GREATER STUTTERHEIM FIRE PROTECTION ASSOCIATION GROTER STUTTERHEIM BRANDBESKERMINGSVERENIGING (/Registration No 1090/01)

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GREATER STUTTERHEIM FIRE PROTECTION ASSOCIATION GROTER STUTTERHEIM BRANDBESKERMINGSVERENIGING (/Registration No 1090/01) APPLICATION FOR PRESCRIBED BURNING AANSOEK OM BEHEERDE BRAND UIT TE VOER For office use only / Slegs vir kantoor gebruik Application Number Aansoek nommer Date received Datum ontvang THIS IS ONLY AN APPLICATION AND NOT A PERMIT / HIERDIE IS SLEGS n AANSOEK EN NIE n PERMIT NIE PROPERTY DATA EIENDOM SE BESONDERHEDE Name of Property Naam van Eiendom Farm Number Plaasnommer Local Municipality Plaaslike Munisipaliteit OWNER s DATA EIENAAR SE BESONDERHEDE GSFPA Membership No GSBBV Lid No (Person responsible for account, if necessary) (Persoon verantwoordelik vir rekening indien nodig) GSFPA Area (Ward) GSBBV Gebied Owner Eienaar Identity Number Identiteitsnommer Contact Number Kontak Nommer Postal Address Posadres Physical Address Fisiese Adres RESPONSIBLE PERSON VERANTWOORDELIKE PERSOON Person Name Persoon Naam (Person in control of the fire) (Persoon in beheer van die brand) Contact Number (Cell phone) Kontak Nommer (Selfoon) BURN AREA AND FLORA BRAND AREA EN PLANTEGROEI Reason for burning Rede vir die brand Veld Type (e.g. Grass Veld) Veldtipe (bv. grasveld) Size of burn area Grootte van brand area (For multiple burns attach schedule or list ) (Vir veelvoudige brande heg skedule aan) Hectares Hektaar Rare and endangered species Skaars en bedreigde spesies 1

Exotic species present Indringer spesies teenwoordig Sufficient protection around area Genoegsame beveiliging om area Yes / Ja No / Nee RESOURCES AT BURNING HULPBRONNE TYDENS BRAND Description Beskrywing Trained Personal Opgeleide Personeel Fire Beaters Vuurplakke Tankers : < 1000 lt Tankers : < 1000 lt Tankers: > 1000 lt Tankers : > 1000 lt Water pumps with hoses Waterpompe met pype Working on Fire Other Ander Amount :Own Getalle : Eie Amount: Other Disciplines Getalle: Ander Instansies LIST OF AUTHORITIES/PERSONS THAT WILL BE NOTIFIED LYS VAN INSTANSIES/PERSONE WAT IN KENNIS GESTEL MOET WORD NOTICE: The Applicant must inform all the relevant Authorities/Persons, fourteen (14) days prior to burning and on the day of burning before it starts. This is for example District Municipality, the Local Municipality, the Fire Marshall of area, Neighbours, Fire- Lookout Towers in vicinity and the Fire Protection Officer. KENNISGEWING: Die Aansoeker moet al die betrokke Instansies/Persone in kennis stel, veertien (14) dae voor die dag van brand, asook die dag van brand, voor die brandwerk begin. Dit is bv. Distrik Munisipaliteit, die Plaaslike Munisipaliteit, die Fire Marshall van area, Bure, Vuuruitkykpunte in die omgewing en die Brand Beskermings Beampte. Name Naam Alliance to Property Verbintenis tot Eiendom Contact Number Kontak Nommer If list is longer, attach extra sheet. Indien die lys langer is, heg aparte bladsy aan 2

Herby I declare, the undersigned as Owner and/or Responsible Person and/or Applicant, for above mentioned controlled burning, that all above information is correct and true. Further do I declare that I will abide by the general rules as attached and given in this application. Hiermee verklaar ek, die ondergetekende as Eienaar en/of Verantwoordelike Persoon en/of Aansoeker, vir bogenoemde beheerde brandwerk, dat alle inligting soos weergee in hierdie aansoek korrek en waar is. Verder verklaar ek dat ek die aangehegte algemene reëls en soos in die aansoek uiteengesit, sal nakom. For any enquiries, contact Vir enige navrae, skakel 043 683 2031 Fax page 1 3 to Faks bladsy 1 3 na 043 683 2031 as application for a fire permit as die aansoek om n brand permit Signature Name in print Date Handtekening Naam in drukskrif Datum For office use only / Slegs vir kantoor gebruik REMARKS BY THE FPO OR A DELIGATE OPMERKINGS DEUR DIE BBB OF n GEMAGTIGDE Application is Aansoek word Reasons for not approval Redes vir afkeur Approved / Goedgekeur Not Approved / Afgekeur Inspection Raport Number Inspeksie Verslag Nommer Fire Permit Number Brandpermit Nommer Permit issued by Permit uitgereik deur Date Datum Date Datum Title Titel Department Afdeling Signature / Handtekening Date / Datum 3

