28.24 CIVIL/PRIVATE AIRCRAFT USE JUSTIFICATION FORM

1) Date
	2) Time     	3) Incident Name     
	4) Dispatcher
	
5) Legal
T           R         ¼ / ¼ 	6a) Latitude
                          ‘               “ N	6b) Longitude
                          ‘               “ W	

7) Agency with Protection Responsibility:	
CERTIFICATION OF IMMINENT THREAT	
8) What is threatened?  (Lives, Homes, outbuildings, timber, grazing land/other-specify)
	
9) Flight Mission Required (e.g. Personnel Movement, Water Drops, Cargo Hauling/other-specify)	

10) Staffing Class___________  (Weather Station_____________ Fuel Model ________________)

Staffing Class I or II requires 12 – 24 hours to respond: Class III – XXXX minutes, Class IV– XXXX minutes, Class V-5 minutes	

11) Aircraft Required:  Type: _____________________________ Time:_______________  Date:_______________	

12) Aircraft Vendor Contacted:	
12) Aircraft Vendor Contacted:	

Who you talked to: __________________________
 
                     When: __________________________	
Who you talked to: __________________________
 
                     When: __________________________	

Vendor’s Aircraft available?   Y         N

                               Time_________ Date_________	
Vendor’s Aircraft available?   Y         N

                               Time_________ Date_________	

Will this private aircraft meet the needs of the mission

            Y       N                   (See block 11)	
Will this private aircraft meet the needs of the mission

            Y       N                   (See block 11)	

Remarks

Remarks

12) Aircraft Vendor Contacted:	
13) Aircraft Vendor Contacted:	

Who you talked to: __________________________
 
                     When: __________________________	
Who you talked to: _____________________________

                     When: _____________________________	

Vendor’s Aircraft available?   Y         N

                               Time_________ Date_________	
Vendor’s Aircraft available?   Y         N

                               Time_________ Date_________	

Will this private aircraft meet the needs of the mission

            Y       N                   (See block  9 & 11)	
Will this private aircraft meet the needs of the mission

            Y       N                   (See block 9 & 11)	

Remarks

Remarks	

Aircraft Assigned                                              Pilot                                                   Owner	

Note:  Evacuation IS in imminent threat.  Demobe of a controlled incident in NOT an imminent threat

Required Blocks: __________, all others optional