California Code of Regulations › Title 27 - Environmental Protection › Division 1 - General Functions and Responsibilities › Subdivision 4 - State Delegation › Chapter 1 - Unified Hazardous Waste and Hazardous Materials Management Regulatory Program › Part II - Operations › Article 10 - Business Reporting to CUPAs › Appendix A

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Certified Unified Program Agency (CUPA)
						  Application Cover Sheet Completeness Checklist
JURISDICTION
								  NAME:
___________________________
CONTACT PERSON
								  NAME:
___________________________
ADDRESS:
___________________________
MAILING ADDRESS (if
								  different):
___________________________
DATE OF
								  APPLICATION:
___________________________
TELEPHONE
								  NUMBER:
__________________
FACSIMILE
								  NUMBER:
___________________________
ITEM
DESCRIPTION
CITATION
PAGE
								  #
1
Appendix A (this
								  checklist)
15150(e)(1)
2
Demographic
								  Information
15150(e)(4)
3
Applicant
								  Information
15150
4
Implementation
								  History
15150(e)(16)
5
Geographic Scope
15150(e)(2)
								  and (3)
6
Structure of
								  CUPA
15150(e)(5)
7
Authorization
15150(c)
7A
Regulatory Authority
7B
Ordinances &
								  Resolutions
15150(c)(1) and (2)
8
CUPA and PA
								  Issues
15150(d)
9
Unified Program Implementation
								  Plan
15150(e)(6)
10
Consolidated Permit
								  Plan
15150(e)(10)
11
Inspection & Enforcement Program
								  Plan
15150(e)(11)
12
Fee Accountability
								  Program
15150(e)(12)
12A
Staff Resource
								  Adequacy
15170(b)(3)(A-E)(b)(4) and (b)(5)
12B
Budget Adequacy/Annual
								  Funding
15150(e)(14)15170(c)
12C
Contents of Fee Accountability
								  Program and Cost Calculation Methods
15170(f) 15210(b)(1)
13
Single Fee Implementation
								  Plan
15150(e)(13)
14
Reporting & Auditing
								  Requirements
15150(e)(15)
15
Recordkeeping & Cost Accounting
								  Systems
15150(e)(17)
16
CCR, Title 22, Section
								  66272.10 -
								  Compliance
15150(e)(18)
17
Training and Technical
								  Expertise
15150(e)(7)
18
Administrative
								  Procedures
15150(e)(8)
19
Additional Program
								  Elements
15150(e)(19)
20
No Adverse Impacts/Less
								  Fragmentation/Coordination and Consistency
15150(e)(20) and
								  (21)
21
Certifications
15150(e)(8),
								  (14) and (15)
22
Signature of Authorized
								  Representative
15150(b)
23
County Waiver of Surcharge Assessment
								  (Optional)
HSC 25404.5(d)
TABLES
1
Enumerations/Demographic
								  Information
15150(e)(4)
2
Summary of Program
								  Activities
15150(e)(16)
3
Time Allocation of
								  Staff
15150(e)(13) 15170(b)
4
Training and Technical
								  Expertise
15150(e)(7)
5
Reporting and Auditing
								  Requirements
15150(e)(8-14)
6
Surcharge Transmittal
								  Report
15290(a)(1)
7
Annual Single Fee Summary
								  Report
15290(a)(2)
CHARTS
1
Implementation
								  Timeline
15150(e)(6)(A)
FIGURE
1
Organizational
								  Chart
15150(e)(5)
Only one signature will be
								  required for the Certified Unified Program Agency Application. Please see the
								  signature block located in Appendix B (Certification Sheet).
(CalEPA rev. 10/17)