Algemene reëls of informasie/general rules or information Redes waarom u moet aansoek doen vir n brand permit:- Owerhede oefen beheer uit oor brand operasies in hul verantwoordelikheids gebied. Gekontroleerde en beheerde metode word toegepas deur beheerde brande te beperk tot dae waar daar veilig gebrand kan word. Statestiek word opgebou oor beheerde brande, die toepassing daarvan en redes daarvoor. Om te sorg dat wanneer beheerde brand uitgevoer word, word die wetlike vereistes nagekom. Toestemming moet verkry word volgens die Beleidsdokument van die GSBBV, vir die maak van enige vuur, uitgesluit die brand van vullis stort terreine, die maak van braaivleis-, kosmaak- en warmmaak vure in gedemarkeerde areas. Die tipes vure moet ook voldoen aan die GSBBV se Beleidsdokument. Deur aansoek te doen word die moets en moenies onder die aandag van die Aansoeker gebring. Deur aansoek te doen, stel dit die gemagtigde Owerheid in staat om die Grond Eienaar te besoek en hom/haar te help met raad en bystand om die brand veilig en verantwoordelik uit te voer. Deur verantwoordelik, volgens Wetgewing en volgens die reëls van die GSBBV op te tree, beskerm die Aansoeker hom-/haarself teen enige onnodige eise. Reasons why you should apply for a burn permit: - Government exercises control over fire operations in their responsibility area. Controlled and controlled method was applied by controlled burning should be limited to days where it can be safely burned. Statistics is built on controlled fires, its application and the reasons there for. To ensure that, when controlled burns are carried out, the legal requirements are met. Consent must be obtained under the Policy document of the GSBBV for making any fire, except the burning of refuse dump sites, the making of roasted meat, cooking fires and heating up in demarcated areas. The types of fires must also comply with the GSBBV's Policy document. By applying the dos and don'ts to the attention of the Applicant brought. By applying, it allows the Authority authorized in the State Land Ownership and visit him / her to help with advice and assistance to the fire and safely carried out. By responsible, in legislation and the rules of the GSBBV to act to protect the applicant him / herself against any undue claims. Permitte word kosteloos uitgereik. Permits are issued free of charge. Die permit wat uitgereik word, is slegs geldig vir die tydperk soos aangedui op die permit. Brandpermitte word slegs tydens kantoor ure uitgereik. Permitte word uitgereik deur die GSBBV volgens die Beleidsdokument van die GSBBV of soos bepaal deur die BBB. The permit issued is valid only for the period indicated on the permit. Burning permits will only be issued during office hours. Permits are issued by the GSFPA according to the Policy Document of the GSFPA or as determined by the FPO. Geen permitte sal telefonies uitgereik word nie. No permits will be issued by phone. Vir hernuwing van permitte moet dieselfde proses gevolg word. Geen brandwerk mag plaasvind in die brandverbod tydperk, soos uiteengesit in die GSBBV se beleidsdokument in die verband. Vir toestemming vir die dag van brand, moet die navrae kontak nommer geskakel word, om te verseker dat die weersomstandighede gunstig is. Die personeel en hulpmiddels, soos uiteengesit in die aansoek, moet die dag van brand teenwoordig en werkend wees, by die brand area. Die Brand Beskermings Beampte of enige ander Gemagtigde, mag die dag van die brand die area besoek en die brandwerk evalueer. For renewal of permits the same procedure must be followed. No burning may occur in the burning prohibition period, as set out in the GSFPA's policy document in this regard. For approval on the day of fire, the inquiries contact number should be contacted to ensure that the weather is favourable. The staff and resources, as described in the application, must be present and working at the fire area on the day of the burn. The Fire Protection Officer or other authorized person may visit the area on the day of the burn. Die Eienaar van die eiendom is ten alle tye The owner of the property at all times is 4

