Information
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Document No.
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Address
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Homeowner Name(s)
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Conducted on
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Prepared by
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Take one photo of front of house
Roof and Eaves
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1) (Required) What is the roof type? (Select all that apply).
- Metal
- Clay
- Tile
- Slate
- Asphalt
- EPDM
- Wood shingle
- Unknown
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Required Action: Replace roof with a Class A fire-rated roof. A building permit is required to replace a roof.
For Metal, Clay, Tile or Slate Roofs Answer Question Below
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Gaps: For Metal, Clay, Tile, Slate roofs, is the roof covering free of gaps and protected from ember penetration?
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Action: Plug all gaps between the roof covering and roof deck, at the roof edges to preclude the entry of flames with embers with either "bird stop" or mortar mix.
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Check this box if you require the homeowner to plug all gaps between the roof covering and roof deck and/or at the roof edges for certification.
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2) Condition: Is the roof in good condition?
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Action: Replace or repair all damaged areas. Make sure that there are no openings, cracks or gaps that are larger than 1/8 inch.
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Check this box if you require the homeowner to replace of repair all damaged areas of the roof for certification.
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3) Roof Design: Are dormers or other complex features mitigated to help protect from ignition (roof covering and exposed wall junction)?
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Action: Install metal step flashing from under the roof covering and up the exposed wall a minimum of 2 inches.
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Check this box if you require the homeowner to install metal step flashing from under the roof covering and up the exposed wall a minimum of 2 inches for certification.
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Action: Replace wood siding with ignition resistant materials.
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Check this box if you require the homeowner to replace wood siding with ignition resistant materials such as fiber cement product for certification.
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4) Debris: Are the roof, gutters, eaves, Solar Panels and Skylights free of combustible debris (needles, leaves and nests) and properly mitigated? (Select all that apply).
- Yes - Pass All
- No - Roof
- No - Gutters
- No - Eaves
- No - Solar Panels
- No- Skylight debris
- No - Skylights (plastic/dome)
Roof Debris Comment, Photo and Check Box
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Specialist comment on roof debris:
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Take photo of roof debris
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Check this box if you require the homeowner to remove combustible debris from roof for certification.
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Action: Remove combustible debris from roof.
Gutter Debris Comment, Photo, and Check Box
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Specialist comment on gutter debris:
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Take photo of gutter debris
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Check this box if you require the homeowner to remove combustible debris from gutters from certification?.
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Action: Remove combustible debris from gutters.
Eave Debris Comment, Photo, and Check Box
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Specialist comment on eave debris:
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Take photo of eave debris
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Check this box if you require the homeowner to remove combustible debris from eaves for certification.
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Action: Remove combustible debris from eaves.
Solar Panel Debris Comment, Photo, and Check Box
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Specialist comment on solar panel debris:
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Take photo of Solar Panel debris
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Check this box if you require the homeowner to remove combustible debris from Solar Panels for certification.
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Action: Remove combustible debris from Solar Panels.
Skylight Debris Comment, Photo, and Check Box
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Specialist comment on skylight debris:
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Take photo of skylight debris
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Check this box if you require the homeowner to remove combustible debris from the skylight for certification.
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Action: Remove combustible debris from Solar Panels.
Skylight Construction Comment, Photo, and Check Box
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Specialist comment on skylight construction:
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Take photo of plastic or dome-type skylight.
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Check this box if you require the homeowner to replace plastic or dome-type Skylights with flat, tempered glass skylights for certification?
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Action: Replace plastic or dome-type Skylights with flat, tempered glass skylights.
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5) Gutters: Is the roof edge above the gutters protected by metal angle flashing and are the gutters and downspouts noncombustible?
- Yes - Pass All
- No - Roof Edge
- No - Vinyl Gutters
Drip Edge Comment, Photo, and Check Box
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Specialist comment on angle flashing at roof edge.
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Take photo of missing angle flashing at roof edge.
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Check this box if you require the homeowner to install metal angle flashing at the edge of the roof for certification.
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Action: To provide additional protection, install metal angle flashing at the edge of the roof.
Vinyl Gutters Comment, Photo and Check Box
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Specialist comment on vinyl gutters.
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Take photo of vinyl gutters.
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Check this box if you require the homeowner to replace vinyl gutters with metal ones for certification.
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Action: Replace vinyl gutters with metal gutters.
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6) Eaves: Is open eave construction properly mitigated?
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Action: Consider converting open eave framing to a boxed-in or soffited-eave design. Caulk any cracks and gaps between the blocking that fills the space between exposed roof rafters and any adjacent members.
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Check this box if you require the homeowner to convert open eave framing to a boxed-in or soffited-eave design for certification.
