GCHNA · 2022 Firesafe Mitigation Form

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FIRESAFE MITIGATION FORM

Are you making your property more firesafe? Let us know!

Please submit before October 1st.

If you prefer to mail in a paper copy, you can download the form.

For more information, visit:
http://www.gchna.com/firewise-community/

If you have any questions, send an email to firewise@gchna.com.

Household Fire Risk Contributions

For Calendar Year

Contact Information

Name

First Name

Last Name

Property Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Phone

ZONE & ACTION

1. Home Ignition Zone – HOUSE - 0 to 5 feet from foundation

(roof to foundation risk reduction)

Clean litter from roof and gutters
Screen vents, enclose soffits and eaves
Clean and clear under decks (flammables and vegetation)
Fire resistant roofing, siding or decking
Replace mulch with gravel and stone
Remove pine needles and leaves
Trim back trees that hang over 5 foot areas near foundation
Move firewood 30 feet from house and cover with a Firesafe tarp

Zone 1 - Hours

Zone 1 - Number of People

Zone 1 - Cost of Materials ($)

2. Intermediate Zone - 5 to 30 Feet from House

Intermediate Zone - 5 to 30 Feet from House

Clear vegetation from under large stationary propane tanks
Create fuel breaks with driveways, walkways/paths, patios, dry creeks
Space trees with an 18’ separation between tree canopies
Reduce all ladder fuels, prune shorter trees up to 1/3 of overall tree height
Thin and limb up all trees reducing distance to minimum of 18’ between the crowns
Cluster trees and shrubs to break up the continuity of vegetation to discourage fire flow
Tree canopy no closer that ten feet to the edge of structure

Zone 2 - Hours

Zone 2 - Number of People

Zone 2 - Cost of Materials ($)

3. Extended Zone - 30 to 100 Feet from House

Extended Zone - 30 to 100 Feet from House

Remove all needles within 30 feet of house
Thin trees and ladder fuels, small conifers growing between mature trees
Remove vegetation adjacent to storage sheds
Trees 30-60 feet from home should have 12 feet between canopy tops

Zone 3 - Hours

Zone 3 - Number of People

Zone 3 - Cost of Materials ($)

OTHER MONEY SPENT

Chipper rental, fuel, disposal fees ($)

Green waste removal fees ($)

include costs for dump runs

Power equipment, hand tools, chainsaws ($)

rental or purchase

Arborists, landscapers, forestry service ($)

Construction ($)

for example, re-siding or re-roofing

Total Money Spent

Total Amount Spent ($)

Sum of costs for Materials and Other Money Spent

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