Forest home fire risk form

Site Hazards

Surrounding Trees

Hardwoods (leafed trees)
No trees within 9m or 30'
10 trees within 9m or 30'
10-20 trees within 9m or 30'
20+ trees within 9m or 30'

Conifers (needled)
No trees within 9m or 30'
10 trees within 9m or 30'
10-20 trees within 9m or 30'
20+ trees within 9m or 30'

Mixed Wood
No trees within 9m or 30'
10 trees within 9m or 30'
10-20 trees within 9m or 30'
20+ trees within 9m or 30'

Ladder Fuels

Underbrush and low branches present?
Yes No

Type of Ground Cover

Majority of type of coverage within 9m or 30'.
Sand, Gravel, etc (Non-combustible)
Grasses up to 15 cm or 6" tall
Grasses 15 cm - 30 cm or 6" - 12"
Grasses greater than 30 cm or 12"
Mosses
Shrubs with leaves
Shrubs with needles

Firewood or Fuel Storage

(e.g., propane/oil tanks)
None
0 to 1m, or 0 to 3' from structure
1m to 9m, or 3' to 30' from structure
9m+, or 30'+ from structure

Brush Piles

None
0 to 1m, or 0 to 3' from structure
1m to 9m, or 3' to 30' from structure
9m+, or 30'+ from structure

Gas Cans, Paint, etc.

None
0 to 1m, or 0 to 3' from structure
1m to 9m, or 3' to 30' from structure
9m+, or 30'+ from structure

Open burning practiced?

Yes No

No burn barrel/incinerator or not to standard?

Yes No

Outbuildings within 6m or 20' of structure?

Yes No

Total Site Hazard =

Structural Hazards

Roofing materials

Metal, tile, or fiberglass
Asphalt shingles/rolled roofing
Wood (Cedar shingles)

Foundation

Enclosed (Fireproof, i.e., concrete, metal)
Enclosed with wood sheeting
Open

Exterior wall materials

Brick/Stone/Metal
Vinyl/Wood

Decks and overhangs?

Yes
No

Total structural hazard =

Hazard Reductions

Site

Trees pruned up to 2 m or 6'
Lot cleared of brush within 9 m or 30'
Grass kept watered and short
Leaves/needles raked
1 m or 3' of gravel or non-flammable material adjacent to structure

Structure

Regularly cleaned roof
Non-flammable skirting on decks
Clear of flammable material against structure

Other

Useable water supply nearby
Fire fighting equipment - hose, ladder, shovel
Communication system (phone, radio)
Knowledge of fire reporting number
Burn barrel/incinerator to standard
Outbuildings hazard-free

Total Hazard Reduction =