Siding, Vents & Openings
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1) Siding Type: Is the siding combustible or noncombustible?
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Recommended Action: Consider replacing combustible siding with a noncombustible or ignition resistant siding product. Alternatively, consider installing non-combustible siding on at least the lower portion of the wall (first 3-4 ft.) where it comes closest to the ground.
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Check this box if you require combustible siding to be replaced for certification.
Select Siding Type from List Below
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What type of siding is on the home? (Select all that apply).
- Hardboard/Cementitious
- Mason/Brick
- Metal
- Natural/Fabricated
- Stone/Rock
- Stucco
- Log
- Fiberwood/Wood comp.
- Natural wood/Cedar
- Vinyl
- Other/Unknown
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2) Siding Condition: Is the siding free of gaps, holes, or other areas where embers could accumulate, lodge, or penetrate?
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Action: Use caulk to fill all holes, gaps and other areas where embers may lodge or penetrate into the walls.
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Check this box if you require the homeowner to fill all holes, gaps and other areas where embers may lodge or penetrate into the walls for certification.
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3) Base of Walls: Are combustible components of walls properly protected (clearance or flashing) from ignition?
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Action: There are several mitigation options available to obtain 2 inches or more clearance. 1) remove siding at the base of the wall 2) lower adjacent grade 3) cover bottom of siding board with non-combustible material.
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Check this box if you require the homeowner to mitigate the base of walls for certification.
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4) Vents: Are vents properly mitigated? (Select all that apply).
- Yes - Pass All
- No - Roof
- No - Gable
- No - Soffit
- No - Wall
- No - Dryer
- No - Other vents
Roof Vents Comment, Photo and Check Box
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Specialist comment on roof vent(s):
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Take photo of roof vent(s)
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Check this box if you require the homeowner to cover roof vents with 1/8th inch mesh for certification.
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Action: Cover roof vents with 1/8th inch corrosion-resistant metal mesh.
Gable Vents Comment, Photo and Check Box
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Specialist comment on gable vent(s):
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Take photo of gable vent(s)
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Check this box if you require the homeowner to cover gable vents with 1/8th inch mesh for certification.
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Action: Cover gable vents with 1/8th inch corrosion-resistant metal mesh.
Soffit Vents Comment, Photo and Check Box
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Specialist comment on soffit vent(s):
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Take photo of soffit vent(s)
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Check this box if you require the homeowner to cover soffit vents with 1/8th inch metal mesh for certification.
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Action: Cover soffit vents with 1/8th inch corrosion-resistant metal mesh.
Wall Vents Comment Photo and Check Box
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Specialist comment on wall vent(s):
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Take photo of wall vent(s)
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Check this box if you require the homeowner to cover wall vents with 1/8th inch metal mesh for certification.
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Action: Cover wall vents with 1/8th inch metal mesh.
Dryer Vent Comment, Photo and Check Box
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Specialist comment on dryer vent:
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Take photo of dryer vent
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Check this box if you require the homeowner to install louver-type dryer vent for certification.
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Action: Install a louver-type dryer vent that automatically stays closed unless the dryer is running.
OTHER Vents Comment, Photo and Check Box
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Specialist comment on OTHER vents:
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Take photo of OTHER vent(s)
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Check this box if you require the homeowner to cover OTHER vents with 1/8th inch corrosion-resistant metal mesh for certification.
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Action: Cover OTHER vents with 1/8th inch corrosion-resistant metal mesh.
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5) (Required) Windows: Are all single-pane windows properly mitigated? (Select only one).
- Yes - Pass All
- No - Replace
- No - Defensible space
- N/A
Single-pane Window Comment, Photo and Check Box
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Specialist comment on single-pane window:
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Take photo of single-pane window
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Required Action: Replace single-pane windows with dual or multi-pane windows - preferably ones with tempered glass.
Dspace near Single-pane window Comment, Photo and Check Box
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Specialist comment on need for dspace near single-pane window
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Take photo of single-pane window and marked vegetation.
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Required Action: Remove all marked vegetation near your single-pane window.
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6) Unenclosed floor area: Are overhangs and other exposed areas properly protected? (Select all that apply).
- Yes - Pass All
- No - Bay windows
- No - Overhangs
- No - Open foundation
- N/A
Open Foundation Comment, Photo and Check Box
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Specialist comment on open foundation:
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Take photo of open foundation
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Check this box if you require the homeowner to enclose foundation with noncombustible material for certification.
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Action: Protect foundation with noncombustible material - this process may include "skirting".
Bay Windows Comment, Photo and Check Box
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Specialist comment bay window(s):
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Take photo of bay window(s)
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Check this box if you require the homeowner to install a noncombustible hard surface under Bay Windows and remove all combustibles in this area for certification.
