045-3 Wyo. Code R. § 3-7 - Forms

(a) Information about forms described in this rule and regulation shall be available through the Wyoming Department of Transportation Utilities and Railroads Section, 5300 Bishop Blvd., Cheyenne, Wyoming, 82009-3340, telephone307-777-4133.

(b) Please see the following page for an example of the fireguard inspection report form.

WYDOT

Form 10B

Sheet 1 of 1

WYDOT FIREGUARD INSPECTION

REPORT FORM

Four copies shall be prepared for each annual inspection or upon completion of periodic inspections. One copy to be retained by each member of the inspection team, and one forwarded to the Commission by September 1 of each year.

Date: ________________

Agent: Wyoming State Forestry Division:

County: ___________________________

Railroad: ___________________________

INSPECTION PARTY

Signatures:

1.

_____________________________________________________

Name Title

2.

_____________________________________________________

Name Title

3.

_____________________________________________________

Name Title

Railroad Mile Posts: (one area per form) _____________________________

Treatment: Select one or combination of treatments from methods 1-10 of Section 4(h) of Chapter 3, Fireguards, Fencing of Railroad Property, and Claims for Injury to Livestock, of the Railroads and Transportation Tariffs Section of WYDOT's rules and regulations.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________

Recommended Completion Date: ______________________________________________________

Forwarded:

Commission Agent

For assistance in containment or notification of burning operations please contact:

Name: ______________________ Title: ____________________________

Tel. No.: ______________________ FAX: ____________________________

Notes

045-3 Wyo. Code R. § 3-7