Smoke Management Plan

SMOKE MANAGEMENT PLAN FOR PERMIT # ______Page 1

MBUAPCD

MontereyBay Unified Air Pollution Control District 24580 Silver Cloud Court

Serving Monterey, San Benito, and Santa Cruz Counties Monterey, CA 93940

PHONE: (831) 647-9411 • FAX: (831) 647-8501

Application for a Smoke Management Permit

Once approved, this completed form will serve as your Smoke Management PLAN. Your PLAN is valid as long as your burn project is the same as described below. The Air District will issue you a separate Smoke Management PERMIT that is valid for up to a year.

PROJECT DESCRIPTION SECTION:Complete pages 1 & 2 for ALL PRESCRIBED BURNS.

If your burn is less than 10 acres with less than one ton particulate matter emissions, and your burn will not impact any smoke sensitive areas, you only need to complete pages 1 & 2. Attach sections A and/or Bfor all other burns.

1. Project Name:

8. If no project address is available,report at least one of the following location descriptions. Provide attachments as needed.

LEGAL DESCRIPTION

T ______

R ______

S ______

M&B ______

or
LATITUDE & LONGITUDE
Lat _____(deg.) ______(min) _____ (sec)
Long _____(deg.) ______(min) _____ (sec)
or
UTM: Zone: ____
N______m, E______m

2. Permittee Name:

______

3. Permittee Mailing Address:

Street: ______

City:______

State: _____ Zip: ______

4. Permittee/Field Contact:

/ 9. Project Elevation (msl feet):
Top:______Bottom:______

5. Telephone:

Fax:

Email:

24-hour phone/pager:

10. Land Owner Name (if different from permitee):______

Street:______City: ______

State: ______Zip: ______

6. Project Site (Address):

11. AirSub-Basin(if known):

7. County and Nearest Town:

12. Anticipated Time of Year for Burn (Month/Year): ______

13. Is the Primary Purpose of the Burn for Fire Hazard Reduction? ______

14. TYPE OF BURN:

 Agricultural Waste  Development  Fire Hazard Abatement Forest Management

 Levee, Reservoir, & Ditch Maintenance  Mechanized  Natural Ignition

 Range Improvement – Livestock Habitat Improvement

 Range Improvement – Wildlife/Game Habitat Improvement

Range Improvement -Initial establishment of agricultural practice on previously uncultivated land

 Right-of-Way Clearing (public entities or utilities)  Watershed Management

 Wildlife Habitat Improvement  Wildland Vegetation Management

15. Vegetation Type (in %): ____% Brush ____% Grass ____% Other (Describe):______

16. Is your project a: ____ Pile Burn or ____ Broadcast Burn (standing vegetation)?

17. Project Size: Number of Piles:______Average Pile Size: ______(diameter x height)

(For assistance, see Table 1 on page 10.) or ______(acres standing vegetation)

18. Total Project Fuel Loading:______(tons vegetation)

19. Particulate Matter Emissions: ______(tons PM10)

(Use Emissions Factors Tables on pages 12-13 for assistance with emissions calculation)

20. Emission Factor Table Used or EPA-Approved Calculation Method (circle one)?

21. Preferred ignition hours for the fire:______

22. Expected burn duration (ignition to complete extinction):______(hours or days)

23. Fuel drying time and conditions prior to ignition:______
______

24. Limitations on pile size, pile number, and/or acreage limitations to minimize smoke impacts (complete as appropriate): ______

______

25. Preferred wind direction:______

It is the responsibility of the permittee to ensure that conditions of the Smoke Management Plan are met on the day of the burn. The permittee will obtain authorization to burn from the Air District contact listed below no more than 24 hours prior to ignition.**

26. Air District Name: MBUAPCD

28. Contact: Compliance Division

27. Address: 24580 Silver Cloud Court

29. 24-hr Phone: (831) 647-9411

Monterey, CA93940

30. Fax: (831) 647-8501

The permittee will report public smoke complaints to the Air District per the procedures described in theInstructions for the Smoke Management Permit Application document.

Check as Applicable:

This burn could have an impact on smoke sensitive areas – I have filled out and attached all of Section A.

This burn could have an impact on smoke sensitive areas and Air District policies require that information on meteorological conditions for ignition and contingency planning be provided – I have filled out and attached items 42 and 43 of Section B.

This burn is greater than 100 acres (or is estimated to produce greater than 10 tons of particulate matter) – I have filled out and attached all of Section B.

Preparer’s Statement: To the best of my knowledge the information submitted in this application is complete and accurate.

SMP Preparation Date: ______

Preparer’s Name/Title (print): ______

Preparer’s Phone (include area code): ______

Preparer’s Signature: ______

Name of Authorized Representative in Control of the Property (if applicable): ______

Permittee or Authorized Representative Signature: ______

Signature Date: ______

**Burner/Air District burn authorization coordination to be determined by the Air District.

SECTION A: AS REQUIRED BY TITLE 17 AND AIR DISTRICT POLICIES, THIS SECTION APPLIES TO ALL BURNS WITH THE POTENTIAL TO IMPACT SMOKE SENSITIVE AREAS (SSAs) *

31. Smoke Sensitive Areas (SSAs) within 10 miles:Describe locations of SSAs and distances from burn site (miles) – (Also the attached Map#_____ shows SSAs)

______

32.The attached map# ______provides smoke travel projections for:

______Day______Night______Topographical considerations.

33.Has prescribed burning historically occurred in this area?____ Yes____ No

____ Don’t Know

34.If yes, were there impacts to smoke sensitive areas?____ Yes____ No

____ Don’t Know

35.If yes, please describe impacts:

______

36.For burns that will occur past daylight hours and/or for more than one day, please provide the Air District with contact information and a description of contact procedures that will be used to affirm that the burn project remains within the conditions specified in this SMP, and/or whether contingency actions are necessary. The permittee will follow any instructions by the Air District to communicate directly with ARB when necessary.

Who will be in contact with the Air District:

______

Telephone:(______) ______-______

24-hour Pager:(______) ______-______

Fax:(______) ______-______

E-mail: ______

37.The permittee will use the frequency and method of contact described below:

______

SECTION A: AS REQUIRED BY TITLE 17 AND AIR DISTRICT POLICIES, THIS SECTION APPLIES TO ALL BURNS WITH THE POTENTIAL TO IMPACT SMOKE SENSITIVE AREAS (SSAs) *

The permittee will monitor the burn project for meteorological conditions and smoke behavior before, during, and after the burn using the following techniques and timing:

38.Weather Observation (Wind Direction, Wind Speed, and Temperature):

MethodDetails

____ Belt Weather KitLocation ______

Beginning ______Interval ______Ending ______

____ RAWS Location ______

Beginning ______Interval ______Ending ______

____ AircraftLocation ______

Beginning ______Interval ______Ending ______

____ OtherLocation ______

Beginning ______Interval ______Ending ______

____ Additional Requirements: ______

______

39.Smoke Behavior Observations:

MethodDetails

____ VisualLocation ______