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<br />Nov.17. 100711 :38AM <br />"Nov 3004 ~~Jsap <br /> <br />Pyrotecnico <br />pulelU.a Re"loat.i'ons <br /> <br />No.9617 P. 3 <br />e:1 s-7aS~En os p,G <br /> <br />:SITElNFOllMATiON FOR:FlREWORKS DISPLAY <br /> <br />Org8ruzadon sponsoring event: Florida Hosllita:l Ze.nhvrhillss ,050 Gall Blvd. J <br />Zephyrhills,FL 33541 - Jerry Sterner 813-235-3150 <br />oarenndtimoo~production:"December 2, 2007 - 6:30PM <br /> <br />Location of production: Florida Hospital Zephyr hills <br /> <br />Nlmle ofmainop<<m11or: Chris Reitano <br /> <br />"Number and ages ofal1uslstBJllS: <br />Ryan Pedraza - 22 yr~, nlrl <br /> <br />Confirmation of License held by operator~ See attached <br /> <br />E1rldence ofpcnnitec's insurance cerrier: See attached <br /> <br />Number" and types ofpyroteclmic device!! and mll1crialS to be <br />used: Spp attal"hprl <br /> <br />. MSDS forpy.rc1echnJcsuaed:~~eatt.a..ched <br /> <br />Bxtinsuisbere on she (ptesmiz.ed water - at least 2): 2 <br /> <br />Diagfam of where production to be.conducted (to include point of firing. fall OU~ radius, <br />aana\ldience location)~ See attached <br /> <br />Piring safepuds in place: <br />. c~uit testers no more than 2S roA <br />. power for firing sources be restricted to batteries or isolated power supplie9 <br />. firing systems ensures against accidental firing (2-step interlock) <br />. not to be left lIll8ttcnc:1cxl <br />. llmoking pro~ibi1ed within 2S' of the firing;handUng aroa .4. ,~\) .~~ <br />. QPPUJ}I1.. iale distance from audience (not 10sI tban twice the iI110ut ndiu() "'l ~.,~ ~~~ . <br />· all~~arcblookod.fflnto~.... -g~~ ~o\~~~"I . 1 <br />"o~<tj<f>o\ (<;ff''l. . ~e~~ #~~ i\\,v4 () <br />~ cdS ~~rJ .~~ 1\ ~~ "'~~ \ <br />. .~&,\~90 S ~\.c~\\.~\."o~ ~'I(;<":1~~ ~ vo~ <br />~~\: e, 'b.~~ e'4e 0\ 1$' ~~ .. <br />~ '\i\.'\.e ~ c:~~ <br />A r,~o.~ Q"f.;s.e <br />,,\.~~ 0-' <br /> <br />