EXPLOSIVES FACILITY LICENSE

1. BASE 2. ORGANIZATION(Include initials of Parent Command in parenthesis, if in Tenant) 3. LICENSE NO.

I. FACILITY DATA
4. FACILITY IDENTIFICATION

5. PRIMARY USE 6. WRITTEN OI'S APPLICABLE

7. ROOM NO. 8. ROOM USE 9. CONSTRUCTION

II. EXPLOSIVES LIMITS REQUESTED

(If more space is needed, use second page)
CLASS/ COMPATIBILIT EXPLOSIV FIRE
DIVISIO Y NOMENCLATUR QNT E SYMBO
E Y WEIGHT L
A B

III. CERTIFICATION
I CERTIFY the above described facility is required in support of the mission of the above organization.
DATE TYPED NAME, GRADE AND TITLE OF CERTIFYING OFFICIAL SIGNATURE

IV. ACTION OF RESPONSIBLE OFFICIAL

DATE TYPED NAME, GRADE AND TITLE OF APPROVING OFFICIAL SIGNATURE

REMARKS

V. COORDINATION

AF IMT 2047, 19980704, V1 PREVIOUS EDITION IS OBSOLETE

 EXPLOSIVES FACILITY LICENSE
II. EXPLOSIVES LIMITS REQUESTED
CLASS/ COMPATIBILIT EXPLOSIV FIRE
DIVISIO Y NOMENCLATUR QNT E SYMBO
A E Y WEIGHT L
B

AF IMT 2047, 19980704. V1 PREVIOUS EDITION IS OBSOLETE (REVERSE)