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 B - Certified Unified Program Agency (CUPA) Applicant Certification

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
I hereby certify the following:
1. I have read and understand Sections
						  15130 and
						  15150(e)(9), (14) and
						  (15) of Article 3, Chapter 1, Subdivision
						  4, Division 1, Title 27 of the
						  California Code of Regulations (CCR).
2. The administrative procedures of the proposed
						  Unified Program, as implemented by my agency, will meet the standards described
						  in Section
						  15180 of Title 27, CCR.
3. The Unified Program, as implemented by my agency,
						  will meet the reporting requirements as described in Article 6 of Title 27,
						  CCR.
4. All responsible agencies involved in the
						  implementation of the Unified Program, as proposed by this application, have
						  adequate resources to carry out the Unified Program.
5. If I am a non-county entity, I have notified the
						  county of my intent to apply to administer the Unified Program within my
						  jurisdiction.
6. I agree to use state certified laboratories for
						  analysis required under the Hazardous Waste Generator Program by Health and
						  Safety Code Chapter 6.5 (refer to Health and Safety Code Section
						  25198)
7. The information provided within this application is
						  true to the best of my knowledge.
8. I understand that this certification is an integral
						  part of the formal application for certification as a Certified Unified Program
						  Agency, and that any false statement may be grounds for denial or revocation of
						  the Unified Program authorization by the Secretary of the California
						  Environmental Protection Agency.
___________________________
___________________________
Signature of Elected Official or Authorized
								  Representative
Date
___________________________
Title
___________________________
Jurisdiction
(CalEPA 1/17)
Jurisdiction
									 ______________________________
Table 1:
									 ENUMERATIONS/DEMOGRAPHIC INFORMATION
PROGRAM/ACTIVITIES
#
								  OF BUSINESSES OR # USTs
MANDATED
								  INSPECTION FREQUENCY
APPLICANT INSPECTION
								  FREQUENCY
AGENCY TO
								  INSPECT
Total # of all regulated businesses
UST facilities
At least once
								  every year
Total # of USTs
APSA
At least once every 3
								  years for tank facilities with 10,000 gallons or more of petroleum
HMMP*
HMRRP
At least once every 3
								  years
HWG
No mandated
								  frequency**
PBR
Initial inspection within 2
								  years of notification and every 3 years thereafter
CA
Initial inspection within 2
								  years of notification and every 3 years thereafter
CE
Initial inspection within 2
								  years of notification and every 3 years thereafter
CalARP
At least once every 3
								  years
* If the
								  HMMP is fully covered by the HMRRP, leave this row blank.
**
								  Although the Hazardous Waste Generator Program (HWG) has no mandated inspection
								  frequency, HWG inspections are to be incorporated as part of the Unified
								  Program, and coordinated with the inspection frequencies of other Unified
								  Program elements.
Regulatory Citations
CCR, Title 27,
								  Sections 15150(e)(4) and
								  (16)
CCR, Title 27, Sections
								  15200(a), (b), and
								  (f)
CCR, Title 27, Section
								  15210(b)
(CalEPA T01 1/17)
Instructions for Table 1
Fill in the Jurisdiction name that is the reporting
						  applicant agency or CUPA.
Fill out the blank and unshaded boxes.
# OF BUSINESSES - Number of businesses regulated under
						  each of the programs listed.
MANDATED INSPECTION FREQUENCY - Lists the statutorily
						  required minimum inspection frequency.
APPLICANT INSPECTION FREQUENCY - The inspection
						  frequency established by the applicant agency in the Inspection and Enforcement
						  Program Plan.
AGENCY TO INSPECT - Which internal CUPA department,
						  office, or agency will inspect or which external local government
						  (participating agency) will inspect.
Total # of all regulated businesses - Total number of
						  all businesses within all regulated programs. Do not double count businesses
						  for this total. Example: A business that stores hazardous waste in two
						  underground tanks for use in an onsite PBR treatment process.
