N.H. Code Admin. R. Saf-C 5029.04 – Accident Report Form

(a) The operator shall submit the following on the accident report:
1. (1) Date of the report;
2. (2) Certificate of competency number;
3. (3) Time and location of accident;
4. (4) Name and address of person(s) injured or killed;
5. (5) Weather conditions at time of accident;
6. (6) Name and address of person who conducted the display;
7. (7) Type of display firework that malfunctioned;
8. (8) Description of the accident;
9. (9) Cause of the accident;
10. (10) Names and addresses of any known witnesses;
11. (11) Name of hospital or doctor where injured person(s) was taken to;
12. (12) Detailed description of failure, if the launching mechanism was involved; and
13. (13) Signature of individual who conducted the display.
  Source. #9765-B, eff 8-2-10 (from Saf-C 5026.02(b)); ss by #12124, eff 3-6-17
  APPENDIX A
  Rule
  Specific State Statute which the Rule Implements
  Saf-C 5001.01 – Saf-C 5001.02
  RSA 160-B:1, X; RSA 541-A:7
  Saf-C 5002.01 – Saf-C 5002.08
  RSA 541-A:7
  Saf-C 5002.09
  RSA 160-B:1, X; RSA 541-A:7
  Saf-C 5002.10 – Saf-C 5002.17
  RSA 541-A:1, XV
  Saf-C 5002.18
  RSA 259:60; RSA 541-A:7
  Saf-C 5002.19 – Saf-C 5002.33
  RSA 541-A:7
  Saf-C 5003.01
  RSA 160-B:3 & RSA 160-B:7
  Saf-C 5003.02(a)
  RSA 541-A:7
  Saf-C 5003.02(b)-(f) & 5003.04
  RSA 158:9-f, I(b) & RSA 160-B:7, I
  Saf-C 5003.03
  RSA 159:9-h, III & RSA 158:9-f, I(b)
  Saf-C 5003.04
  RSA 158:9-f, I(b) & RSA 160-B:7, I
  Saf-C 5003.05
  RSA 160-B:3 & RSA 160-B:7
  Saf-C 5003.06
  RSA 159:9-h, III & RSA 158:9-f, I(b)
  Saf-C 5004.01 – Saf-C 5004.04
  RSA 158:9-c, III-a ; RSA 160-B:8, VIII
  Saf-C 5004.05
  RSA 160-B:4, I(e); RSA 160-B:6, III
  Saf-C 5004.06
  RSA 160-B:6, III-b
  Saf-C 5004.07
  RSA 160-B:6, III-a
  Saf-C 5004.08
  RSA 160-B:6, III-b
  Saf-C 5005.01
  RSA 160-B:7, I; RSA 160-B:8, I
  Saf-C 5005.02
  RSA 160-B:8, I; RSA 541-A:30
  Saf-C 5005.03
  RSA 541-A:31
  Saf-C 5006.01 – Saf-C 5006.02
  RSA 160-B:6, VI
  Saf-C 5007.01
  RSA 160-B:7
  Saf-C 5007.02
  RSA 160-B:7
  Saf-C 5007.03 – Saf-C 5007.04
  RSA 160-B:7
  Saf-C 5007.05 – 5007.07
  RSA 160-B:7, V
  Saf-C 5008 – Saf-C 5013
  RSA 160-B:6, III-a, III-b & RSA 160-B:8, VIII
  Saf-C 5014.01
  RSA 265:115, VI
  Saf-C 5014.02(a)
  RSA 265:115, III(c)
  Saf-C 5014.02(b) – Saf-C 5016
  RSA 265:115, RSA 158:9-f, I; 160-B:8, VIII
  Saf-C 5017- Saf-C 5028
  RSA 158:9-f, I; RSA 160-B:7, IV
  Saf-C 5029.01(a)
  RSA 160-B:8, V
  Saf-C 5029.01(b)
  RSA 160-B:6, X
  Saf-C 5029.02
  RSA 158:9-c, III-a ; RSA 160-B:8, VIII
  Saf-C 5029.03
  RSA 160-B:7, V; RSA 160-B:8, V
  Saf-C 5029.04
  RSA 160-B:8, VI
  APPENDIX B
  MATERIALS INCORPORATED BY REFERENCE
  Rule
  Title
  Obtain at:
  Saf-C 5015.03
  National Fire Protection Association (NFPA), 10 Standard for Portable Fire Extinguishers, 2018 edition.
  National Fire Protection Association
  One Batterymarch Park
  Quincy, MA 02269
  Phone: 1-800-344-3555
  Web site: www.nfpa.org
  Ordering and pricing options:
  Softcover or pdf - $54.00
  Saf-C 5016.03(c)
  National Fire Protection Association (NFPA) 498 “Standard for Safe Havens and Interchange Lots for Vehicles Transporting Explosives”, 2013 Edition
  National Fire Protection Association
  One Batterymarch Park
  Quincy, MA 02269
  Phone: 1-800-344-3555
  Web site: www.nfpa.org
  Ordering and pricing options:
  Softcover - $40.50 for non-NFPA members and $36.45 for members
  Online subscriptions are available at www.nfpacodesonline.org
  Saf-C 5017.02
  National Fire Protection Association (NFPA) 1123 “Code for Fireworks Display”, 2014 Edition.
  National Fire Protection Association
  One Batterymarch Park
  Quincy, MA 02269
  Phone: 1-800-344-3555
  Web site: www.nfpa.org
  Ordering and pricing options:
  Softcover - $49.00 for non-NFPA members and $44.10 for members
  Online subscriptions are available at www.nfpacodesonline.org
  Saf-C 5018.01(e)
  National Fire Protection Association (NFPA) 701 “Standard Methods of Fire Tests for Flame-Propagation of Textiles and Films”, 2015 Edition
  National Fire Protection Association
  One Batterymarch Park
  Quincy, MA 02269
  Phone: 1-800-344-355
  Web site: www.nfpa.org
  Ordering and pricing options:
  Softcover - $40.50 for non-NFPA members and $36.45 for members
  Online subscriptions are available at www.nfpacodesonline.org
  Saf-C 5023.01, Saf-C 5025.01, Saf-C 5028.01
  National Fire Protection Association (NFPA) 1123 “Code for Fireworks Display”, 2014 Edition.
  National Fire Protection Association
  One Batterymarch Park
  Quincy, MA 02269
  Phone: 1-800-344-3555
  Web site: www.nfpa.org
  Ordering and pricing options:
  Softcover - $47.50 for non-NFPA members and $42.75 for members
  Online subscriptions are available at www.nfpacodesonline.org