California Code of Regulations Page 1 of 4 

16 CA ADC 5 3340.41 

16 CCR 5 3340.41 

Cal. Admin. Code tit. 16, 5 3340.41 

BARCLAYS OFFICIAL CALIFORNIA CODE OF REGULATIONS 

TITLE 16. PROFESSIONAL AND VOCATIONAL REGULATIONS 

DIVISION 33. BUREAU OF AUTOMOTIVE REPAIR 

CHAPTER 1. AUTOMOTIVE REPAIR DEALERS AND OFFICIAL STATIONS AND ADJUSTERS 

ARTICLE 5.5. MOTOR VEHICLE INSPECTION PROGRAM 

This database is current through 7/10/09, Register 2009, No. 28 

5 3340.41. Inspection, Test, and Repair Requirements. 

(a) A licensed station shall give a copy of the test report printed from the emissions inspection system to the 

customer. The report shall be attached to the customer's invoice. 

(b) No person shall enter into the emissions inspection system any access or qualification number other than 

as authorized by the bureau, nor in any way tamper with the emissions inspection system. 

(c) No person shall enter into the emissions inspection system any vehicle identification information or 

emission control system identification data for any vehicle other than the one being tested. Nor shall any 

person knowingly enter into the emissions inspection system any false information about the vehicle being 

tested. 

(d) The specifications and procedures required by Section 44016 of the Health and Safety Code shall be the 

vehicle manufacturer's recommended procedures for emission problem diagnosis and repair or the emission 

diagnosis and repair procedures found in industry-standard reference manuals and periodicals published by 

nationally recognized repair information providers. Smog check stations and smog check technicians shall, at 

a minimum, follow the applicable specifications and procedures when diagnosing defects or performing 

repairs for vehicles that fail a smog check test. 

(e) A smog check station shall not perform an initial test, except for an official pre-test, on or issue a 

certificate of compliance to any vehicle that has been directed to a test-only station for its biennial smog 

check pursuant to Sections 44010.5 or 44014.7 of the Health and Safety Code, unless the station is licensed 

as a test-only station pursuant to subdivision (b) of Section 44014 of the Health and Safety Code. The 

reinspection and certification of a test-only directed vehicle that has failed an initial test at a test-only statior 

and has undergone subsequent repairs to correct the cause of the failure, may be performed by a test-only 

station, or by a test-and-repair station that performs those repairs and that is also certified as a Gold Shield 

station pursuant to Section 44014.2 of the Health and Safety Code and Article 10 (commencing with section 

3392.1) of this chapter. 

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Note: Authority cited: Sections 44002, 44016 and 44030, Health and Safety Code; and Section 9882, 

Business and Profession Code. Reference: Sections 44010.5, 44012, 44014, 44014.2, 44014.7, 440 16, 

44030, 44036(a) and (b), 44050 and 44051.5, Health and Safety Code. 

HISTORY 

1. Amendment of section heading filed 8-24-88; operative 9-23-88 (Register 88, 

No. 37). 

2. Amendment filed 4-16-90; operative 4-16-90 (Register 90, No. 19). 

3. Editorial correction of printing error correcting section heading (Register 

91, No. 6). 

4. Amendment of subsection (c) filed 8-18-92; operative 9-17-92 (Register 92, 

No. 37). 

5. New section heading, new subsection (d) and amendment of Note filed 7-26-96 

as an emergency; operative 7-26-96 (Register 96, No. 30). A Certificate of 

Compliance must be transmitted to OAL by 11-25-96 or emergency language will be 

repealed by operation of law on the following day. 

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California Code of Reg~llations Page 4 of 4 

6. Editorial correction of subsection (d) (Register 97, No. 2). 

7. Certificate of Compliance as to 7-26-96 order transmitted to OAL 11-19-96 

and filed 1-6-97 (Register 97, No. 2). 

8. New subsection (e) and new Forms TI-T6 filed 2-1-2001; operative 2-1-2001 

pursuant to Government Code section 11343.4(c) (Register 2001, No. 5). 

9. Amendment of subsections (a)-(c) filed 6-9-2003; operative 7-9-2003 

(Register 2003, No. 24). 

lo. Amendment of section heading, section and Note filed 5-30-2006; operative 

6-29-2006 (Register 2006, No. 22). 

16 CCR 5 3340.41, 16 CA ADC 5 3340.41 

1CAC 

16 CA ADC 5 3340.41 

END OF DOCUMENT 

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Docs In Sequence Table of Contents 

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@ 2009 West Privacy ' Accessibility 

file://D:\$ 3340.4 1. Inspection, Test, and Repair Req~.~irements. htm 
16 CA ADC $ 3340.4 1 

16 CCR $ 3340.41 JiflflhE I 

Cal. Adinin. Code tit. 16, 5 3340.41 

Page 2 

STATE'OF C~U~OHNIA - STATE A-413 CO~~SLIMER SEKX~ICCB AGEN~ -...- 

BUREAU OF AUTOMOTIVE REPAIR 

cjifgELd 19340 STSTEMS PARkW,4Y. S4CACVAEP4TO. CA 85827 

PHONE: (B16i 252-3485 

Cmnw 

.MIS 

APPLICATION TO RECOME A BUREAU CE.RTIFIED TRAiNlNG INSTITUTION 

Check One: 

a hew [nstituriw Ccttlfilion 0 Upgrading from a kicm Ad~ancid L11~~1ution 

tf Re~wal of tnditutioa Cenilicatkm ilidc~~cw~~. in !FJ~ WCYC~:,! a Imlit~t~ Rckrcotion 

Prclvidc the name of the ituton~o~ive drpanrl~eat head administrative pe~son wl~o will be respi~siblc for 

cwrdinating bureau-approved tcinir~g coorws, rnsintuining records, and be responsible for receivitlg. 

distributing, and responding to all bureau cormpon&me. 