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Action: Install a noncombustible surface under bay windows and remove all combustibles in this area.
Overhangs Comment, Photo and Check Box
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*Specialist MUST enter comments on overhangs:
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*Specialist MUST take photo of overhangs
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Based on comments above, check this box if you require the homeowner mitigate overhangs for certification.
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7) Other Openings: Are other openings (dog doors, crawl space doors, cellar doors, other) properly mitigated? <br>* Specialist must enter comment and photo for 'no' response.
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8) Garage Doors: Are garage doors free of gaps? Are plastic windows mitigated? (Select all that apply).
- Yes - Pass All
- No - Gaps
- No - Plastic windows
- N/A
Garage Door Gaps Comment and Photo
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Specialist Comment on garage door gaps:
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Take photo of garage door gaps.
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Recommended Action: install new weather stripping around the perimeter of the door.
Garage Door Plastic Windows Comment and Photo
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Specialist Comment on plastic garage windows
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Take photo of plastic garage windows that should be replaced.
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Recommended Action: Replace garage windows with dual or multi-pane windows, preferably ones with tempered glass.
Decks, Porches and Structure Attachments
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1) Fence: Are wood fences attached to structure (that could carry fire to the home) properly mitigated?<br>*Specialist MUST take photo for "no" response.
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Action: Retrofit fence so it ends with a noncombustible material, like masonry or metal.
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Check this box if you require homeowner to retrofit fence so it ends with a noncombustible material for certification.
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2) Deck Connection: Is there protection at combustible siding to deck junction?
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Action: Install a metal flashing strip between the top of the deck and the exterior combustible siding.
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Check this box if you require the homeowner to install a metal flashing strip between the top of the deck and the exterior combustible siding for certification.
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3) Deck Condition: Are deck boards in good condition (free from rot and large cracks)?
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Recommended Action: Replace all rotten or heavily damaged deck boards with new ones.
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4) Items on Deck: Is the top of the deck AND deck-to-wall intersection free of combustible material (fire wood/pine needles)? *Specialist, MUST enter comment and photos for "no" response.
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Action: Remove combustible materials from on top of the deck.
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Check this box if you require the homeowner to remove combustible materials from on top of the deck for certification.
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5) Other Attachments: Are other attachments (trellis, arbor, dog house, lattice, landings) properly mitigated? <br>*Specialist MUST enter comment and photos for "no" response.
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Based on your comment, check box if you require the homeowner properly mitigate other attachments for certification.
Noncombustible Zone 1A (0 - 5ft)
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1) (Required) Noncombustible Surface: Is there a noncombustible surface extending around the entire home and any attachments such as decks?
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Required Action: Create a noncombustible surface around structure. At a minimum rake down to bare mineral soil so nothing combustible is present.
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2) (Required) Live and Dead Vegetation: Are organic mulches, grasses, woody shrubs, junipers, pine needles and tree branches in Zone 1A properly mitigated?
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Required Action: Remove combustible live or dead vegetation from Zone 1A.
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3) (Required) Landscape Timbers: Are landscape timbers properly mitigated in Zone 1A?
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Required Action: Remove or protect landscape timbers in Zone 1A.
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4) (Required) Under Decks: Is the area under all decks and extensions clear of combustible materials?
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Required Action: Remove all combustible material and/or vegetation from under all decks and/or extensions.
Zone 1 (5 to 30ft)
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1) (Required) Trees: Do the trees in Zone 1 meet CO State Forest Service guidelines?
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Required Action: Remove all marked trees in Zone 1.
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Required Action: Remove all marked trees in Zone 1. If high value trees are kept in Zone 1, consider them part of the structure, isolate them from other trees, remove ladder fuels and remove the lowest branches so they are 10 ft from the ground.
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2) (Required) Pine Needles: Are deep accumulations of pine needles, mulches and grasses raked away from high value trees in Zone 1?
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Required Action: Remove pine needles and dead grasses within the first 3 ft of the base of all high value trees in Zone 1 because they act as ladder fuels. Rake so that bare mineral soil is exposed.
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3) (Required) Junipers: Are rocky mountain and ground Junipers properly mitigated in Zone 1?
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Required Action: Remove all marked ground junipers and juniper trees in Zone 1.
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4) (Required) Shrubs: Are shrubs well spaced and removed from the drip line of "keep" trees in Zone 1?
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Required Action: Remove all marked shrubs in Zone 1. Remove excessive growth, dead stems and accumulated dead leaves..
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5) (Required) Maintenance: Are all grasses and weeds cut to a maximum height of 6 in in Zone 1?
