# COMAR Title 10 — Maryland Department of Health ## Subtitle 16 — Housing ### Chapter 05 — Health Permits for Outdoor Musical Festivals **Authority:** Business Regulation Article, §17-1404; Health-General Article, §§2-104(b) and (l) and 20-303; Annotated Code of Maryland **Administrative History:** Effective date: January 25, 1980 (7:2 Md. R. 115) **Administrative History:** Regulations .01 — .07 repealed and new Regulations .01 — .16 adopted effective September 12, 2005 (32:18 Md. R. 1520) **Administrative History:** Regulation .01B amended effective December 23, 2013 (40:25 Md. R. 2069) #### Regulation .01 Scope. *COMAR 10.16.05.01* A. This chapter governs health permits for outdoor musical festivals, as set forth in Business Regulation Article, §§17-1401 — 17-1407, Annotated Code of Maryland. B. In addition to a health permit, a person who wants to be a promoter of an outdoor musical festival shall obtain a safety permit and a promoter license in accordance with Business Regulation Article, §§17-1401 — 17-1407, Annotated Code of Maryland. C. This chapter applies only: (1) If admission is charged to attend the outdoor musical festival; (2) To an outdoor musical festival with 500 or more spectators in attendance for: (a) Carroll County; (b) Frederick County; (c) Kent County; (d) Queen Anne's County; and (e) Washington County; and (3) To an outdoor musical festival with 1,000 or more spectators in attendance for: (a) Anne Arundel County; (b) Baltimore County; (c) Calvert County; (d) Caroline County; (e) Cecil County; (f) Charles County; (g) Dorchester County; (h) Garrett County; (i) Harford County; (j) Prince George's County; (k) Somerset County; (l) St. Mary's County; (m) Talbot County; (n) Wicomico County; and (o) Worcester County. D. This chapter does not apply to an outdoor musical festival held in: (1) Baltimore City; (2) Allegany County; (3) Howard County; (4) Montgomery County; (5) Carroll County by a college or public school; or (6) Kent County by a nonprofit agricultural, charitable, civic, fraternal, religious, social welfare, or war veterans' organization operating in Kent County. #### Regulation .02 Definitions. *COMAR 10.16.05.02* A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Applicant” means a person who is applying for a health permit as part of the process of applying for a promoter license in order to hold an outdoor musical festival. (2) “Health officer” means the health officer or the health officer's designee for the county in which the outdoor musical festival will be held. (3) “Health permit” means a permit issued by a health officer verifying that an applicant has complied with: (a) This chapter; and (b) Business Regulation Article, §17-1404(b), Annotated Code of Maryland. (4) “Outdoor musical festival” means an event at which a group of individuals participates in musical entertainment: (a) In an open space; (b) Not in a permanent structure; and (c) Not on publicly owned property. (5) “Permanent structure” means a structure that: (a) Has been approved by the local authority administering building codes to remain in place for a period of more than 180 consecutive days; and (b) Is used for sheltering performers and spectators. (6) Promoter. (a) “Promoter” means a person who: (i) Organizes, operates, produces, or stages an outdoor musical festival; or (ii) Owns or leases property where an outdoor musical festival is held. (b) “Promoter” does not include the State or a political subdivision of the State. (7) “Promoter license” means a license to act as a promoter issued by the clerk of the circuit court for the county in which the outdoor musical festival will be held. #### Regulation .03 Incorporation by Reference. *COMAR 10.16.05.03* The Maryland Medical Protocols for Emergency Medical Services Providers (MIEMSS 1999 Edition) which has been incorporated by reference in COMAR 30.01.02.01, is incorporated by reference in this chapter. #### Regulation .04 Health Permit Application. *COMAR 10.16.05.04* An applicant shall: A. Post a cash bond with the application in accordance with the requirements of Regulation .09 of this chapter; B. Submit documentation to show that the applicant has obtained approval of the local law enforcement unit to hold the outdoor musical festival; and C. Submit a completed health permit application form, plans, and descriptions to the health officer at least 60 days before the date that the festival will be held including: (1) Copies of contracts, leases, agreements, or other documentation that verifies compliance for the provision of health services and facilities, safety, and sanitation at the outdoor musical festival as required in Regulations .05 — .08 of this chapter; (2) The name, address, and telephone number of the applicant; (3) The name, address, and telephone number of the property owner where the outdoor musical festival will be held; (4) The location of the outdoor musical festival by: (a) County; (b) Tax district; (c) Plat; and (d) Street or highway location; (5) The dates and times that the outdoor musical festival will be conducted; (6) A written description, a site plan, and photographs of the outdoor musical festival site; (7) Documentation of local zoning approval for use of the