ࡱ> %` n{bjbjٕ kn****lB<2 j$j$j$j$%'43)<<<<<<<$">h@)<P-%"%P-P-)<j$j$k<x0x0x0P- j$j$<x0P-<x0x0V7@8j$ $*Z-8 9<0<+8xJAp-JA8JA8d)*x0+l}+))))<)<n0 )))<P-P-P-P-BBBDBBB.$Rj NEBRASKA STATE FIRE MARSHALS OFFICE APPLICATION FOR PUBLIC DISPLAY OPERATORS LICENSE Please TYPE or PRINT LEGIBLY all information. There is no charge for the license. Application must be received in the State Fire Marshals office in Lincoln at least 5 business days prior to the examination date. APPLICANT INFORMATIONLAST:  FORMTEXT      FIRST:  FORMTEXT      MI:  FORMTEXT      STREET:  FORMTEXT      APT #:  FORMTEXT      PO BOX #:  FORMTEXT      CITY:  FORMTEXT      ST:  FORMTEXT NEZIP CODE:  FORMTEXT       -  FORMTEXT     TELEPHONE:HOME: ( FORMTEXT    )  FORMTEXT     -  FORMTEXT     WORK: ( FORMTEXT    )  FORMTEXT     -  FORMTEXT     SSN:  FORMTEXT     -  FORMTEXT    -  FORMTEXT     DATE OF BIRTH (MM/DD/YYYY):  FORMTEXT      NUMBER OF DISPLAYS YOU HAVE BEEN INVOLVED WITH:  FORMTEXT    TEST INFORMATIONTEST DATE (MM/DD/YYYY):  FORMTEXT      CITY: APPLICATION FOR: ORIGINAL  FORMCHECKBOX RENEWAL:  FORMCHECKBOX CURRENT LICENSE #:  FORMTEXT    -  FORMTEXT    /  FORMTEXT    REFERENCESLIST THREE PEOPLE, NOT RELATIVES, WHO CAN ATTEST TO APPLICANT S EXPERIENCE, TRAINING, AND INTEGRITY.1. NAME: FORMTEXT       ADDRESS: FORMTEXT       CITY:  FORMTEXT      ST:  FORMTEXT NEZIP CODE:  FORMTEXT       -  FORMTEXT     TELEPHONE: ( FORMTEXT    )  FORMTEXT     -  FORMTEXT     2. NAME: FORMTEXT       ADDRESS: FORMTEXT       CITY:  FORMTEXT      ST:  FORMTEXT NEZIP CODE:  FORMTEXT       -  FORMTEXT     TELEPHONE: ( FORMTEXT    )  FORMTEXT     -  FORMTEXT     3. NAME: FORMTEXT       ADDRESS: FORMTEXT       CITY:  FORMTEXT      ST:  FORMTEXT NEZIP CODE:  FORMTEXT       -  FORMTEXT     TELEPHONE: ( FORMTEXT    )  FORMTEXT     -  FORMTEXT     TRAININGTRAINING ATTENDED IN FIREWORKS SAFETY (INCLUDE DATES): FOR FIRE MARSHAL S USE ONLYDATE RECEIVED:TEST NUMBER:NUMBER MISSED:PASS  FORMCHECKBOX  FAIL  FORMCHECKBOX LICENSE NUMBER: EXPIRATION DATE:DATE LICENSE ISSUED: NEBRASKA STATE FIRE MARSHALS OFFICE PHONE: (402) 471-2027 246 SOUTH 14TH STREET FAX: (402) 471-3118 LINCOLN, NE 68508-1804 State Fire Marshal Title 157, Chapter 3 003.11 An adequate number of operators, assistants, and monitors shall be on hand to conduct the display. At least one public display operator licensed by the State Fire Marshal shall supervise all displays. 003.11A \]mqry    + 3 I J N P Q [ \    2 4 6 @ B L N b d f p r t v ӶӯtjhcUjhcUjhcUmHnHujhcUjhcUhc hc5\hc5B* CJ\ph3fhxafB* phhHxB* phhcB* phhc5B* \phhcB* CJph3fjhcCJUmHnHu-*\]2 3 I J  D t ysss$Ifqkd$$Ifl4'8(  04 laf4p $$Ifa$ & F$a$ n{t v wqqq$Ifkd$$Ifl4F"!'0    4 laf4v      " . 0 D F H R T ^ ` t v x | ~ jhcUjhcUhcmHnHuj#hcUjhcUhcB* phjhcUjhcUjhcUmHnHujhcUhcjhcU hc5\2 " V zttt$Ifkd$$IflF'D 0    4 la   " $ & , . 2 4 H J L R T Z \ p r t | ~ ҿʱҦʱқʱҐʱ҅ʱzj{ hmUj hmUjhmUjhmUjhmUjhmUmHnHuj-hmUjhmUhm hm5\hcB* phhcjhcUmHnHujhcU0  ztttt$Ifkd$$IflF'D 0    4 la    " $ & , . 