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Required Action: Mow grasses and weeds to a maximum height of less than 6 inches
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6) (Required) Surface Fuels: Are heavy accumulations of branches, logs, pine needles and wood chips removed from Zone 1?
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Required Action: Remove heavy accumulations of branches, logs, pine needles and wood chips from Zone 1.
Zone 2 (30 - 100+ ft)
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1) (Required) Topography: Does 100 ft meet CO State Forest Service DISTANCE guidelines for Zone 2? <br>*Specialists must enter distance for 'no' response.
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2) (Required) Conifers: Is there proper crown spacing between conifers and appropriate clumping in Zone 2?
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Required Action: Remove all marked trees in Zone 2.
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3) Aspen: Are aspen present?
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When possible promote Aspen in Zone 2.
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4) (Required) Shrubs: Are shrubs well spaced and removed from the drip line of "keep" trees in Zone 2?
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Required Action: Remove all marked shrubs. For retained shrubs, remove excessive growth, dead stems and accumulated dead leaves in Zone 2.
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5) (Required) Low Limbing: Are the lowest branches in Zone 2, removed within 6 - 10 ft from the ground or limbed to 1/3 the height of the tree, whichever is less?
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Required Action: On all retained trees in Zone 2, remove all branches within 6 - 10 ft from the ground or limb to 1/3 the height of the tree, whichever is less.
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6) (Required) Surface Fuels: Are heavy accumulations of dead branches, logs, pine needles and wood chips removed in Zone 2?
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Required Action: Remove heavy accumulations of dead branches, logs, pine needles and wood chips in Zone 2.
Accessory Structures & Personal Property
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1) (Required) Detached Accessory Structures: Are other structures in Zone 1 adequately mitigated? *Specialist MUST enter comment and photo for 'no' response.
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Required Action: Remove all marked trees and apply the same mitigation measures as you would for the home.
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2) (Required) Firewood: Are firewood piles stored at least 30 ft from all structures and are there are least 10 ft of clearance between the piles and the closest conifer branches?
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Required Action: Relocate pile to an open location so it is uphill or on the same elevation and at least 30 ft away from all structures. There should also be 10 ft of clearance between it and the next conifer branches.
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3) (Required) Propane Tanks: Are propane tanks properly mitigated?
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Required Action: Clear all combustible debris and vegetation within 10 ft of all propane tanks.
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4) (Required) Other Items: Are other combustible items (scrap lumber, junk, cars, boats, rvs, etc.) properly mitigated? <br>*Specialist MUST enter comment and photo for 'no' response.
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Required Action: Perform mitigation of combustible items.
Insurance
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1) Underinsurance: Are you aware that a large percentage of homeowners are NOT adequately insured?
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2) Home Inventory: Have you conducted a home inventory and stored it in a safe place outside your home?
Emergency Preparedness
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1) Evacuation: Have you practiced and/or actually evacuated your home?
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2) Belongings: Have you prepared a written list of items to take with you and a disaster evacuation kit?
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3) Notification: Have you signed up to receive free emergency alerts from the Office of Emergency Management?
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4) Communication: Have you planned how your family will stay in contact (where you will meet) if separated during a wildfire?
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5) Pets: Do you have a plan for evacuating your pets?
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6) Address Marker: Is there a proper property address marker?
Community Involvement
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1) Neighbors: Have you talked to your neighbors about linking mitigation efforts?
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2) Community: Would you like more information on existing wildfire programs in your community? <br>
Wildfire Partner Internal Use Only
Information For Forestry Contractor Use
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Dspace: What is the homeowners current plan for removing vegetation?
Zone 1 Trees
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Zone 1: How many trees greater than 8 inches did you mark for removal?
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Zone 1: Are there technical trees marked for removal? *Specialist must enter comment and photo of technical trees.
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Zone 1: How many trees less than 8 inches did you mark for removal?
- 1-10
- 10-20
- 20-30
- 30-40
- 40-50
- 50-100
- more than 100
Zone 2 Trees
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Zone 2: How many trees greater than 8 inches did you mark for removal?
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Zone 2: How many trees less than 8 inches did you mark for removal?
- 1-10
- 10-20
- 20-30
- 30-40
- 40-50
- 50-100
- more than 100
Zone 1 and 2 Shrubs
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Zone 1 and 2: How many shrubs did you mark for removal?
- 1-10
- 10-20
- 20-30
- 30-40
- 40-50
- 50-100
- more than 100
Financial Questions
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1) What is the homeowner’s need for financial assistance?
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2) Is the homeowner interested in completing home retrofits before dspace work?
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Specialist Comments on Homeowner Financials