property as a site for an outdoor musical festival; (8) A description of the type of entertainment and events scheduled during the outdoor musical festival; (9) Attendance estimates listed by dates and times; (10) The total number of tickets that will be printed for: (a) Sale; and (b) Complimentary distribution; (11) A written description of: (a) The water supply; (b) The toilet facilities and sewage waste disposal method; (c) The hand-washing facilities; (d) Garbage and refuse storage; and (e) Garbage and refuse removal; (12) A written plan for: (a) Emergency medical services; (b) Litter control; and (c) If applicable: (i) Temporary food service facilities; and (ii) Overnight placement of recreational vehicles during the outdoor musical festival; (13) A statement of compliance with the Worker's Compensation Act; and (14) The signature of the applicant. #### Regulation .05 Requirements for Obtaining a Health Permit. *COMAR 10.16.05.05* In order to obtain a health permit, an applicant shall submit to the health officer written documentation, such as a contract, service agreement, permit, or similar documentation showing that: A. The water supply provided for the outdoor musical festival will be: (1) From a public or individual potable water supply system that is: (a) In conformance with COMAR 26.04.01, 26.04.03, and 26.04.04; (b) Adequate in volume to supply the total quantity of water anticipated for use at the outdoor musical festival using a figure of 5 gallons per spectator per day or less as determined by the health officer or applicable local authority; and (c) Connected to a distribution system so that plumbing fixtures are provided with a potable supply of water in the amounts and pressures as specified in COMAR 09.20.01; or (2) A temporary potable water supply that has been approved by the local health department or applicable local authority; B. Disposal of sewage and waste water generated during the outdoor musical festival will be in accordance with all applicable State and local sewage disposal laws and regulations; C. A dump station or sewage waste scavenger service that has been approved by the local health department or applicable local authority will be provided on a daily basis for recreational vehicles that remain overnight on the outdoor musical festival premises; D. For the duration of the outdoor musical festival: (1) One drinking fountain will be provided for each group of 500 spectators or fraction of 500 spectators; (2) One designated male toilet facility and one designated female toilet facility will be provided for each group of 200 spectators or fraction of 200 spectators; (3) One designated male hand-washing facility and one designated female hand-washing facility that are supplied with water, soap, and hand towels will be provided for each group of 200 spectators or fraction of 200 spectators; (4) The toilet and hand-washing facilities provided for the outdoor musical festival will be: (a) Permanent on-site facilities if the sewage disposal system has adequate capacity to handle the anticipated flow of waste as determined by the local health department or applicable local authority; or (b) Portable sanitary facilities, with a service contract for daily pumping out of waste and cleaning, that have been approved by the local health department or applicable local authority; (5) Garbage and refuse storage and removal will be provided so that a health problem, hazard, or nuisance is not created; (6) Litter control measures will be provided to prevent the accumulation of bottles, broken glass, and other sharp and dangerous objects; (7) Weeds and grass will be cut to a height of 3 inches or less as a tick control measure; (8) The site will be kept free of puddles of stagnant water as a mosquito control measure; (9) Lighting will be provided at the following locations when the outdoor musical festival is conducted between the times of sunset and sunrise: (a) Entrances and exits; (b) Toilet and hand-washing areas; (c) Water supply outlets; (d) Food service areas; and (e) Emergency medical treatment areas; (10) Warning signs or barriers will mark clearly potentially hazardous areas at or adjacent to an outdoor musical festival site, such as: (a) Water; (b) Holes; (c) Drops; or (d) Similar features; and (11) Emergency medical services will be provided that meet the requirements of Regulation .06 of this chapter. #### Regulation .06 Emergency Medical Services. *COMAR 10.16.05.06* An applicant shall ensure that emergency medical services will be provided on-site for the duration of an outdoor musical festival, including from the time of the initial arrival of spectators until the departure of spectators, as evidenced by: A. An emergency medical services plan that includes: (1) The expected number of individuals that will attend; (2) Details of arrangements and copies of contracts made to satisfy the requirements of this regulation; (3) Confirmation that the local jurisdictional emergency medical services operational program and hospital emergency department have been notified of the location, date, and expected number of attendees of the outdoor musical festival; (4) Approval of the plan by the local jurisdictional emergency medical