Mailing .4ddress (ifdifferent horn addres listed above): 

Form 

O 2010 Thornson Reuters. No Clairn to Orig. US Gov. Works. 
16 CA ADC $ 3340.4 1 

16 CCR $3340.41 s)~fiGe z 

Cal. Admin. Code tit. 16, 8 3340.41 

To bc certified to teach Bsslc arm tcchnlcian training conrscs, :,pour institution must employ rither r 

"Basic" or "'-4dvanccdg bureau certified ihstnrctor, and haw tllc is~t!owing to&, equipment, edi~cmtinnol 

materials, and lecture ad Irkwatury facilities: 

Whar is thc maximum legal stucitnr seating capacity of your lecture laciliry? . 

Note: Do not write in shaded area 

- Burwu I~F Only - 

Inspector FkM Audit Area 

Adequate Icclure and [nhvr~~ur): I'xililics to rrccc-~nu~iudale 

the number of .;tudcnls to he insimcled. 

Emission Test Analy zcr System (T.4.S - BAR WE3 or BAR 97 EIS) 

approvcd by the burcau for use in a Rasic Pr~zram '"rcs 

Insrrucrional hiaterials for Basic Area Technician f ty,irxsj 

(~wiy,fi?r CCUFJC~ beitrg ~itrdghr: sc.e pugc 4 

kmonsnrion vehicles (5 computer conuo[led vehicles reyuireiii: 

Nak: A[ lea~! r~ne vehicle must h= nwnrd. Irzsd. rend (rr Jcrnat=i! ril your ins[irlrr:c~n. Fra-;ide documentatioa af his vehicle 

wilh ;~ppiicarinn. 

Form TS-1 iRcviscd 10f99) 

Page t 

Engine performance c:nalyrtr (with prinwr) 

'T;icrh~mettrld~~cll meter 

Arnmerer 

\l~dcc~ equipmcn t: (Ir4inirnurn:l 1 - VCR, 1 - 25" Th' (or 2 - 19'':) 

Digital VoltlCl hm Mctcrs (D'~'DE1) (4 minininst~rnj 

Filip~pe restrictor dowel gauges (2 minimum} 

Ti.ming Lights with advance iesring capabilities (2 rmnirnurn:) 

Prc~panc hrichmrn[ TIMI 

O 2010 Thornson Reuters. No Clairn to Orig. US Gov. Works. 

'YES . .KO 

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16 CA ADC $ 3340.41 

16 CCR $3340.41 DlZAeE 3 

Cal. Admin. Code tit. 16. $ 3340.41 

Hand vxuum pumps (2 miaimurn) 

Vacuum gauge (1 mininiun-I j 

Fuel Cap Tester 

Fuel pressure gauge 

Compurcr diagnostic equipment (scan tool - I minimum) 

Compression Lester ( 1 minimlrrn) 

Haad lcrojs necessary tn insp.r.1. adjust. tmintdn. and repir vthizulu 

ignitio~~ systems. fuel deliver), sys~ems, and emissioa c~mtrol systcrns 

L'ummt r mission contml manuals and systems appl~cation girlcs qqrt ur c~momic (slmr! 

Aurornollve ci~mputrc diagnostic and rep;Lir manuals {ppcr s:,r tlmnmii L-KWL.I -.- .. :a. ."':' ' .:": . .'t,, - :.-' . . 

. . 

. ,. . ..I' .:; . . ' .. . " .. ' . Electronic conponcnr lxntion manuals ~ppernrc~ccr.,jni; rurnJl) 

..->. ... .... .. .." .*<\..; ,:-;., ."' ;. 

Currtdr Dureokt manuals ancl bullelins , , . , ; :; . . .>> . ,4-.. .,,.' . \.t., < . ;;.tr ..,: , . . ., ,' ; . .. " ', 

. ;#;', '. ..,%> . ,: -: 

ADVANC.F.U FIMIS$[Oh' SPECIALIST TECHNlCIAlil TRAIhl3G CNSTITUTION 

To be rrdditlowlly certified to leach Advanced Emission specialist technlclan training coums, an 

institution mas1 employ an "bdvanced" bureau certlkd im~tructur~ and hive all the equipment, tools, 

educational materials, and lecture and labordory facilities required for inslltutluns teaching Bait area 

technician training c6umcs (except BAR 9UET), und the futlu~~ing additionat equlpment!materials: 

Digital storaze cxui Ilc~scopc!graphing lr>ult irnctcr I: 1 minjmurn) 

Emission Inspection Syslcm (BAR 97 EIS) approvcd by the bureau 

for use in nn Enhnnced Prr~gram Ama 

Dies yimr insrilutio~l awn this equipment (BJ4R 37 EIS), 

or lease the equipmen1 from the n~rtnufrrcturtr'? 

!if m, prr?-bidc r copy of cvidewc of ~62~s te rh~s equtpmnt aL ~~~~~hrr f~ciliry'j 

Fuel cup teSltr [may he incorp?r;lrcd in 8.4R '?5 E1.5) 

Inatructi~nal hhterials for Rdvanccd Emivsiori Specialist Courses 

j4~nl~jorru~~r.t~~ king uujh~: swju,ye 4) 

Fcrrm TS.1 (Revised I(IAYI 

Page 3 

0 2010 Thomson Reuters. No Claim to Orig. US Gov. Works. 
16 CA ADC 3340.4 1 

16 CCR 3 3340.41 md dE 4 

Cal. Admin. Code tit. 16, 5 3340.41 

Basic Area Technician Training Courses (check the cuurch: your ihi.utu[ica wishes to be certified to morhk]: 

Basic Clcan Air Car Course 

Citation Remining for Rosjc ,Area Technicians 

Bureau Trajnisrg Program {ASE Alternative Coi~rses A6, A$, cE Ll) 

0 Cpdatc Training for Basic Area Technicians 

Advanced Emiwion SpeciJIst TwhnicSsn Training Courses rclwcl: rhr coursc; pur lnd: tuttnn wi.shrp In hc crrriiied 

In pruvldej: 

3 rtdrlaoced Clcsn Air Car Ccjufie 

,f Cimri~ri rerraiiiing for Advartced Emission Spcidtisl lechnicians 

B.4R 97 Transition Class 

0 Updale Training for Advaninctd Emission Spec id l sst techn iuians 

I certify under penalty of perjury under Ute laws oP the State of California that the shternents In this 

applkallon and supporting dmunwnts perhlning to this uppliciiliun art: true 366 correct, 

Sisnarure of Adrninistra~ive rr~nlncl Prr:;nn: - Date: 

Print Name: - TI tlc: County Wbcrc signed: . . - 

Vpcm the receipt of n c~nlylrted and qua1ify:ng initial 3ppli~~~i011. a bureau field representative will contact your 

sul~ocd to schedule n sitc inspction. Once certified, your institution will bc i.ort~aclcd 3y s h~lreou reprrsentarlve 

to make panodic die in:;p~ri~ns. 

