OPERATIONAL PERMIT STORAGE MAGAZINE PERMIT APPLICATION

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PRINCE WILLIAM COUNTY DEPARTMENT OF FIRE AND RESCUE FIRE MARSHAL S OFFICE 5 COUNTY COMPLEX CT. SUITE 160 PRINCE WILLIAM, VA 22192 (703) 792-6360 office (703) 792-6492 fax WWW.PWCGOV.ORG/FIRE For Office Use Only Permit Number: Date Issued: Expiration Date: I. Instructional Section 1. Please review this application thoroughly, fill out all requested information and submit with all necessary attachments to the Prince William County Fire Marshal s Office at the above address. 2. A permit fee of $281.99 is required at time of application submittal. Checks can be made out to Prince William County. 3. Prince William County Storage Magazine Permits are good for 12 months from date of issuance. 4. A review of this application packet will be conducted and either approved or rejected based on the information provided. If approved, this packet will be returned to the applicant at the time of permit delivery. 5. An onsite inspection will be made after packet approval and the permit will be delivered during this inspection if found to meet all requirements. II. Informational Section Company Information Name of Company: Address of Company: Company Phone: Emergency Contact Name and Number (after hours): Federal Identification Number: Site Information Site Name: Site Address: Name of Onsite Supervisor: GPIN: Phone: Page 1 of 5

The following individuals will be involved in monitoring of magazine: Name: DOB: Certification #: Phone #: The following are identified as potential hazards associated with this magazine: (gas lines, overhead power lines, close occupied structures, etc.) 1. 6. 2. 7. 3. 8. 4. 9. 5. 10. III. Site Plans Attach a site plan for this magazine. The following information shall be included on the site plan: Description of magazine site Distance from occupied building Distance between magazines Amount and type of explosives stored Distance from roadways Fire Department vehicle access roads (in case of emergencies) Fire hydrants if available IV. List of Required Documents Documentation of $5,000,000.00 Liability Insurance Copies of Blaster s Background Clearance Card Site Plan Page 2 of 5

Carefully review the following: All explosive storage in Prince William County is regulated by the following sources: Virginia Statewide Fire Prevention Code Chapter 56 (2012 edition) NFPA 495 (2010 edition) Prince William County Code (Chapter 9.2 Article VII) Applicable Code Sections: VSFPC 107.2 Permits may be required by the fire official as permitted under the SFPC in accordance with Table 107.2. VSFPC 107.4 Before a permit is issued; the fire official shall make such inspections or tests as are necessary to assure that the use and activities for which application is made comply with the provisions of this code. VSFPC 107.7 Plans approved by the Fire Official are approved with the intent that they comply in all respects to this code. Any omissions or errors on the plans do not relieve the applicant of complying with all applicable requirements of this code. VSFPC 107.9 the permit shall become invalid if the authorized activity is not commenced within six months after issuance of the permit, or if the authorized activity is suspended or abandoned for a period of six months after the time of commencement. VSFPC 5601.1.1 in addition to VSFPC Chapter 56, NFPA 495 shall govern the manufacture, transportation, storage, sale, handling and use of explosive materials. VSFPC 5601.2 the manufacture, storage, possession, sale and use of explosives shall not take place without first applying for and obtaining a permit. VSFPC 5601.2.4 before a permit is issued, the applicant shall file with the jurisdiction a corporate surety bond or a public liability insurance policy for the purpose of the payment of all damages to persons or property which arise from, or are caused by, the conduct of any act authorized by the permit upon which any judicial judgment results. The legal department of the jurisdiction may specify a greater amount when conditions at the location of use indicate a greater amount is required. VSFPC 5601.4 persons in charge of magazines, blasting, firework displays or pyrotechnic special effect operations shall not be under the influence of alcohol or drugs which impair sensory or motor skills, shall be at least 21 years of age, and possess knowledge of all safety precautions related to the storage, handling or use of explosives, explosive materials or fireworks. VSFPC 5601.6 whenever a new explosive material storage or manufacturing site is established, including a temporary job site, the local law enforcement agency, fire department and local emergency planning committee shall be notified 48 hours in advance, not including Saturdays, Sundays and holidays, of the type, quantity and location of explosive materials at the site. VSFPC 5601.5 the fire code official is authorized to require operations permitted under the provisions of Section 5601.2 to be supervised at any time by the fire code official in order to determine compliance with all safety and fire regulations. VSFPC 5603.3 the loss, theft or unauthorized removal of explosive materials from a magazine or permitted facility shall be reported to the fire code official, local law enforcement authorities and the U.S. Department of Treasury, Bureau of Alcohol, Tobacco and Firearms, and Explosives within 24 hours. VSFPC 5603.7 current safety rules covering operation of magazines, as described in Section 5604.7, shall be posted on the interior of the magazine in a visible location. Page 3 of 5