This business would count as one (1) regulated business
						  for the "Total # of all regulated businesses" block of the chart. This same
						  business would count as one (1) regulated business in the UST Program with a
						  total of two UST's, one (1) regulated business in the HMRRP, one (1) regulated
						  business in the HWG Program, and one (1) regulated business in the PBR Onsite
						  Hazardous Waste Treatment Program.
UST Program - Underground Storage Tank Program
Total # of USTs - Total number of underground storage
						  tanks that the business has onsite.
SPCC - Spill Prevention Control and Countermeasure
						  Plan.
HMMP - Hazardous Material Management Plan.
HMRRP - Hazardous Materials Release Response Plan and
						  Inventory Program.
PBR - Permit-By-Rule Onsite Hazardous Waste Treatment
						  Program.
CA - Conditionally Authorized Onsite Hazardous Waste
						  Treatment Program.
CE - Conditionally Exempt Onsite Hazardous Waste
						  Treatment Program.
CalARP - California Accidental Release Prevention
						  Program.
HW - Hazardous Waste Generator Program.
(CalEPA T01 Inst 1/17)
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Instructions for Table 2
Fill in the Jurisdiction name that is the reporting
						  applicant agency or CUPA.
Fill in the fiscal year that the Table is used
						  for.
Fill out the blank and unshaded boxes.
See instructions for Table 1 for definitions of program
						  abbreviations.
PROGRAM HISTORY:
PROGRAM IN PLACE IN ABOVE FISCAL YR? (Y/N) - Insert yes
						  or no as appropriate.
ESTIMATED BUDGET FOR THIS PROGRAM DURING THE FISCAL YR
						  ABOVE (IF PROGRAM WAS IN PLACE) - Give the dollar amount of the estimated
						  budget or the actual budget of the fiscal year reported.
INSPECTIONS:
# OF ROUTINE PLANNED - Number of routine inspections
						  planned in the fiscal year reported.
# OF ROUTINE COMPLETED - Number of routine inspections
						  completed in the fiscal year reported.
# OF COMPLAINT COMPLETED - Number of complaint
						  inspections completed in the fiscal year reported.
# OF MINOR VIOLS - Number of minor violations in the
						  fiscal year reported.
# OF MAJOR VIOL - Number of major violations in the
						  fiscal year reported.
ENFORCEMENT ACTIONS TAKEN:
INFORMAL ACTION/RETURNED TO COMPLIANCE - The number of
						  informal enforcement actions or return to compliance actions taken during the
						  fiscal year reported.
ADMIN - The number of administrative enforcement
						  actions taken during the fiscal year reported.
CIVIL - The number of civil enforcement actions taken
						  during the fiscal year reported.
CRIMINAL - The number of criminal enforcement actions
						  taken during the fiscal year reported.
TOTAL PENALTIES ASSESSED - The total dollar amount of
						  penalties assessed in the fiscal year reported.
TOTAL PENALTIES COLLECTED - The total dollar amount of
						  penalties collected in the fiscal year reported.
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The following are guidelines/definitions to be used in
						  determining time allocations:
1. Inspection: inspections travel, research, analysis
						  of findings, documentation, warnings and notices
2. Enforcement: includes warnings, notices, meetings,
						  hearings, legal proceedings and documentation
3. Permit activities: includes application review,
						  modification, revision and evaluation
4. Training: includes field, meeting, seminars,
						  workshops, courses and literature reviews
5. Management: includes day-to-day scheduling and
						  supervision
Regulatory Citations
CCR, Title 27,
								  Section 15170
CCR, Title 27, Section
								  15150(e)(13)
(CalEPA T03 1/17)
Jurisdiction ______________________________
TABLE 4
TRAINING AND EXPERTISE
Please indicate the
								  number of staff with experience related to any/all program
								  elements:
Job
								  Title
0 - 2
								  years
3 - 5
								  years
6 - 9
								  years
10+ years
It is suggested that all job titles in the first column
						  of the table be provided in the following format for each applicable program
						  element:
Program element, staff level.
Example: UST, Supervisor(s)
Generator, Field Staff
See instructions for Table 1 for program
								  abbreviations.
(CalEPA T04 11/95)