Iri~te: Passing the site inspection does not wnstitvtt ~ertiticallon of yr:bur insti~utron. 'r'our instituti~rl 

cannot commence bureau ccnificd raining courxs. iinril yc~ rcceivc wti tten approval frum 1111s office, 

Form TSf [R=v~& ~~991 

Pogtr 4 

8 20 10 Tholnson Reuters. No Clal~m to Ong. US Gov. Works. 
16 CA ADC 9 3340.41 

16 CCR 9 3340.41 mlj6E 5 

Cal. Adinin. Code tit. 16, $ 3340.41 

PROCEDURm TO BECOME ,P BUWAU CERTIFIED INSTRUCTOR 

Iwtructor The hureau has two instructor categories: 

GertifitaUon 

Calagories Basic Instructor. -4 Basic instn~ctnran reach thr f~llowir~g bureau canjfied 

COklTSeS: 

. Basic Clem Air Car Courx 

BAR ASE nlternntive courr;er 

Pasic Area (m) Smog Technician update traj~~ing sounc . Basic Ares Smog 'Technician citatiun [raining uourscs 

Advanced Instructor. An Advanced instructor can teach all Basic instjuctor 

courses, an3 the fo!li-wing addilirjrial courses: 

t Ad\>ance J Clean Air Chr Course 

t BAY, 97 Transirion Course 

Adr.;mced Emission Specid l i at (F. ,4 :) updare tritining course . .Advmced Emi:;siai~ Specialist citation rmning course 

Note: To k an .A.'njanccd instrucror, an individual rncsi huld 3 current Basic 

instn~ctol~cunifi;. r, and must haw com~pleted an insiructor training course 

('Train-the-T'riuner) gr ven hy a h,¶~sitr instructor. 

Bsic Instructor An applicant %hi3 .+vi.jhrs to btco~ne a burcau certified Basic instructor 

Credmtialing rnrlsr fill oul pa~e: 5 nF rh~s applicalion, and must rnccr one of the fc~llowing 

Requi trments instructor certification criteria; 

1. Crcdcntiald Applicants. Thr ;lppllcant must pctsscss; 

A. 4 teaching credential in autonlotivs kchnology thnr is recognized 

by 1L1e Ikpaittslent of Educ~tion; or 

B. bfcct the California Curnrnuniry Collzge eligi bjli ty requircmcnrs for 

!caching an engine perfamrrc-r course. 

Note: An orlglnal letrer from a c'alilorni~ com~liunity college (on 

cnllrgp Ictterhcsd sfstionary] stating th applicant has been hired ro 

cracll an cnginc ptrfomat~ce course(s) will be ficceyted as meeting 

chc eligibility rcquircrnct~ts. 

OR 

2. Non-Credtntialed 4yplicants.Thr applicant must meet one of the 

following qualificutions: 

A. A !iiininrurn of two ycars e,tperience in the enginc perfirrm>~nce 

area, and a Bacsalaurrratc degree in vKational eciucakiorr {emphasis 

id ~utornoti~e terinoing).:~: or 

B. A rninimtrm Tout* i1e3rs r.apenenct irl the enpiiic prformnce ma, 

and arl Assocrate of Am dc_gt OT Crflificate in autornocivc 

technology: 

or 

C. A minialum of six years experience i11 the engine perf~~rmsncc ara. 

Form TS - 2 {Rev. 1UMj 

Page 1 

8 2010 Tholnson Reuters. No Claim to Orig. US Gov. Works. 
16 CA ADC 5 3340.41 

16cc~#3340.41 fi?IHGE 6 

Cal. Admin. Code tit. 16, 5 3340.41 

Basic Instructor Non-cdcntialcd applicmr.5 rnusr submit a (~yp~d) esume detailing job 

ereden tiahng txpcricnce. The rcsurne shu1.11d include: thc crnplo)rr's nmc, ddrcss, 

Keguirementv phcln~ number. dates of cmplayment, lcrig~h ul'timc: employed: a short 

(can't ) description of job duties. supervis~r's nmc. and a copy af =hod 

transcriprs or diplnrnm tu verify minimum cducatiort requiemen ts (if 

applic~lb[tr,l. 

In addition ta the expericr~cei~educ"~tiori requirements n~ted abave. rhc noncredenti:lled appllcnrlt must site a short in~tmct~onal pesentacioa in I'nint 

of an evduahon conunittee. Ttlr corrrmittw will determine ii' Lhe rtpplicanr 

meet5 a minimum reaching skills Equirtllient. (set ''Instwctor Prcsent/;ltion 

nnd E.valuation Prcxtdure" CUI pases 3 and 4 for furthc.r dcrhjls rcgwding 

the prescnl:t~.iun). 

Llunsing and ALL applicants must hxre currenl Advancrd Eng~ne Yerfnmance 

C:ertlflcatkbn Spcialist tEE;A j anlog tecl~ t~ician liceilse, slid be curre~~tly cedfied by the 

Require~rrenls National Institute of Xutt:mrstivr Scrvicc Excellence (ASE) in the 

lhllnwing areas: 

Electric;rlElrctroni~ Sysrems (-46) 

Engrnc Pertimnancc (AS) 

ndvrrnced Engine Pcrt'omlonca iL1 :I 

Instructor Applirotirs nj;r;y be. rrqui~:eJ Ln attend an instrrccrof update tlaainitig course 

Updatc [pursua~~t to se~cion 3M-ll:t._li(g:rj, ss a requireml~i to become a certified 

Training instmaor. Contact Wayne Emmctt at (31 6) 255- 1391 for further 

Informntion on this tmin~n:g,. 

