30 Day Residential

Applicant Name

First Name (required)

Last Name (required)

Location of Burn

Address (required)

City, State (required)

Zip Code (required)

Mailing Address (if different from above)

Address

City, State

Zip Code

Phone (must be available during burn) (required)

Email (required)

Description of Burn (required)

Residential

Construction

Prescribed

Other

Burn Method (required)

Pit

Pile

Approved

Not Approved

Quantity to be burned (size of pit, pile, etc) (required)

Anticipated Burn Duration (hours/burn) (required)

Anticipated Number of Days to Burn All Material (required)

Actions taken to limit emissions (i.e. dry material before burning, immediately extinguish smoldering burns, minimize material to be burned) (required)

Materials that CANNOT be burned: [A.A.C.R18-2-602.D.A.13] (Please check each box to indicate you have read the section) (required)

All treated wood including: Chemically treated or painted wood, Railroad ties, Telephone poles

All plastic and rubber material including: Bottles for household chemicals, Grocery and retail bags, Tires

All waste petroleum products including: Waste crankcase oil, Transmission or used oil, Oil filters

Containers that contained: Pesticides, Lead, cadmium, mercury, or arsenic compounds, Pesticides

Hazardous waste products including: Paints, stains or varnishes, Solvents, cleaners

Other Prohibited Burning Materials (Please check box to indicate you have read the section) (required)

Household waste/garbage, Poison oak, Poison ivy, Asbestos, Oleander, Poison sumac, Thermal insulation, Batteries, Polyester products, Electrical wire insulation, Composite counter tops, Anti-freeze, Tar paper, Aerosol spray cans, Flammable liquids, Transformer oils, Ammunition, Explosives, Asphalt shingles, Linoleum flooring

Fire controls available on-site (Must be on-site for duration of burn) (required)

Distance to nearest structure (Note: permit cannot be granted if distance is less than 50ft) (required)

Please upload a picture of the burn area here (required)

Permit Conditions

Please check box to indicate you have read the section

1. Permittee must call (520) 281-8687 prior to burning each day to receive burn approval.

2. Fires can be started no earlier than one hour after sunrise. Burn must be extinguished at least two hours before sunset.

3. Permittee must attend fire at all times until it is completely extinguished.

4. Permittee must have a copy of this permit on-site during open burning.

5. Permittee must start fire using items that do not cause the production of black smoke.

6. Permittee can only conduct open burning during atmospheric conditions that:a. Prevent dispersion of smoke into populated areas b. Prevent visibility impairments on roads or at airports that result in a safety hazard c. Do not create a public nuisance or adversely affect public safety d. Do not cause an adverse impact to visibility in a Class I area e. Do not cause uncontrollable spreading of the fire

7. Burning cannot be conducted when an air stagnation advisory has been issued by the National Weather Service for the area.

8. Burning cannot be conducted when any stage air pollution episode has been declared

9. Any public official may order that the burn be extinguished or may prohibit burning during periods of inadequate smoke dispersion, excessive visibility impairment, or extreme fire danger.

ARS 13-1706. It is unlawful for any person, without lawful authority, to intentionally, knowingly, recklessly or with criminal negligence to set or cause to be set on fire any wildland other than the person’s own or permit a fire that was set or caused to be set by the person to pass from the person’s own grounds to the grounds of another person. A person who violates this section is guilty of a class 1 misdemeanor, class 2 misdemeanor, class 3 felony or class 6 felony.

By submitting this electronic form (required)

I certify that I have knowledge of the facts herein set forth, that the same are true, accurate and complete to the best of my knowledge and belief. I further state that I will assume responsibility for conducting open burning in accordance with the Arizona Administrative Code, Title 18, Chapter 2 and any open burning permit issued thereof. I acknowledge that all information not identified by me as confidential shall be treated by Rio Rico Medical and Fire District and the Arizona Department of Environmental Quality as a public record.

Signature

First Name (required)

Last Name (required)

Date (mm/dd/yyyy) (required)

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