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2 <br />PYROTECHNICS PERMIT CHECKLIST---ORANGE COUNTY SPEEDWAY T-T-0T <br />North Carolina General Statue 14-413 empowers County Commissioners in the State to issue permits for <br />the use of pyrotechnics in connection with shows of all descriptions after satisfactory evidence is <br />produced to the effect that the pyrotechnics will be used for the aforementioned purposes and no others. <br />The Orange County Commissioners have adopted a policy which cites the completion of the following <br />criteria as prerequisite to the issuance of a pyrotechnics permit. Verification of the receipt of information <br />will be evidenced by the signature of the appropriate official on this form. Only after all criteria listed <br />below have been met will the permit be issued. It should be further noted that all signatures must be <br />written on the face of the permit in order for the permit to be valid. Penalties for use of pyrotechnics <br />without a permit are cited in the North Carolina Building Code, Administration and Enforcement, Volume <br />1A, Chapter 8.1. <br />CRITERIA APPROVED BY DATE <br />1. LETTER OF REQUEST RECEIVED FROM SPONSORING AGENCY Mike Tapp 6-6-07 <br />2. FIRE DEPARTMENT CONFIRMED ADEQUATE FIRE PROTECTION Contract with Caldwell Fire 6-11-07 <br />MEASURES WILL BE OBSERVED AT EVENT. Dept to provide fire <br /> protection for all race . <br /> events. (New requirement <br /> er Fire Code <br />3. LAW ENFORCEMENT CONFIRMED THAT ADEQUATE MEASURES Race track security on 6-11-07 <br />WILL BE IN PLACE TO ENSURE PUBLIC SAFETY DURING EVENT. duty during races will <br /> handle the crowd control; <br /> Sheriff to supplement <br />4. QUALIFIGATIONS/LICENSE SUBMITTED FOR PYROTECHNIC Mike Tapp 6-6-07 <br />OPERATOR <br />5. SITE LAYOUT SUBMITTED BY THE PYROTECHNIC OPERATOR. Mike Tapp 6-6-07 <br />6. INVENTORY OF PYROTECHNICS TO BE USED SUBMITTED Mike Tapp 6-6-07 <br />7. CERTIFICATE OF INSURANCE FOR GENERAL LIABILITY COVERAGE Pam Jones 6-6-07 <br />RECEIVED; MUST INCLUDE COUNTY AS A NAMED INSURED ON THE <br />FACE OF,THE CERTIFICATE; MINIMUM LIMIT $1,000,000 PER <br />PERSON/PER OCCURRENCE. <br />8. LOCATION OF PYROTECHNIC DISPLAY HAS CURRENT FIRE Mike Tapp 6-6-07 <br />INSPECTION AND IS IN COMPLIANCE WITH THE NORTH CAROLINA <br />FIRE PREVENTION CODE, 20001NTERNATIONAL CODE WITH NORTH <br />CAROLINA AMENDMENTS. <br />9. SHOW SETUP HAS BEEN APPROVED BY THE FIRE OFFICIAL IN <br />APPROPRIATE JURISDICTION PRIOR TO THE BEGINNING OF <br />SHOW. NOTE: FIRE OFFICIAL SHALL NOT EXECUTE THIS PERMIT IN <br />THE EVENT ENVIRONMENTAL CONDITIONS AT TIME OF <br />PERFORMANCE PRESENT A HAZARD FOR EITHER BURNING OR AIR <br />QUALITY CODE RED . <br />CERTIFICATION RESPONSIBILITIES: <br />ITEMS 1-7: ORANGE COUNTY DIRECTOR OF PURCHASING AND CENTRAL SERVICES or ORANGE COUNTY <br />DIECTOR OF EMERGENCY MANAGEMENT OR DESIGNATE. <br />ITEM 8: JURISDICTION'S FIRE OFFICIAL <br />ITEM 9: ORANGE COUNTY DIRECTOR OF EMERGENCY MANAGEMENT OR DESIGNATE''' NOTE: THIS <br />SIGNATURE CERTIFIES THAT THE FIRE OFFICIAL IN THE APPROPRIATE JURISDICTION HAS MADE <br />THE SETUP INSPECTION. IT IS NOT INTENDED TO INDIGATE THAT THE COUNTY'S EMERGENCY <br />MANAGEMENT DIRECTOR MUST INSPECT AND APPROVE 5ET UP PERSONALLY. <br />FOLLOWING CERTIFICATION OF ITEM 9, PLEASE RETURN THIS FORM TO THE PURCHASING AND <br />CENTRAL SERVICES DIRECTOR. <br />1.1 FWPMTCKL <br />