Basic 7.0 k corlsidrred for Basic ~nstructor certifiiat~on, an apyl~car~f n-~rfit 

Instructor submit to the bureau the fo1lov:lng documtnts for re.rrievr: 

Application 

1. A compleltd page f uC [his q1pl1cariot.1. 

2. A copy of the appiicmr's Ad\:anceQ Emission Specialist (E.4) srllog 

technician license 

3. A copy of A.SE certificaler; in the follouring categories: At;, AS. and LI. 

Notc: 34K ASE alternative courses are not acceptahlc. 

4. X copy of a vwaticmiil instructor credential (:crdct~tialcd appljcanrs 

0~1I)f:l 

5. A ccrp of a de.yee[s) anaor job experience resum (ncrn-crarknt ialed 

appiic~nts onIyl 

Applicant shall mail rhc application pnck~gc lo: 

AlLcaLiun; Wayne Brun~tl 

Burtau of AurornotI vc Rtpair 

10240 Systerrls Yrtrkway 

Sacramellto, C.4 95827 

Note: After review of application, nofi-credcntided applicanrs will k 

conrnctcd by phone to ser up a presedrotion date. . 

Form TS 2 [Rev. 1W.W) 

Page 2 

O 2010 Thoinson Reuters. No Claim to Orig. US Gov. Works. 
I6 CA ADC $3340.4 1 

I6 CCR 8 3340.41 mA4E 7 

Cal. Adtnin. Code tit. 16, 4 3340.41 

Instructional The applicant will provide a lecrure and laboratuty demcrnstration tcb an 

Presentation ev~luacion team of BAR and Educational Advisory Committee members (up tv 

Evaluation 4 cvalualors). The applicant's presentatinn wi[l ur~nsisl cd': 

Format 

A lccrurc on rhc rhci_rty/opr3rion md dja~m~is of a computer controlled 

system or compjntnl sclccled from thc "Clcan Air Car Cou~e Training 

h4mud" (1993j. The app[iu;int may chmse the Iwture subject moterial. 

A labantory dem~nsBm0n relevant to thc ICGNTC subject matter. 

The applicant's lecture and de.mtmstrution presentation will not be less than 15 

minuter;. or more than a marinlum t:~f 4.5 tnirrutes iri length. 

Evaluation Appljcan~ can ch~?c.sc to lx evdlmted at any of several public autornotiv.~ 

Sites cvents th~~r crcur rtr various localions and times throughour the yew. 

Applicants may opt to be evaIua~cd at the Bureau rtf Aucnnn>tivt Rcpair in 

Sadrammlo at any rimc oi thc )'car. 

,.\frr review nf the application, applicants will be cnntacted by th~s office In 

discu5s scheduIing a prcscntation. 

kJukrialc and The applicant must provide the evaluation group (up [a four rnrnlkrsj with 

Ecluiprnrnt any written moteriais relevant ro the lectu~/demons(r;ltion (i-c. handout.;, 

Crihria dingi.ams. ctc.). The applicar~l will supply any diagnostic testing cqu~pn-renr, 

tnirling aids. suppm equipment, demonsrracion -..chicles, etc. needed tt- cury 

out the prcsencation. 

Applicants tra\/eling to Sacramento to give ;1 presetitation, rtiay make 

arrangements with (his office to provide suppm equipnxnt Islick projector, 

ovcrhead projector, VCR. etc.). The applicant must infurn~ this office at least 

Lwn ~l;eks prior lo the plesenlfitjun of thcir materi:il needs. 

The bureau will provide a training room, and a marker board at any of the 

above nored ev:~lustion sires. Vehicle demonstrations cvill be pcrfornieii in the 

parking lot of the host setr~ng. 

Applicants will be. evaluated on several criteria. some of which ;ue: 

Or.a,ani;..ntiirn of maknals 

Knowledge of sul?j~~r tnatter 

Clear cxplanbon of subject mattt'r 

Prupcr usc ol training aidis) 

Mattrial Laugttt 31 studcnt levcl 

&sentation sh1ls 

km~nstmttd sate practice 

Observcd pruprr diagnns~ic prr~cdums 

Form TS - 2 (Rev. 20199) 

Page 3 

O 2010 Thornson Reuters. No Claitn to Orig. US Gov. Works. 
1 6 CA ADC 4 3340.4 1 

16 CCR 9 3340.41 MflGE 8 

Cal. Admin. Code tit. 16. 9 3340.41 

INSTRUCTOR PRESENTATION Am EVALLIATCOfi PROCF.DURES 

Evaluailon The evuluation cotnnliltee will assess the applicant's knowledge of the suhjec~ 

Criteria (c~n'tj niauer. Jelivcr). skills. and adherence to time constraints. 

The bureau high!). cumm men& that the applicant p~ticc their prcscnld~i~n in 

Crc~nr of athcr aulornnki.",~ instrur:lor for critiquing, prior ta hiog evalurrtcd by 

the comrnirtec. 

Evaluation Committee members will use a fom to evaluai~ thc presentation. AC the cfid of 

hceS the evaluation process. the bureau will discuss with thc applicant thc outcumr: 

of the cvaluvtion (JK)SIL~Y~ ;md negnli\;e aspects). The bureau wjll n-take 1 he 

final dewrrninliiit3n in granting instructor oen~ficatiun to the applicant; based. 

in pafi. on the inpur af rk evaluation commitlitrce membcn. 

Applicant Applicars hat fail thc prcscnration ciial~3ti0n. may chow& one of ~hc 

Re-Evnluations thllowing 

i , Give o follll~ur up (same da!;) prcsentnliorr (zmc ~~lbjccl rncltrtrr wirhjri a 

rime I'i-me agreed upon hy thc cvvalustiun curnmittec. The committee mu? 

limit lbt: prescnts~ion to cover only the areas first odequatciy addressed 111 

the original prcsent:rtiodlsbratoy demonstration. Far those applicants 

thar the committee Rels my require additional traininglprccticc, the 

applicant will k required LO folic7w e\!~Iua[ion process nurnhec trro 

(,helo\v). 

