a call. Burn approvals will consider:
a. The size, duration, and location of the proposed open burn, the current and projected air quality conditions, the
forecasted meteorological conditions, and other scheduled burning activities in the surrounding area.
b. The order of burn requests received from applicants (“first come, first served” basis).
c.

Other factors indicating whether or not the proposed large open burn can be conducted without causing or contributing
to an exceedance of a NAAQS.

d. Other relevant burn-specific factors indicating whether or not the proposed large open burn can be conducted without
causing any other adverse impact on air quality.
Step 5. If the preliminary burn decision changes due to poor air quality and/or updated forecast information, the
Air Quality Program will notify the Permittee by 9:00 AM the day of the burn.
Step 6. The person conducting the burn must be reachable by phone during the day of the burn in case there is a change in the
burn decision and it is necessary to cease all burning.
Step 7. Within 24 hours after completing the burn, the Permittee must contact the
the following post-burn information:

Tribe and report

e. Name, as it appears on the application.
f.

Date and time of the burn(s).

g. The area or amount of any remaining unburned material (if burn was not completed).
Applicant’s Printed Name (applicant must be owner or lessee of property):

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 terms
and conditions, including instructions and procedures.

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

Date

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 49.132). The public reporting and record keeping burden for this collection of information is estimated to
average 0.5 hours 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 7630-12

THIS IS YOUR PERMIT: Keep Available While Burning

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OMB Control No. 2060-0558 Approval Expires XX/XX/XXXX

[Tribe Name]
[Address]
[Contact Information]
[Insert tribe logo in box to the
right]

United States Environmental Protection Agency, Region 10 ARD
1200 Sixth Ave, Suite 155 MS: 15-H13
Seattle, WA 98101
Federal Air Rules for Reservations (FARR)
Hotline: 800-424-4EPA
Website: www.epa.gov/FARR
Email: [email protected]

RESERVATION OFFICE OF AIR QUALITY:
LARGE OPEN BURN PERMIT AND APPLICATION
Complete this application and submit it at least
forms to:

business day(s) prior to the proposed burn date. Submit completed

Dates & Contact Information
1. Requested Date(s) of proposed large open burn(s)

2. Date of Application

3. Applicant Name (must be owner or lessee of property)

4. Applicant Phone Number

Owner

Lessee

5. Applicant Mailing Address

6. Applicant Email Address

7. Name of Owner or Lessee of Property (if different from Applicant)

8. Owner/Lessee Phone Number

Owner

Lessee

9. Owner/Lessee Mailing Address

10. Owner/Lessee Email Address

11. Name of person conducting the burn

12. Phone Number of person conducting the burn

13. Mailing Address of person conducting the burn

14. Email Address of person conducting the burn

Description of Burn Location
15. Burn Location:

16. Township:

EPA Form 7630-12

17. Range:

18. Section:

THIS IS YOUR APPLICATION: Return to

19. Quarter section

Tribe

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OMB Control No. 2060-0558 Approval Expires XX/XX/XXXX

20. Burn Information
Burning Method(s)

Means of Ignition

Materials to be Burned

(e.g. pile burn, ditch
burn, broadcast burn,
windrow burn)
Example: Pile Burn

Example: Propane Torch

Example: Wood Debris

Amount of Material

Area of Burn

(specify pounds or
tons)

height x length x width

Example: 50 tons

Example: 10x10x15 ft

(specify feet or acres)

21. Fire Safety Methods: Please indicate the measures you will take to prevent escaped burns:
Water Truck

Hand Tools

Heavy Equipment

Fire Breaks and Safety Zones

Flaggers

Other:
22. Map: Attach a plot plan showing the location of the proposed open burn in relation to the property lines and indicating the
distance and directions of the nearest residential, public, and commercial properties, as well as roads and other sensitive areas
that could be affected by smoke from the burning.

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, including instructions and procedures.

Signature of Applicant

Printed Applicant Name

Date

For Internal Use Only
Approved by:
EPA Form 7630-12

Date:
THIS IS YOUR APPLICATION: Return to

Tribe

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