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Instruction Sheet - Agentur KONSENS

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26<br />

26<br />

<strong>Instruction</strong> <strong>Sheet</strong> “Pyrotechnics/actions<br />

involving fire hazards” (continued)<br />

5. Type and scope of planned stage pyrotechnic effects<br />

Class (BAM no.:) Trade name Rise Safety clearance Duration of effects Number<br />

(in surrounding area and above)<br />

6. Date of test:<br />

Date Time Venue (hall/building, room, area, level)<br />

7. Planned security measures:<br />

During preparation<br />

During display<br />

General<br />

8. Miscellaneous/remarks (e.g. special hazards or safety improvement measures)<br />

9. Enclosures:<br />

– Copy: License/certificate of competence<br />

10. License charges to be invoiced to<br />

Surname First name Company<br />

Street, number Postcode Town<br />

Telephone Fax E-mail (if available)<br />

I hereby confirm the correctness and completeness of the information provided above.<br />

Place and date Company stamp and authorized signature<br />

i4.5

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