2, Set up ~doIhcr full prescntati~n cvaluarion with this office for a difierent 

rirnc and dntc loc car ion:^. 

Applic'ants that fail Iwu presents~lons in a row, musr wail three ~o~lths trwn 

the date of rhc last filed prrscnratiofi. to request mother evaluation. 

0 2010 Tholnson Reuters. No Claim to Orig. US Gov. Drorks. 
16 CA ADC 4 3340.4 1 

16cc~$3340.41 jlllHG€ 7 

Cal. Admin. Code tit. 16. 3 3340.41 

STA~E C* CRUFOR~IIA - STATE AND COMUMER SEWICES PGW~ GWi DAVIS. f3mrw~r 

w.. - - 

BUREAU OF AUTOMOTIVE REPAIR 

c7&2&d lTJ+l;l TISTEMS phRIYr'4\ S&CF.&hlEIIKI, 07 $5827 

morrc (91 51 xe-5466 

(imwms 

A.l%irs APPLICATION TO BECOME ri BUREAU CERTlFIED BASIC INSTRUCTOR 

City. Stare, ZIP; . .-...--. 

Home Phone f: i-1 Da).timc: Phew#:() ExtiNsme of bureau cenified training insti~utinni:~) wherc you ore curnn~1:" employed; 

School Nm: School Yumkr: 99 

Advaficed Emission Speci nlist (EA) Licen* Number: Expiration Ds~e: 

Automotive Service Exccl~ence IASEj cefiltlcarlon In the CollowlLng crtegorles: 

Elm~ricalt'Elcctron i r Sys terns (A6j Expirotinn Date!: 

Engine Perf~m~ance (A81 Expiration L:&tc;.. 

Advanced Enginc Perf~rmance Specialist (L 1 ) Expirarion Dilte: 

Note: RAR .ASE Altermlive courses art 11st ac~~ptmhle. 

Meet at least one of the follow in^ (check one): 

fl Possessifin of 3 current credential reco&aizcd by the State Deparunenr of EJuca~ion in the field of 

auromai*"c technology: ur 

Mtct current Calilbmia Community College eligibility rcquircmcnts for s crcdcntid in rhc fidd of 

automotive technology: or 

i3 Posseas m auiutumotive-relared degree or credential. or other qualifying csprience, which the bureau 

datrmints, up17 pctitim 6f Cht appljcan~, [Q bc suhrtanridly equiualml to a Califomi;i Cmnrnunily 

Collcge irnstnicror's credential or a crcdcntial r~~pJitcd by the St& kpanrncnt or Education in thc 

littld ofaulomotiee technology. 

I certrfy nuntier penalty of perjury under the Laws of the state of Culifurnia that the statcn~enta in this 

application are true and correct. 

Form TS - 2 (Rev. 10i99) 

Pap 5 

8 2010 Thoinson Reuters. No Claiin to Orig. US Gov. Works. 

" - - -- -- 
16 CA ADC $ 3340.41 

16CCR$3340.41 mhG6 10 

Cal. Admin. Code tit. 16, $ 3340.41 

GRAY 34V15. Qovana~ 

- 

BUREAU OF AUTOMOTIVE REPAIR 

lC?JO SY5f EMS PARTkVAY. $&CR.AMEPtTO. C& 95927 

fh~tm PHO* Ill 1 S;) 2P.5.:wci!; 

Al%lirs 

APPLICATION TO BECOME A BII'WAU CEHTIFLED ADVANCED lNSTULC,TOR 

Nm: 

First IvI iddlc L~EL 

Dayrime Phone #: [-;i Ent: Horn- Phonr S. i-> 

'rib 1-nr 3 hureau rrertiliod Ad.r.m~ccd inclructor, you niuqt nwrt tllc requiwomnts in cafegories t, 2, m~d 3. 

and mccr~fully complete the California ?'rain-the Trainer cwrse: 

1, Pi>w-;iM of a current nu% teckrdcirr~ licetrw: 

Aiivaac::d Emwion Specialis: Technician License Kun-~kr: E.4 

Liccasr Enpirariun bare: 

2. C~~rrent Auzontollve Service Esecliencr (,%.SE..) ccrtifjatlon In thr FoJlomiop categories: 

Eb~rrisal/Elecrrmic Systems i.M) Expiration DateEngine Pcrtjrmncr (AS) Erpirarion Dart:- 

Advancrd Engirrt Pcriorrl~afiit Specialis! (1.1 J E.<piration Dare. 

1. Pmwsion 4C a current bnrenu kmed Etasic -struttar ceificate: 

I cefilfy uradcr penalty or perjury undrr ihc IPW.~ or the stale or Califr~rnia thur thc darrmcnir jr~ this applicnlia~r are trw 

and mt. 

Q 201 0 Thornson Reuters. No Claim to Orig. US Gov. Works. 

- ProaF of Cirurse Completion - 

T7ris ~~c:rior: rc.* Be fil!af OLU I?' rhtb,4iczffer l~urmtor >rovidin,y fha yp Rcuri,' 'r tmir~lng 

1 declrrc rht the ahvc oorcd applican: has succcutllll)' cccCmpkred the Californ~a Train-[he-fraincr courursc. 

>Iarcer Instruct~r's Nmne Ipnnr:,: 

d 

I ., 

Dale al Cwt~ Co~nyMion:, 

rhlmtr tcwtrut!nrts -l~r~i 1 
16 CA ADC $ 3340.41 

16 CCR $ 3340.41 >jlh& /I 

Cal. Adinin. Code tit. 16, # 3340.41 

STATE OF C.WMR.'JIA - STATE AND OZFISUMEH SEWICE S AGENCY GRAY DA'I'jS, GOWP?.' 

