FORMS

Form Description
Fire Department Citation 3737.41 Form used by a fire department when issuing an Ohio Revised Code 3737.41 citation.
Fire Department Citation 3737.42 Form used by a fire department when issuing an Ohio Revised Code 3737.41 citation.
Fire, Tornado, and Safety Drill Instructions Form to be used by schools to track all fire drills, tornado drills, and safety drills held at the facility.
Flammable and Combustible Liquid Tank/Bulk Plant Application for Inspection Application for the removal, installation, temporary out of service or abandonment of aboveground/underground flammable and combustible liquid tanks.
Nursing Home Fire Report Form filled out by a nursing home when a fire occurs at the facility
Form Description
Burn Injury Form This form is used to report a burn injury per R.C. 2921.22.
Form Description
Exhibition Permit This form is used to apply for an Exhibition Permit.
Explosive magazine permit This form is used to apply for an Explosive Magazine Permit.
Fireworks Exhibitor License Application This form is used to apply for an Fireworks Exhibitor License.
Fireworks Exhibitor Registered Employee Application This form is used to apply for an Fireworks Exhibitor License.
Flame Effect Exhibitor License Application This form is used to apply for an Flame Effect Exhibitor License.
Indoor Exhibit checklist This form is used for all indoor exhibits.
Out of State Shipping Permit This form is used to apply for an Out of State Shipping Permit.
Outdoor Exhibit Checklist This document includes a Checklist for an Outdoor Exhibit.
Form Description
Fire Department Information Form This form is used to update Fire Departments Information in the Directory.
Fire Prevention Materials Order Application This form is used to order Fire Prevention Materials.
NFIRS 5 Field Casualty Report This form is used by Fire Departments to gather needed information at the time of incident to be able to report a Casualty.
NFIRS 5 Field Collection This form is used by Fire Departments to collect information at the scene.
Smoke DOG Application This form is used to nominate someone for the Smoke DOG Award.
Form Description
Application For Decals This form is used to apply for the Public Safety Decals.
Official Inspection Station Application Used to apply to be an Official Inspection Station.
Vehicle Inspection Form Inspection Form to be filled out by Official Inspection Station and kept on file at the fire department.
Form Description
Evidence Submission Form (Microsoft Word) This form is used in the evidence submission process for Investigators.
Evidence Submission Form (PDF) This form is used in the evidence submission process for Investigators.
Form Description
Direct Delivery Request Form This form is used to request Direct Delivery classes to be held at locations other than the Ohio Fire Academy.
Ohio Fire Academy Audio-Visual Catalog This document is a list of videos with descriptions located in the Ohio Fire Academy Resource Center that can be loaned out for training.
Ohio Fire Academy Audio–Visual Request Form This form is used to request audio-visual materials for loan from the Ohio Fire Academy Resource Center.
Ohio Fire Academy Residential Quarters Applications This form is used to register for use of a room while staying at the Ohio Fire Academy if you have not pre-registered for a class.
Ohio Fire Academy Room Request Form This form is used to request usage of Academy rooms and training grounds.
Student Course Application This form is used in lieu of the On-Line Course Application to apply for Ohio Fire Academy courses.
The Rural Community Financial Assistance Application This form is used to apply for financial assistance for low population communities to attend Academy classes.
Form Description
Fire Protection Company License Application This form is used to apply for a Fire Protection Company License.
Fire Protection Individual License Application This form is used to apply for a Fire Protection Individual License.
Fire Protection Individual License Exam Schedule This Document lists the Upcoming Individual Certification Exams Information.
Fire Protection Irrevocable Consent To Legal Service This form is used to Give your Irrevocable Consent To Legal Service for Fire Protection Individual Licensees.
Fire Protection Provisional Application This form is used to apply for a Fire Protection Provisional License.
Form Description
Fireworks Exhibitor License Application This form is used to Apply for a Fireworks Exhibitor License.
Fireworks Exhibitor Registered Employee Application This form is used to register a New Employee for a Licensed Fireworks Exhibitor.
