California Code of Regulations
Title 19 - Public Safety
Division 1 - State Fire Marshal
Chapter 10 - Explosives
Subchapter 7 - Forms
Article 20 - Application
Section 1583 - Application and Permit Forms
Current through Register 2024 Notice Reg. No. 38, September 20, 2024
The application and permit for explosives shall contain all the information on the following form and such other information as may be required by the issuing authority.
NAME AND ADDRESS OF ISSUING AUTHORITY
(See Section 12007 Health and Safety Code)
APPLICATION AND PERMIT--EXPLOSIVES
| Application & Permit No. ___________________________ | ___________________________Application Date |
| Fee: $2.00 100 lbs. or less | ___________________________Permit Date |
| $10.00 more than 100 lbs. | (Min. 7 day waiting period) |
1. Permittee:
Name __________ Blasters Permit No. __________
| Address ___________________________ | ||||
| Color | Color | Drivers | ||
Age___ (Min. 21) Hgt.___Wgt.___Eyes___Hair___Sex___Lic. # ___
Representing ___________________________
2. Vehicle for Trans: Make _____Model_____ Yr. _____ Lic. No. _____
State Registration__________ Travel Route & Safe Stopping Places __________
3. Activity: Manufacture [] Store [] Receive and/or Transport [] Use []
Sell or otherwise dispose [] Oper. Terminal* [] Park Vehicle []
4. Material: Type of Explosive __________ Quantity__________lbs.
How and/or where stored ___________________________
How and/or where used ___________________________
I, the undersigned, certify that I understand and will abide by all Federal, State and local laws, ordinances, rules or orders to perform those acts noted herein. I also understand that all unused inventory covered by the permit on or before the expiration date will be disposed of in the following manner:
______________________________
APPLICANT'S SIGNATURE
APPROVAL
This permit is granted on __________(Date) to perform those activities noted above, and will expire__________(1 yr. max. from date of issue)
The permittee is limited to perform these activities__________times or during the tenure of the permit, subject to the conditions noted below. This permit is not transferable.
______________________________
ISSUING AUTHORITY
Restrictions:
Distribution:
* Terminal Approvals shall be forwarded to: Enforcement Services Division California Highway Patrol, P.O. Box 898, Sacramento, California 95804
1. Amendment filed 11-4-77; effective thirtieth day thereafter (Register 77, No. 45). For prior history, see Register 71, No. 5.
Note: Authority cited: Section 12081, Health and Safety Code. Reference: Sections 12000-12401 inclusive, Health and Safety Code.
