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Nov 30 04 12133p Public Relations 913- 703.8109 p. <br /> • <br /> SITE INFORMATION FOR FIREWORKS DISPLAY <br /> Organization sponsoring event: Ze hvrhi t i _ <br /> Date and time of production: 3/13/10 - approx. 7:OOPM - 5 Minutes <br /> Location of production; _Zephyr Park /Lake Zephyr, 38116 5th Ave. , Zephyrhills, FL 33542 <br /> Nano of main operator: _ Chr Reitargo <br /> Number and ages of all assistants: <br /> Confirmation of License held by operator: See attached <br /> Evidence ofpermitee's insurance carrier: , See attached <br /> Number and types of pyrotechnic devices and materials to be <br /> used: See attached <br /> MSDS for pyrotechnics used: See attached <br /> Extinguishers on site (pressurized water — at least 2): 2 <br /> Diagram of where production to be conducted (to include point of firing, fall out radius, <br /> and audience location): See attached <br /> Firing safeguards in place: <br /> • circuit testers no more than 25 mA <br /> • power for firing sources be restricted to batteries or isolated power supplies <br /> • firing systems ensures against accidental firing (2 -step interlock) <br /> • not to be left unattended <br /> • smoking prohibited within 25' of the firing/handling area <br /> • appropriate distance from audience (not less than twice the fallout radius) <br /> • all access points are blocked off into firing/handling area <br /> Ori /7n — N1Ht — ,rn.• +. ......• • <br />