Fireworks Manufacturer List List of certified fireworks manufacturers.
Fireworks Out-of-State Shipper List List of certified out-of-state fireworks shippers.
Fireworks Renewal Application For Out-Of-State Shipping Permit This form is used to Apply for a Renewal of your Out-Of-State Shipping Permit.
Fireworks Shipping Permit - Section 3743.40 Code relevant to Fireworks Shipping Permit
Fireworks Wholesalers List List of certified fireworks manufacturers.
Flame Effect Exhibitor License Application This form is used to apply for the Flame Effect Exhibitor License.
Form Description
Hotel Motel Information Change Application This form is used to make changes to your Information for a Hotel Motel License.
Hotel Motel License Application This form is used to apply for the Hotel Motel License.
Form Description
Reduced Ignition Propensity Cigarettes Manufacturer Application This document is used to apply for a reduced ignition propensity cigarette certificate.
UST Installer Exam Schedule This document includes the latest Underground Storage Tank Installer Exam Schedule.
UST Installer License Application This form is used to Apply for a Underground Storage Tank Installer License.
UST Permit Application This form is used to apply for a Underground Storage Tank Permit.
UST Registration Application New, Modified, Transfer This form is used to Register a Underground Storage Tank.
Form Description
300-foot Door-to-Door Survey Form (Microsoft Word) or (PDF) This form is used to document the results of the door-to-door survey, and must be submitted with the Tier 2 Evaluation Report. The survey is performed during the Tier 2 Evaluation to identify potable water well usage within 300 feet of the UST site.
Free Product Recovery Report Form (Microsoft Word) or (PDF) This form is used to describe the free product recovery activities that were performed, and must be submitted every month.
Immediate Corrective Action Report Form (Microsoft Word) or (PDF) This form is used to describe the immediate corrective actions performed and must be submitted within twenty days of starting an immediate corrective action.
Interim Response Action Notification Form (Microsoft Word) or (PDF) This form is used to notify BUSTR of your plan to perform an interim response action, and must be submitted ten days prior to beginning the interim response action.
Interim Response Action Report Form (Microsoft Word) or (PDF) This form is used to describe the interim response actions that were performed, and must be submitted within sixty days of completing the interim response action.
Land-Use Survey Form (DOC) This form is used to document the results of the land-use survey, and must be submitted with the Tier 2 Evaluation Report. The survey is performed during the Tier 2 Evaluation to determine land-use within 300 feet of the UST site.
Petroleum Contaminated Soil Form(Microsoft Word) or (PDF) This form documents the quantity of PCS, disposition, etc. and must be submitted to BUSTR any time petroleum-contaminated soil is generated.
Soil Classification Report Form (Microsoft Word) or (PDF) This form is used to identify the soil classification for each exposure pathway evaluated during the tier evaluation and reporting process, and must be submitted with the tier reports.
Tier 1 Delineation Notification Report Form (Microsoft Word) or (PDF) This form is used to summarize the information obtained and evaluated during the Tier 1 Source Investigation, and must be submitted when at least one of the chemical concentrations exceed tier 1 action levels.
Tier 1 Evaluation Report Form (Microsoft Word) or (PDF) This form is used to summarize the information obtained and evaluated during a Tier 1 Source Investigation, and must be submitted when all concentrations are below tier 1 action levels (i.e., when the release qualifies for No Further Action status).
Tier 1 Investigation Report Form (Microsoft Word) or (PDF) This form is used to summarize the information obtained and evaluated during a Tier 1 Delineation investigation.
Tier 2 Evaluation Report Form (Microsoft Word) or (PDF) This form is used to summarize the information obtained and evaluated during the tier 2 evaluation process, and must be submitted within eighteen months after BUSTR’s approval of the Tier 1 Investigation report.
UST Closure Assessment Form (Microsoft Word) or (PDF) This form is required when any portion of the UST system is permanently removed (including removals resulting from modifications and major repairs), closed-in-place, changed-in-service, or has been out-of-service for more than 12 months.