2. Blasting Permit Inspection Request
4. Fire Blasting Permit #*
5. Development Location
7. Anticipated Blast Time and Date*
   Anticipated Blast Time and Date

   Anticipated Blast Time and Date
8. Blast #

   What is the sequence number of this blast for the project? Example: 1st Blast, 2nd Blast, etc.

10. Site Contact Name of Blaster*
11. Phone Number of Blaster*
13. Email Address of Blaster*
14. Is Blaster making this request?

    1. Yes
    2. No
16. Name of Requestor

    If different than Blaster.

17. Phone Number of Requestor
19. Email Address of Requestor
21. Blasting Area for Reference*

    Upload the map for visual reference and identify test shot area for this blast.

23. Questions, comments or additional information:
25. Inspection Agreement*

    24 hour blast notifications are required, this request form fulfills that requirement. Once we receive your request we will send a meeting invite to confirm and you will see the inspection scheduled in your CSS Portal. If you have not received a response to this request via email or telephone prior to 8am on the day of the blast, please call our office at (509) 585-4302 or the Deputy Fire Marshal directly at (509) 521-2103.

    1. I agree to notify the Deputy Fire Marshal by phone at (509)521-2103 at least one hour prior to the blast.
    2. I agree to email the Post Blast Shot Report to fireprevention@ci.kennewick.wa.us within 24 hours of the blast for review.
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field