AURE.4U OF AI'TOMOTIIVE REPAIR 

Standards and Training Branch 

10240 Sy5krns Parkway 

Sacramento, CA 95927 

(9161 255-365: [916) 25~S-JXt (fax) 

BUREAU CERTIFIED INSTRUCTOR RENEWAL APPLICATION 

Check One: Basic Instructor 17 Advanced Instructor 

Stmet .4ddress; 

(no PO Box) 

Ci tp, Srarc, Z[F: .. .. . 

:,.;lrne oi bureau arli fied tnirling in:;~iiutirrn{s;l where ~JII 3rc currenily ernplqcd; 

Schclc~l Er'amc; khwl Numhr 99 

Xdvawed Emission Spwiatis~ IEA) Smg Ttchnician Lic:ase Nmber:-,, 

Automoliw Service Excellenre I:ASE) certification in the h-dkrwing categories: 

E:crtric;rLrEltctrc7nic Sy strrns i.46) Expiration Date: . . . 

Enginc Perforroansct (A81 Expiration Date: 

Advanced Engine Perhmnte Specialist [Llj Ex pintion Date: 

Nale: BAR ASE Alternative - arc d a~~qihblc. 

O 2010 Thoinson Reuters. No Claim to Orig. US Gov. Works. 
16 CA ADC $ 3340.4 1 

16CCRtj3340.41 ~v~AGE (Z 

Cal. Adinin. Code tit. 16, 9 3340.41 

Page 13 

O 2010 Thoinson Reuters. No Claim to Orig. US Gov. Works. 
16 CA ADC 9 3340.41 

16 CCR 5 3340.41 Pfld~E 13 

Cal. Admin. Code tit. 16. 3 3340.41 

':TI.' t OF <:A1 If I)Hrrllt - :.TAT€ LQt4SUf.IER SEF(VICES AGENCY (>MA I DAbrs, G0.e itdr 

-- - - - - -- - -- - - -. 

O 2010 Thomson Reuters. No Claiin to Orig. US Gov. Works. 
16 CA ADC 4 3340.4 1 

16 CCR \' 3340.41 DNA bi5 14 

Cal. Adinin. Code tit. 16, 4 3340.41 

Page 15 

Ir:+tlE (;= CAUFORt<IA S-ATE COESIJMkA StAVlCtS AGENCY 

Ut l<F:it (IF $L!Tt)!lOll\l. 

Status: C'!#,n~I;.re~i 

0 2010 Thoinson Reuters. No Claim to Orig. US Gov. Works. 
16 CA ADC $ 3340.41 

16CCRp3340.41 5)lfl~E 15 

Cal. Ad~nin. Code tit. 16, 3 3340.41 

WL- APPUCATION FOR SMOG CHECK TECHNICIAN LICENSE t.--~t LICENSING DIVtSIOH IBARI 

P.Q. BOX SBSOOI ~ULLEU~CI WET SACKAMMTO, CA 36798-9001 

,%(t'?l,~ (9161 256-3145 

Guraau af Automotive Rw~ir 

Llcsnsirrr Is requlrcd fw all persons islspezting. Irsllnq. dlegrrpslng, ardor repeidrrg uehicleg ~~fh the purpose of cerlificelicn 

lri U'la Sn~q Check prvg,am {'Per 0631 5 fa! erirt 44033 ol I!le hedlfi and .Sdfeb. I~I&J 

Nu pehnn shal Sell. Issue. tal;se ~4 wm~lt tn be k",Pusd any csflihcata prprtMi Iii kc a v.?lld c~#lfl~;lle of cnmph~ncr: or 

nor~~mpl~ance unless lhnied tn dn sn. (Per sechinn 3-340.J5(ml nf TiUe 96 of !he &/JTD.TJD ti)& ~d~vgd~td~r:.!~~ 

All apDlic~nt$ me required Irs rnea the training ailla cerifrcalbn requiremenla as Iisl~d in:his a~li~:-~ifan. ar14 va%S all 

examind~lr~n la chlain a licensa. P.n sramkat~nn tpe will he cnargrfl (PerrJQoS $ d 8 ond 44034. I of Me Ha.alth ad S&!Y 

CLWe1 

L. Ikcnspd tcchnitai-rr~ rvhieit: litdf~~~ has expired shall immdiatdy cease to IW.~MT, lest, d~sgnose, analor repair failad 

vuhiclas (Bt SCCf,'I(Wb 3JdO 3Clidl of 'Titie 16 ilf Me Cat~tom;j P&jrj O/ Repdelior~s;) 

All licmsees rnusr infcmt Ihe 'du4e;kr of an addr'6sr clmgr vhllkn 14 days. Sanu 8dUr*5S .ctta:~p 10 Me nbclve W~?rx 

iFvr section 5305.3 LV' TI~)Q 16 dttre C~Qrzmia Code of R+gutaciuns,J 

ALL APPLICATIONS WILL BE REllE.CJ.E,D AMO FEE.NOJ REFUNDED FOR FAILURE TO : 

- Incrdc rarruvau Oxurnontation [I,?. 4.SE centWacan angler original c~rr~ylgbd page 4); nr 

- C:ornplate ques:lons req~r@~~g appli~anr~ bEt~)tgr~)~nd:. w 

. Scrbm~t a r~myY&ted au~inel =Sication pith all pages. 

IF YOUR APPLICATION IS ACCEPTEO. you will be cc-ntewqed by lw exemnetion irewise wnlraclarto schedule yooJr exarnirrbi~r.m ,,/I 

5.11.5.rA erdminatim ha 1s ranulmd allkmpl ad 1% r-rryabk dlrec!:y to the mandnatlon servtce. You mnt bring hvo forms 01 ID 

tha ~KM7Iinatidn. Read Iha Cdnd~dalc Iii3ndbrcnk fw UIWM inslflldbns 

Dlrclos~rre of your sochl secuhty number [SN) ia mendat~y. Slc6M XJ of !he B!,ir1~~65 a-ld Pmfessiuns Cud* and Pl~tllc L .iW 

W455(42 USCA 435jcl(lj(C) aultwflir4s c~llmllon of your 5dN. Yu;lr SSN w~ll b used erclvsively lor tax anbrcemml purpnsvz. lor 

01trmsa6 01 c=xhpliance wiln my pldgrr&lrl 01 ofbet IIY family SII~CIOI? In ZICCO~~~I~C~ -.ulth Famly Tmde ~acbiurr 17520, or far veriliatlnll 

of I~C~~IBUC ur cx~m~n;l(LCIn sla1~1S 07 d Iiccr.~slng or eqat?bn;il;o~? er131ly 'rllcth Iltllizt$ 3 nmnal ararninat~nn fino wkrr? licmure k 

reramca with the requerhg state !f you fall to dlaclnaa your SSN. yourappHcmUonrribl mt lm moss& and you will be 

mporud to thm Franchi$r TU B-4, which my +rsr$$ r flW.00 penally apltn.t yw. 

