Fire Management Consultant Inc.
1382 Chaplin Court, Tracy, CA 95376
Phone:
209.612.8832
 
SERVICES REQUEST FORM
To: Wood Chipping Services at FMC
Subject:
Your Email:
Your Name:
Your Phone: (enter as: 9165551212) Ext:
Address:
City: State: Zip Code:
Lot Type: County:
REQUIRED Wood Chipping Services Information:
Daytime Contact Phone Number: (if different)
Nearest Cross Street:
Are you the owner of the property? YesNo
Property Owners Name: (if different)
Total Number of Piles:
Average pile size (in ft.): Width: Length: Height:
Location of piles: DrivewayPrivate RoadCounty Road
Approximately how many hours did it take to prepare your piles?
Approximately how many acres of property did you clear?
Are you a member of a Fire Safe Chapter? YesNo
If “Yes” which chapter?
NOTE: Piles must be located alongside of established road or driveway!
By submitting this request, I agree to the following terms and conditions:
1. I agree to allow Fire Management Consultant onto my property
2. I agree to have the material chipped back onto my property
3. I understand that Fire Management Consultant has final authority in determining if piles are suitable for chipping
4. I understand that if the pile is not prepared to our specifications it will not be chipped
5. I agree to comply with Fire Management Consultant decisions where to place the chips, as safety is our number one concern
6. I understand that I will pay Fire Management Consultant the agreed price
The applicant agrees to save, indemnify, and hold harmless Fire Management Consultant and/or its representatives from all liabilities and clams for damage by reason of injury or death to any person or persons, or damage to property from any cause whatsoever, while, in, upon, or in anyway connected with the work associated with this request.
Additional
Information:
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