services operational program; (5) Confirmation of a communication system capable of contacting fire, rescue, police, and 9-1-1 services; and (6) Procedures for the documentation and tracking of patient care and transport; B. A plan providing emergency medical staff in the following ratios: (1) Fewer than 5,000 people, a minimum of two first responders who are: (a) Licensed or certified in Maryland in accordance with Education Article, §13-516, Annotated Code of Maryland; (b) Trained in CPR and the use of automatic defibrillators; and (c) Functioning under an emergency medical services operational program as defined in COMAR 30.02.01.01B; (2) From 5,000 — 10,000 people, a minimum of: (a) Four first responders who are: (i) Licensed or certified in Maryland in accordance with Education Article, §13-516, Annotated Code of Maryland; (ii) Trained in CPR and the use of automatic defibrillators; and (iii) Functioning under an emergency medical services operational program as defined in COMAR 30.02.01.01B; and (b) Two advanced life support providers who are: (i) Licensed or certified in Maryland in accordance with Education Article, §13-516, Annotated Code of Maryland; and (ii) Functioning under an emergency medical services operational program as defined in COMAR 30.02.01.01B; and (3) More than 10,000 people, a minimum of: (a) Four first responders who are: (i) Licensed or certified in Maryland in accordance with Education Article, §13-516, Annotated Code of Maryland; (ii) Trained in CPR and the use of automatic defibrillators; and (iii) Functioning under an emergency medical services operational program as defined in COMAR 30.02.01.01B; (b) Two advanced life support providers who are: (i) Licensed or certified in Maryland in accordance with Education Article, §13-516, Annotated Code of Maryland; and (ii) Functioning under an emergency medical services operational program as defined in COMAR 30.02.01.01B; (c) One physician licensed in the State; and (d) One advanced life support ambulance and crew functioning under an emergency medical services operational program as defined in COMAR 30.02.01.01B; C. A plan for a health assessment and treatment area that is: (1) An enclosed area that is environmentally controlled to provide protection against extremes of heat or cold; (2) Equipped with cots and blankets; (3) Well lighted and ventilated; and (4) Maintained in a clean and sanitary condition; D. A plan for equipment necessary to implement Maryland Medical Protocols for Emergency Medical Services Providers to treat the expected number of injuries anticipated at the outdoor musical festival, which includes: (1) First aid supplies; (2) Defibrillation equipment, including at least one automated external defibrillator with portable oxygen device; (3) Supplies and equipment necessary for the staff required in §B of this regulation to deliver care according to Maryland Medical Protocols for Emergency Medical Services Providers; and (4) Supplies and equipment necessary for the staff to maintain precautions against disease transmission; and E. A plan for transportation in the event an individual requires additional care, which includes: (1) An agreement of the local emergency medical services operational program to provide ambulance service; or (2) A contract with a Maryland licensed commercial ambulance service to provide ambulance service. #### Regulation .07 Food Service Facilities. *COMAR 10.16.05.07* An applicant shall ensure that a food service facility operating on-site during the outdoor musical festival will meet all applicable food service facility standards as set forth at: A. Health-General Article, Title 21, Subtitles 1 — 3, Annotated Code of Maryland; and B. COMAR 10.15.03. #### Regulation .08 Environmental Noise Control. *COMAR 10.16.05.08* An applicant shall ensure that the outdoor musical festival will meet the environmental noise limits as specified in COMAR 26.02.03. #### Regulation .09 Bond Requirements. *COMAR 10.16.05.09* A. In St. Mary's County, this regulation does not apply if the applicant owns the property where the outdoor musical festival is held. B. Amount of Bond. (1) Except as provided in §§A and B(2) and (3) of this regulation, an applicant shall post with the application for a health permit a cash bond in an amount to be determined by the health officer. (2) The health officer may not set a bond in excess of: (a) $25,000 in Frederick and Washington counties; and (b) $50,000 in the other counties to which this chapter applies. (3) In St. Mary's County, an applicant may pledge real or personal property instead of posting a cash bond if the applicant submits to the health officer a verified financial statement confirming that the fair market value of the pledged property equals or exceeds the amount of the bond required. C. The health officer shall: (1) Keep the bond until 30 days after the end of the outdoor musical festival; and (2) Return to the applicant any money that has not been used and is not needed to satisfy pending claims. D. If, within 72 hours after an outdoor musical festival ends, the promoter fails to remove all trash and to begin repair of any damage to property caused or created by the outdoor musical festival or its