Prescribed Burn Workshop Request Form

Name (required)

Property Address (required)

Directions to Property (optional)

Contact Phone (required)

Email (required)

What type of workshop could you host?

Pile Burning

Burn Unit Preparation (control lines, ladder fuel removal, and potentially water set up)

Prescribed Burning (unit is or is close to prepared)

What paperwork do you have prepared?

Burn Plan

Air Pollution Permit (if you plan to burn an acre or more in a year)

Smoke Management Plan (if you plan to burn 10 or more acres in a day)

I have everything I need to apply for a LE-7 Burn Permit

Do you want assistance with your burn plan?

Yes

No

I plan to take a burn plan workshop

Preferred season to burn?

Fall

Winter/Open Burning

Spring

Unsure/No preference

How Many Acres? (required)

What is the vegetation/habitat type? (Check all that apply)

Treatment History on the Property

Do you have an EQIP program contract?

Preferred point of contact?

Email

Phone Call

Text

Would you prefer to host a Nevada County Prescribed Burn Association (NCPBA )burn instead of a NCRCD workshop? If so, can I send your contact information to the NCPBA Board?

Is there anything else you want to mention?

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