verantwoordelik en aanspreeklik volgens die Nasionale Veld & Bosbrand Wet (101 van 98), vir enige aksie of skade wat mag ontstaan as gevolg van die brandwerk. Die Persoon in beheer van die brandwerk, moet ten alle tye teenwoordig wees by die brandwerk. Die brand area moet vir n voldoende tydperk opgepas word, deur personeel altyd teenwoordig by die brand area te hê of totdat die area veilig is. Die GSBBV, bure en / of plaaslike Munisipaliteit moet dadelik in kennis gestel word indien die brand buite beheer raak en ekstra hulp benodig word. Daar sal nie toestemming gegee word en u mag nie brand op dae wat die Brand Gevaar Indeks rooi of oranje geklassifiseer is nie. Daar mag nie gebrand word op naweke of publieke vakansie dae of die dag voorafgaande van die dae nie. Geen vuur mag aangesteek word op winderige of bergwind dae, al is die Brand Gevaar Indeks aanvaarbaar. Indien die wind opkom gedurende die brand proses, moet daar gepoog word om alle vlamme te blus en die vuur tot die aanvaarbare standaard op te ruim. Brandbane as voldoende en doeltreffend moet gekonstruktureer word, dat die brand area veilig sal wees tydens die brandwerk en oppas tydperk om te verseker dat die brand nie sal versprei op die betrokke eiendom of na aangrensende eiendom nie. Daar n opvolg plan is vir indien die brand buite beheer raak en sorg te dra dat dit nie skade aanrig nie. Die Persoon in beheer van die brand moet ten alle tye in radio of foon kontak wees met die Owerheid wat die permit uitgereik het. Die rede is dat hulp onmiddelik ontbied kan word, in geval van nood en die Owerheid moet die Persoon kan kontak met enige navrae tydens die brandwerk. Die Brand Beskermings Beampte of enige Gemagtigde, het die reg om die area te besoek voordat die permit uitgereik sal word. Met die afkeur van die permit sal die redes duidelik aan die Aansoeker gestipuleer word. Die Aansoeker is verantwoordelik vir enige kostes o Aangaande die maak van brandbane; o Die gebruik of huur van Personeel en/of Uitrusting om die brandwerk te doen; o Beveiliging van die brand area tot die aanvaarbare standaard; o Wat mag voortspruit uit die brand wat onbeheerd raak en hulp wat ingewin moet word om die brand onder beheer te bring; en o Vir enige skade wat sodanige onbeheerde brand veroorsaak het. responsible and accountable to the National Veld & Forest Fire Act (101 of 98), for any action or damage that may arise as a result of the burning operation. The person in charge of the burning, must always be present at the burning operation. The fire area should be guarded for a sufficient period and staff must always be present at the burn area or until the area is safe. The GSFPA, neighbours and / or local municipality must immediately be notified if the fire out of control and extra help is needed. There will not be authorization and you may not burn on days that the Fire Danger Index are classified as red or orange. No burning may take place on weekends or public holidays or the day preceding these days. No fire may be lit on windy days or bergwind, though the Fire Danger Index is acceptable. If the wind pick up during the burning process all attempt should be made to extinguish all flames and the fire to mop-up the fire to an acceptable standard. Adequate and effective fire breaks should be constructed, that the fire area will be secure during the burning period and to ensure that the fire will not spread to adjacent properties. There must be a follow up plan for if the fire gets out of control to ensure that it does not cause damage. The person in charge of the fire must at all times in radio or phone contact with the Authority that the permit was issued. The reason is that aid can be summoned immediately, in case of emergency and the Authority must be able to contact the permit holder with any queries during the burning. The Fire Protection Officer or any authorized, have the right to visit the area before the permit will be issued. With the decline of a permit, the reasons will be stipulated clear to the Applicant. The Applicant is responsible for any costs o With regard to the preparation of fire breaks; o The use or rental of Staff and / or equipment to perform the burning; o Protection of the fire area to the acceptable standard; o As a result of the fire unattended and get help should be obtained for the fire to bring under control, and o for any damages that such uncontrolled fire caused. Met die uitreiking van die permit sal daar in ag With the issuance of the permit it will be 5

geneem word, indien rook besoedeling vir die omgewing tot nadeel sal wees. Uitkyktorings van AFC rapporteer enige rook aan relevant Owerhede en Maatskappye, wat dan die rook sal besoek om toe te sien dat dit veilig is. Indien daar geen permit vir sodanige brand is nie, sal kostes van die Eienaar verhaal word volgens die Reëls van die GSBBV. Met die brand van tak- of afval hope, moet die volgende reëls nagekom wordo Hope mag nie hoër wees as twee (2) meter en meer as drie (3) meter in deursnit wees nie; o Hope moet ten minste vyf (5) meter van mekaar wees; Die minimum vereistes vir n beheerde brand volgens die GSBBV se beleidsdokument, moet nagekom word. Die Aansoeker moet die GSBBV kantore in kennis stel as die brand suksesvol afgehandel is en beveilig is. considered if smoke pollution will be detrimental to the environment. AFC Lookout towers report smoke to all relevant Authorities and Companies, the smoke may be visited to ensure that it is safe. If no permit for such fire was issued, cost may be recovered from the owner by the Rules of the GSFPO. With the burning of branches or waste heaps, the following rules should be complied witho Heaps may not exceed two (2) meters in height and be more than three (3) meters in diameter; o Heaps must be at least five (5) meters from each other; The minimum requirements for a controlled burn by the GSFPO's policy document, must be met. The Applicant must notify the GSFPA offices when the fire has been successfully completed and safeguarded. Lys van Kontak nommers List of contact numbers Kantoor/Instansie Afdeling/Department Kontak Nommer/Contact Number Distric Municipality Beheerkamer/Control Room Distrik Munisipaliteit Local Municipalities Plaaslike Munisipaliteit Amahlati Municipality Mr CD Solani 043 683 1390 078 732 7873 AFC Forestry Look-out Tower AFC Bosbou Uitkyk Torings Quanti 043 683 1185 Quacu 043 683 7982 Gubu 043 683 7314 Fairview 043 683 1529 Fire Departments Amahlati Fire Dept. Trevor Komga Fire Dept. Leon van de Merwe 043 831 1084 082 778 8500 6