spectators, including crops and livestock, the health officer may use as much of the bond as necessary for the: (1) Removal of the trash; and (2) Repair of the damage. E. A person who has a claim against the bond shall submit the claim to the health officer within 30 days after the outdoor musical festival ends. F. If a claim is submitted, the health officer shall: (1) Determine the validity of the claim and, if justified, the amount of money needed to cover the claim; and (2) Pay from the bond the amount necessary to cover the claim. #### Regulation .10 Approval or Denial of Health Permit. *COMAR 10.16.05.10* A. Within 30 days of receipt of an application, the health officer shall: (1) Review the application and required documentation for a health permit; and (2) Approve or deny the issuance of a health permit. B. If the health officer denies the issuance of a health permit as set forth in §A of this regulation, the health officer shall notify the applicant in writing: (1) Of the reason for the denial; and (2) That the applicant has an opportunity for a hearing in accordance with Regulation .15 of this chapter. #### Regulation .11 Permit Form Requirements. *COMAR 10.16.05.11* A health officer shall issue a health permit that stipulates the: A. Maximum number of spectators that may be accommodated at any one time on the premises of the outdoor musical festival; B. Duration and times of the outdoor musical festival; C. Location of the outdoor musical festival; and D. Name and address of the: (1) Applicant; and (2) Property owner. #### Regulation .12 Health Permit Posting Requirement. *COMAR 10.16.05.12* A promoter shall post the health permit in a conspicuous location at the site of the outdoor musical festival. #### Regulation .13 Inspections. *COMAR 10.16.05.13* The health officer may inspect the site of the outdoor musical festival to verify compliance with this chapter. #### Regulation .14 Injunctions and Suspension or Revocation of a Health Permit. *COMAR 10.16.05.14* A. In addition to any other enforcement action set forth in this chapter, a health officer may seek an injunction to enforce the provisions of this chapter. B. Suspension or Revocation. The health officer may: (1) Suspend or revoke the health permit if the permit holder: (a) Violates a requirement of this chapter; (b) Fraudulently or deceptively obtains a health permit; (c) Fraudulently or deceptively uses a health permit; or (d) Fails to correct a situation that threatens the health, safety, or welfare of a spectator at the outdoor musical festival; and (2) Summarily suspend the health permit and close an outdoor musical festival if protection of the public health, safety, or welfare imperatively requires emergency action. C. If the health permit is suspended or revoked, the health officer shall give the permit holder: (1) Written notice of the suspension or revocation of the health permit; (2) The reasons for the suspension or revocation; and (3) In accordance with Regulation .15 of this chapter, an opportunity for a hearing. #### Regulation .15 Opportunity for a Hearing. *COMAR 10.16.05.15* A. Except as provided in §B of this regulation, if a health permit is denied, suspended, or revoked, before the health officer takes final action against the applicant or permit holder, the health officer shall give the applicant or permit holder an opportunity for a hearing pursuant to the Maryland Administrative Procedure Act, State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland. B. If the health permit is summarily suspended, the health officer shall give the permit holder an opportunity for a hearing pursuant to the Maryland Administrative Procedure Act, State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland. C. The hearing is not required to take place before the health officer takes action against the permit holder. D. The suspension is in effect when the notice of suspension is served on the permit holder. E. If a hearing is desired, an applicant or permit holder shall request a hearing by submitting to the health officer a written request for a hearing. F. To preserve the right to a hearing, an applicant or permit holder shall submit the written request within 10 days of the receipt of the denial, suspension, or revocation notice. #### Regulation .16 Prohibition to Operate. *COMAR 10.16.05.16* A. A permit holder whose health permit is suspended: (1) Shall cease operation of the outdoor musical festival; and (2) May not resume operation of the outdoor musical festival until: (a) An inspection shows that the condition or conditions responsible for the suspension no longer exist; and (b) The health officer reinstates the health permit. B. An applicant or permit holder whose health permit is denied or revoked: (1) May not start operation of the outdoor musical festival; and (2) Shall cease operation and may not start or resume operation until: (a) A new application is submitted in accordance with Regulation .04 of this chapter; (b) An inspection shows that the condition or conditions responsible for the denial or revocation no longer exist; (c) All requirements of this chapter have been met by the applicant or permit holder; and (d) The health officer issues a health permit.