4 6 J L N R T Z \ p r t | ~ ǹΨǚΨᒎumf`Z`Z`f hHxCJ hcCJ hc5\hmB* phjhyYUmHnHuj hyYUhyYjhyYUjg hyYhcU jhyYhmUmHnHuj hyYhcU hyYhmjhyYhmUhmhm5 hm5hmjhmUjhmUmHnHu# fd^^$IfkdS $$Ifl4\&'   04 laf4 BDXZ\bdfh,.JLNbdӺӞӐӞӂwjRhcUjhc5U\jjhc5U\jhc5U\jLhcU hHxCJ hcCJhcB* phj hcU hc5\jhcUmHnHuj hcUhcjhcU.fh$Iftkd $$Ifl40'Z04 laf4$Ifqkd $$Ifl4'8(  04 laf4p P$Iftkd$$Ifl40'^04 laf4 "8:024>@BD`bvxzޑކjhcUj hcUh/45B* CJ\phhc5B* CJ\phhcB* CJph3fhcB* phj>hcUjhcUhc hc5\jhcUmHnHujhcU0 wq$Ifkd$$Ifl4F'D@0    4 laf4 "8:&qkd$$Ifl4'8(  04 laf4p $Ifakdb$$Ifl4'8(04 laf4:Bakd$$Ifl4'8(04 laf4$IfBD`$Iftkd$$Ifl40'z!04 laf4X$Iftkd$$Ifl40'z!04 laf4 *,24HJLTVprӴөמאtj{hcU jhc5U\mHnHujhc5U\jhc5U\jhcUjhcUhcmHnHujhcUhc hc5\jhcUmHnHujhcUj)hcU*"$&(DFZ\^hjln,˵˪˟ˋjhcUhcmHnHuj?hcUjhcUjhcUjhcUhchcB* ph hc5\jhcUmHnHujhcUjhcU2d^$Ifkdg$$Ifl4\ &'X :  04 laf4&$Ifakd+$$Ifl4'8(04 laf4&(Dl$Iftkd#$$Ifl40'!04 laf4ln<$Iftkd1$$Ifl40'!04 laf4,.08:TVjlntvz|  (*>@BLNP׾̭쩞쩓׋׋쩀׋uj["hcUjM!hcUhcB* phjhcUjhcUhc jhc5U\mHnHujhc5U\jhc5U\ hc5\jhcUmHnHujhcUj/hcU.d^$Ifkd $$Ifl4\ &'X :  04 laf4 $Ifakd $$Ifl4'8(04 laf4  (P$Iftkd!$$Ifl40'!04 laf4PR $Iftkd"$$Ifl40'!04 laf4PRhj~8:NPRXZ^`tvx~wlj%hcU jhc5U\mHnHujE%hc5U\jhc5U\j$hcUjY$hcUhcmHnHuj#hcUjhcUmHnHuji#hcUhcjhcU hc5\hcB* ph*~26FH  CDY[^˭˦wohD{B* ph3fj*hc5U\jM*hc5U\jhc5U\hs|B* ph hs|5\hcB* ph3fha5B* \ph3fhc5B* \ph3fhcB* phjhcUmHnHuj1&hcUhc hc5\jhcU(d^$Ifkd&$$Ifl4\ &'X :  04 laf4&qkd'$$Ifl4'8(  04 laf4p $Ifakdk'$$Ifl4'8(04 laf468:<>@BDFH $$Ifa$ckd($$Ifl4'8(04 laf4$If $Ifqkd)$$Ifl4'8(  04 laf4p $Iftkd)$$Ifl402'04 laf42C$Iftkd5+$$Ifl402'04 laf4CDYZ"akde,$$Ifl4'8(04 laf4$Iftkd+$$Ifl402'04 laf4Z[\]^tovott>v@v"x$xtzvzn{ @ `^@ ``gdxafgdxaf p`^p``gdxaf `^``gdxafgdD{~n~nntovoooo0ppppp(sfs:t@ttttttttttRuTuZuuuuv@vPvRvvvvv x"xƽƲƶƲƲƲƫƧƣƟƛƲƧƲƧƧƲƧƲ hxaf5\hHxhw rh/4h6} hcH*Uhxaf hc5\hc5CJ\hchD{hc5B* \ph3fhD{hD{5B* ph3fhD{hc5B* H*ph3fhD{hc5B* ph3f:No person shall handle or be involved in the firing of fireworks while under the influence of alcohol, narcotics, or drugs which could adversely affect judgment, movements or stability. 003.11B Applications for the Fireworks Display Operator s examination are available from the State Fire Marshal s Office located at 246 South 14th Street, Lincoln, NE 68508, (402) 471-2027. Please call for exam times and locations. Applicants shall submit their completed applications to the State Fire Marshal s Office in Lincoln at least five (5) business days prior to the examination date. Applicants shall be required to successfully pass a multiple choice/true-false examination concerning the laws, firework display regulations of Title 157, Chapter 3, and the safety practices of the State Fire Marshal. Licenses from other states WILL NOT be accepted. 003.11B1 Completed applications shall include the names and addresses of at least three persons as reference who are not relatives and who can attest to the applicant s experience, integrity and training. 003.11B2 Any applicant who fails the examination may reapply to take the next examination. However, if the applicant fails a second examination, he or she will be required to wait six (6) months from the date of the first unsuccessful exam. 003.11B3 Public display operator licenses shall be valid for a period of three years. This subsection shall not prohibit the revocation of a permit for just cause where a fire nuisance exists or where personal injury may occur. The State Fire Marshal may require a reexamination of any licensee. 003.11B4 An applicant for the public display operator license must be at least 18 years old on the date of the examination. 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