VSFPC 5604.2 explosives and explosive materials, and Division 1.3G fireworks shall be stored in magazines constructed, located, operated and maintained in accordance with the provisions of Section 5604 and NFPA 495 or NFPA 1124. VSFPC 5604.3 the storage of explosives and explosive materials shall comply with Table 5604.3. VSFPC 5604.5 the use of magazines for storage of explosives and explosive materials shall comply with the requirements of Sections 5604.5.1 through 5604.5.3.3. VSFPC 5604.6 magazines shall be constructed in accordance with Sections 5604.6.1 through 5604.6.5.2. VSFPC 5604.7 magazines shall be operated in accordance with Sections 5604.7.1 through 5604.7.9. VSFPC 5604.7.2 smoking, matches, flame-producing devices, open flames, firearms, and fire arms cartridges shall not be allowed inside or within 50 of magazines. VSFPC 5604.10 explosive materials shall be disposed of in accordance with Sections 5604.10.1 through 5604.10.7. VSFPC 5604.10.1 the fire code official shall be notified immediately when deteriorated or leaking explosive materials are determined to be dangerous or unstable and in need of disposal. NFPA 495(9.2.1) all explosive materials not in the process of manufacture, transportation, or use shall be kept in storage magazines. NFPA 495(9.2.3) Detonators shall be stored in a separate magazine for blasting supplies and not be stored in a magazine with other explosive materials. NFPA 495(9.4.6.1) Any person who stores explosive materials shall notify the AHJ for fire safety in the locality in which the explosive materials are being stored of the type, magazine capacity, and location of each site where such explosive materials are stored. NFPA 495(9.4.6.2) Such notification shall be made orally before the end of the day on which storage of the explosive materials commenced and in writing within 48 hours from the time such storage commenced. NFPA 495(9.7.1) Magazines shall be supervised at all times by a competent person who is at least 21 years old and who is responsible for the enforcement of all safety precautions. NFPA 495(9.7.2) All magazines containing explosive materials shall be opened and inspected at maximum intervals of 3 days to determine whether there has been unauthorized or attempted entry into the magazines or whether there has been unauthorized removal of the magazines or their contents. NFPA 495(9.8.1) Smoking, matches, open flames, spark-producing devices, and firearms shall not be permitted inside of or within 15.25 m (50 ft) of a magazine, except for firearms carried by authorized guards. Sec. 9.2-51(PWC Code) Magazine required. Explosives and explosive materials, and Division 1.3G fireworks shall be stored in magazines constructed, located, operated and maintained in accordance with the provisions of section 5604 of the International Fire Code (2012 Edition) and NFPA 495 or NFPA 1124. The storage of explosives, explosive material, blasting agents and Division 1.3G fireworks shall be prohibited within the legal geographic boundaries of any district where such storage is prohibited by the fire marshal with the following exceptions: Storage of fireworks at display sites in accordance with section 5608.5 of the International Fire Code (2012) and NFPA 1123 or NFPA 1126. Portable or mobile magazines not exceeding 120 square feet in area shall not be required to comply with the requirements of the International Building Code. Page 4 of 5

Sec. 9.2-52(PWC Code) Financial responsibility; certificate of insurance required. Before a permit is issued, as required by section 5601.2 of the Fire Prevention Code (2012 Edition), for the storage, transportation, disposal, or use of explosives or blasting agents, wholesale or retail sale of permissible fireworks, or any fireworks display, the applicant shall file with the fire marshal's office a certificate of insurance which shows that the applicant has liability insurance in the amount of at least $5,000,000.00 combined single limit for bodily injury and property damage. This insurance policy shall become available for the payment of any damage arising from the acts or omissions of the applicant, his agents, or his employees in connection with the storage, transportation, disposal, or use of explosives or blasting agents, retail sales of fireworks, or fireworks display. The applicant shall ensure that the insurance policy is in effect at the time of the commencement of the activities authorized by the permit, and remains continuously in effect until such activities are completed. Sec. 9.2-53(PWC Code) Emergency contact for certified blasters. In addition to the provisions set out in Sections 5601.4, et seq., of the Fire Prevention Code, persons using explosive materials, within the confines of the county, shall provide emergency contact information to the fire official and update such by the first day of January, April, July, and October. Such information shall include the employer's name, office address, office telephone number, 24-hour emergency contact telephone number, blaster's name, and a 24-hour emergency contact telephone number. Sec. 9.2-55(PWC Code) Improper or unlawful storage of explosive materials. In addition to the provisions in sections 5603.1, et seq., of the International Fire Code (2012 Edition), if at any time explosives or explosive materials are found stored in an improper or unlawful manner, immediate notification shall be made to the fire official who shall take all necessary actions to safeguard or dispose of such explosives or explosive materials. The above references only list the most commonly used code sections. Depending on the application other code sections could apply. Applicant Signature: FMO Reviewer: Date: Date: Page 5 of 5