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Rx Burn Notice
Agency
– Select –
BLM
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USFS
DES
MDS
OHS
PAS
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NJS
Unit ID
Rx Name
Rx Units
Project Number
Financial/Fiscal Code
Ignition Date & Time
Number of Ignition Days Planned
Anticipated End Date & Time
Latitude (Decimal °N)
Longitude (Decimal °W)
Location Description
Daily Target Acres
Total Project Acres
Ignition Type
Broadcast Burning
Pile Burns
Ignition Method
Hand
ATV/UTV
Terra-Torch
Helicopter
sUAS/Drone
Other
Burn Boss Name
Burn Boss Phone
Burn Boss Trainee Name
Trainee Phone
Burn Resources – Include Position Codes
Contingency Resources – Include Position Codes
Notify the following agencies and organizations:
Name/Agency 1
Name/Agency 2
Name/Agency 3
Name/Agency 4
Name/Agency 5
Name/Agency 6
Name/Agency 7
Name/Agency 8
Name/Agency 9
Name/Agency 10
Phone for Agency 1
Phone for Agency 2
Phone for Agency 3
Phone for Agency 4
Phone for Agency 5
Phone for Agency 6
Phone for Agency 7
Phone for Agency 8
Phone for Agency 9
Phone for Agency 10
Submitted By
Submitter’s Email
DO or FMO Name
DO or FMO Email
Submit Form
