Agricultural Post Burn Report
Blue Card Information


Use this form to electronically submit your Agricultural Post Burn Report.


Please provide the following information: * Required fields, must be completed

 
*Growers Name: 
(as it appears on permit)
*Permit Number:
*Counties and Zones:  
 

*Burn Date and Legal Description:

If you have more than one burn date for the same permit, please use these additional boxes to record burn dates


                     
           
Section     Township      Range         Section     Township      Range

                   
           

Section     Township      Range        Section     Township      Range

*Common name of field where burning occurred:
 (as it appears on permit) :
*Time Burn Ignited:
*Time Burn Out:
*Wind Speed, and Direction:
*Acres Burned or Number of Orchard Tear Out Piles Burned:
*Is your burning for this permit complete:   
Additional Information
Please enter this Information and print for your records:
Date Submitted:
Approximate Time Submitted:

Your email address will not be stored or recorded, sold or provided to any other agency, public or private, it is simply a tool to contact you for more information on this form only.

My e-mail address is:

Are there any changes you would like made to this electronic form? Please let us know Post Burn Reporting.