Pu I;aliorria C~ril Cae. Stdh 1 798,li (lnfpwli3n Prgdic;e ,4~1). Ihe Direlor of the Department is ~~qon6ibte lur maintainmy the 

inllrrflalion in lhis bpplir,alicii?. This i~~lornmi~n may bc lrensferrsd tn olher yo..rcrr~nrrnlal and enforwmsnl agencies. Indbidual~ 

haw Ihe dghl In review Ihe rec~rds min!aineti on them hy Ihe agenci~.. unless tha rao~ds era sxempl by %tion 179P. 40 of lhe 

Gwil Cede. 

Cxanllrlatton chtlnq Is In .vidaUon a? SccUon 123 of the Business and Prcfessions Ch. Examination chretn:y WII iewl4 in 

denra) OI appllcar.or7. sljspuos on. re>Jfiwlldn and rettnctmn 9 a Ir-enscr Once lhe :~3mln~tinn teginr no lalk~ng nr ?thm 

(x~ti~siik~~lC;;~tiOn rvhif.31 rnrngwnislt.S tt~a erait i:; ~wniiiled h~+l~'wn sppllcantr. Oelairr are conlainro in Seu* 123 a: the t3u51nes6 

arbd P(o~~$sIc~~s Cl.We A ciip is cwilai~lca if1 Itla Cixldi&!~: Harhlco~:k I0 the r,alifumta 811wau or Aut~~a ur Fiepar Srr~nfl Check 

Techll%:lnll L Itxwr;.lg Vxawdistln~t no all A$ ,I-I thn lanms ord regulations hni&lrk pth:laM by MR. 

1HSTHUC;TIO NS; 

I. flead fill instnuc!io1i2 ar.3 ~r,mllji'inat~un rr-onralnad in trlis application. 

2. Pay fbaa hy ctteck or rn0ns.r order made payable to 'Licamrmg Division - BAR." 

3. Sl~brnil a 1:~:1rq4elrrl a~tl~~ii-rlivbr w11tl all the app~cp'i;~(e d~~bifer~ls 1111 frsltz k4 lhe Lkt~lea1)~r Dabiliirr~ bt the above addvess. 

2010 Tholnson Reuters. No Clairn to Orig. US Gov. Works. 

- -- 
16 CA ADC $ 3340.41 

16 CCR \' 3340.41 1 fit€ i 6 

Cal. Adinin. Code tit. 16, \' 3340.41 

Page 17 

APPLICATION FOR SMOG CHECX TECHNlClAN LICENSE 

Application Fee $20.00 -. - - Type of LLiwns~: .?k+rv nr'r or?l$' .- - 

O Advanced Emissiw Speciaiist 1-1 Intern Technician 

O Bnsr Area Teckl,~clan - 

Application Type: ir1rv.k c.,w rxliy - . -. - - -. . - 

O Ir.irial U Rcnawar 

r 

Smog Check Trchr~kvn CICC~M hlwitw. Er; rainn Oat*: 

E i i 1 

L I 

rrel;a*~Cs Elach;)rcur~d: dmch ad&wir~fi~~ rtmxesw? 

: Fare gdl~ %Cr ten IS~IJ~J d )I:.PnSe. ~rrl~lkata. r~ re~lstrar~on by Ihi% [?wabm~t'? a YES U NO 

11 yes sea= +iUIBIn: 

:awe Fu w.'er ha3 srlv Iimnsr. w:ntme, cnrregigrslirm enla, suwnbe, ~VOJ:M, or pamd (n PID>3tTHI by th15 hk.~llrtwn~?O YES CI NO 

II yes PI~BK ehplall: - -.- 

9. HJ*~ you avsr heas issue: a ~dot~~ by lhis Depamni: a YES 3 tdn If ST,, plr;;lre cx~,ain. 

6 1twe yuu rwar itcn tsrhrlcd 01. b~ pk~ 1~t4;. ccnrmt!+~a 10. any rnkd~rnas~~ m idpay QWMW oraay We. .r ~4 me U VFS NO 

Ur~~lcd Slalas? 

~f p,haM r~~,m%u:~ 

WE: I1 pu bma dlnDllr 1Xxq3a1'wnt b-**l~h.,~*l R+V .I& MsutnA,jl~rrqCr, wlmnalln Maw !;.I h hAF.Lmq Unltar ;$la; 255.3145 It rarrnm~*hl 

-~>II-~Dc~T~ Pm," mid rm mltbe mrrft.lad t+, ahumuavtt-ZI ardk urnbjta ih ~\mq Owwn vv.~twat~- 

I 

Crrpbtfr F11 E~ls1nc5r t(anu: 

rw8rtr (rn.~+ rrrrp em ha rrhi rr.8 - 4 I# am ag~amn); 

I p.-xz~: uw~~dtrt~rr~ TE~U~ LTUTLY. haw ms-w-a. an I- ~clhrryln, d,w.cmmct*j mt ~ru.eau's'~dvw*~~ ~kan k: -1 

ic.~lze-niltlll th. &I ~br:m~s (.mnaq~ shEUtd k wWm I~iIbl$,~~:. 

