Appendix J

Instruction Sheet
Public /Civil Aircraft Utilization
Dispatch Work Sheet / Documentation Record

If it is necessary to utilize a State, or County aircraft for a Federal incident or a Federal aircraft for a state incident or mission you must complete this form each operational period to remain within compliance of public law 103-411. This form must be filled out by the Agency representative (Dispatcher) every time a State aircraft is dispatched to a Federal incident, certifying that a civil operator was not available. 

1.	Determine if there is a need to utilize another government’s aircraft for the mission or incident.
a.	If the answer is yes fill in the blocks stating the Date/Time of request, Incident Name, Jurisdictional Agency, Incident #, Resource Requested, and the Date Time needed.

2.	Determine if a Significant or Imminent Threat Exists. This must be a yes. Next determine what that threat is, a Threat to Life, a Threat to human Health or a Threat to Property or Natural Resources.

3.	Next identify whether a civil commercial aircraft operator is unavailable to meet the request. If the answer is yes continue. If the answer is yes then state the reasons why the civil operator was not utilized. This would include an Aircraft not available in a timely Manner an Aircraft not capable of meeting the operational needs, or an Aircraft not Available (within ordering area of influence).

4.	Paragraphs 2 and 3 above must be identified with a yes response or the flight will not meet the guidelines of public law 103-411.

5.	Write any significant information in the Remarks section.

6.	Sign and date the form with your name, the dispatch office, and the date and time the dispatch was made. Then, fax the completed form to the Northern Rockies Coordination Center at 406-329-4891. This form must be submitted each operational period.

Failure to certify can result in an $1100.00 fine per incident, for the using agency.

Public /Civil Aircraft Utilization
Dispatch Work Sheet / Documentation Record
(To be completed each operational period by the Dispatcher that is representing the user agency.)

The intent of this work sheet is to accomplish the essential documentation required by the Public Safety act amendments pertaining to Public Aircraft 14 CFR part 1 definitions, not to delay the dispatch of initial Attack aircraft resources requested.

1. Utilization of Non – federal aircraft (State, County, etc) for a Federal incident / mission (or vice versa) where reimbursement will be required and a common treasury does not exist:
Yes: 		  No:		

a If yes was identified; the following elements MUST be completed. (Additional clarification and information is identified in the Public / Civil Aircraft Dispatch matrix or Agency Policy on the Definition of public Aircraft 14 CFR Part 1 Definitions.)

Date/ time of request:				Incident Name:						

Jurisdictional Agency:				Incident #:							
Resource Requested:				Date / Time needed:							
2.* 	Significant or Imminent Threat Exists:    			YES		NO		
 	a. Threat to Life							
	b. Threat to human Health							
	c. Threat to Property or Natural Resources			

	3.*	Commercial Civil Aircraft Operator unavailable to meet flight request:  YES	NO	
		a. Aircraft not available in a timely Manner					
		b. Aircraft not capable of meeting needs							
		c. Aircraft not Available (within ordering area of influence)			

* Items 2 and 3 need to be identified with a “yes” response or the flight will not meet the guidelines of Public Law 103-411.

	4.	REMARKS:																																																																			

5.	Certifying Dispatcher:

Name: 								Date:					
Dispatching Office:						Time:						

01/26/2004