J I hhbcnr lrar JU-a r~aancs ar.61 e+icabcr.i~ hqimpedcrrrarw*ra. ar~rna~rmpal*: &b&rau'r .~nrc aid~hwwau ~~r,~i.ila~ GUW~ 

bllhln We b*mvr nmnm I:mlurww+aunsc~.mm rotam - 4 d& r~zliz-11. * 

I pv;.abral azsxwlr d.mb .CYIvak J Mare. whm &dre mAul-Tmrumbu,r Mcwa*;M w th%lUM WW, crwM xrH V 

riPml.4bdCl1 hr.rcrusrrrh;Pir.-kicbrrc BueuulAul-tRa~ds Ya,car-j&d,-Clsa,Ad Czyntr.hmthezWI-?h# RWU'xt PAGE C.C TH~~APPLL~:.~~TI.:~~( mas UEFWCCI~LETEC 

I w:ulbb .l CBr(:rd*l =I AuwOlibe TBQlm 1nw111 a** xuwh~d m .*lpi;ec cz.Wb. [uEk e-1 w lW xk 

r(g,.(ic PAGE FOLIR OF MI5 hPPLITLnl)U M: EFEEl GTMimD, 

{ > - Pn~tmarlvr Rcpl~! kalw Rylatrarle.n ar Fleet Starlon Lkn~a (rlmtcr: 

El- ~+IK-. (-w Page 2 of 4 

0 2010 Thoinson Reuters. No Claiin to Orig. US Gov. Works. 
16 CA ADC 4 3330.41 

I6 CCR 3340.41 zll,]bE 17 

Cal. Admin. Code tit. 16, 5 3340.41 

Page 18 

N*r r-D* J~.'~.LWII~IKV, iq raLnwdH n Itr,euruu rar -si.:rud uwmpic Mrilfc+%rr r~cwrsm :lorn 3 prh-, d~:&m I 

RE-EHEHTL UPDATE TRLLltdlH~: *% 1-wiEd by148wal:) Cml h U. d+.A""., ,b.lU*r3 I ~(~.~e~wmete:ldd Bw~r~lu)).rdr~e Rw; t~eIICb~~~emoir!! om PACE FOlJT OFTnlSAPPLILbbTIOPI Ha5 SEEN CCAiPLnED 

B~SICARB TECWCIW: Uayru,mV. -:a sQ'udf ~rFatrmJca~tf:Wm~\*ut~:rct 1Wrn mb~mrCsz;I_Mkllm % CMCX sh>Vdmb'%3 IKhfifJ 

aiasllars anew d:.~ 35% AhJLW 5rBast:. Smcg Chtd cf~d;n drc& 

REGJIREIENTL FOR L*;EHLlB?E: F.vrnlrubm !ivJrCd 'ICU mild KmbX r#qllIvm3ts !.Z,d 3 bLiloaI*+X8!4kC WX.C&lm~n 

tEMIPEUENT3 EDLICATIOWEXCERIENCE! vWla!~5'DW~Mlm.~'*r~dtt~~llt C3th.k !W h owtk rwr~'?&lW,,~x~nbhU I *rrru-rr par* -&*?maniw .brcamn n hoqm~~r)pmnr area, aw ha~rc~~r~j,jhVCY;s m:htC~?~& C* ~hur9e'~~ IM LL*~ I l*,:~nrnh~ IrNmPr~~n shmba ccMrn~lrp4 rf rra qlp-I 

I rat.: 7s -,mant.acrr;r rr~ wart* Burearn -5 A W.<Q ~(~wqi:~ CL~~~WC~ITW u~~iwln;ln ~p+~v~.a~~dw, 

7- 

I 

WECUIRM 3. LM~~TRAIHIHC~: rPr ~wrcnlq br Om; c**-tprrrrnil,- 

U*:u~~a anu dk6lrn-rmi aud~~a wn~yw*. FrM rwa OF TwsNRunU ke UEkN CaAElED - 

U I rmt- irarcr-arrYm shalrr:lr mqmgmp+w-~rta a~ haw w.v.n~~letm ~~rt krms Bari:: Clr;lnPr Ca h*lsa*olhlnItr mst~.~ wrw 

I,m-Amemr,sh%&i hh'.mlmo-i mr s dihk-c:n ..- 

1 CERTIFY :.INnFF: PFhlkl TY OF PERJURY LJHWR WE UWS OF THE STATE OF CAI.ImRNIA lht xt;mlmanb I I~s.ra R* 181 in6 awhcannn are 

1 121t rrd -4rta 

0 2010 Thomson Reuters. No Claiin to Orig. US Gov. Works. 
16 CA ADC 5 3340.4 1 

16 CCR 9 3340.41 xfilt~~~ i g 

Cal. Admin. Code tit. 16, 4 3340.41 

Page 19 

1 EVIDENCE OF COMPLETION OF BUREAU CERTIFIED TRAINING COURSE($) ] 

THIS PAGE MUST BE CDMPLETED BY THE INSTRUCTOR 

+ lr1slruLl.31 wrrall chcct; Inc 'Ycs' hox on ~~~~~3 suw-ccssfull~y carnpl.$lM hy the studc?nt. 

- Iasrructnc shall ch&k tht 'NO* box on courses mot given by tele inscnxtur, or not succMtlly cc~mpleta by the: slu&nt 

Sct108:lr or trade organization certificates cannot be u-A hn plam d $1~ fc~rnl to qualify for Ikens~~re 

Studen!s mksl send in this form wlth instruitar's @rQir,al signatwe (f3~3 and cnpls are nal accqilah!e) 

- Schoch shell maintain a mpy of th~s page on hie for three yes6 

Nois: The insivdm m3y copy this pqa if sthar blank copies ore r~eeded 

NOTE: NS-PClCTOR SHALL Slb*A LERTiFlCAnON STAMP 

AREA It1 P. CXOR 6THER TH4N BLACK 

+bllit the rim* o4 ;h0 schcc~. 

s 

Prid ihe ray ad mnly *here IM vrtirWlion war s.gnad: 

Page 4 of 

COURSE CEF3lFICATION STAMP AREA 

O 2010 Thoinson Reuters. No Claim to Orig. US Gov. Works.