Starting January 1, 2013 all Certified Unified Program Agency (CUPA) regulated businesses are required by law (Assembly Bill 2286) to submit business information electronically through the California Environmental Reporting System (CERS). This includes information related to your:
- Unified Program Facility Permit (UPFP)
- Hazardous Materials Business Plan (HMBP)
- Hazardous Waste
- Hazardous Waste Onsite Treatment
- Hazardous Waste Tank Closures
- Remote Waste Consolidation
- Recyclable Materials Reports
- Underground Storage Tanks (UST)
- Aboveground petroleum storage (APSA) over 1,320 gallons
Many of the forms previously available through the Hazardous Materials Division (HMD) are now required to be completed and/or uploaded in CERS. The form list is now organized by subject and submission requirement. Locate the form you need to complete and refer to the subheading for submittal directions.
All forms required to be submitted to HMD should sent to: Hazardous Materials Division P.O. Box 129261 San Diego, CA 92131
Ask your Specialist for the
best FAX number or e-mail address to use. If you do not know who
your Specialist is, contact the HMD Duty Desk at
(858) 505-6880.
***PLEASE BE ADVISED***
A copy of all completed forms should be kept onsite for inspection review.
For more details on completing CERS, please refer to our CERS Information Page.
| General Business Forms for All Facilities |
| Complete in CERS in the Facility Information section: |
| Business Activities |
| Business Owner/Operator Identification (Certification Statement is included) |
| Complete form and send to HMD (mail, email or fax): |
| CERS Application Form (English) HMF-1000 (Replaces old CERS Access Form) CERS Application Form (Spanish) HMF-1000 NEW! |
| Corrective Action Form to Document Return to Compliance HM-926 |
| Hazardous Materials Questionnaire (Please utilize the Online Hazardous Materials Questionnaire during this time) |
| Tenant improvement and new business forms and information |
| Hazardous Materials Forms including Business Plan |
| Hazardous Materials Business Plan (HMBP) Instructions and Templates HM-952 |
| Complete in CERS in the Hazardous Materials Inventory section |
| Hazardous Materials Inventory - Chemical Description |
| Complete form and upload in CERS in the Hazardous Materials Inventory section: |
| Sitemap Multi-page site maps should be uploaded as a single document (Microsoft Word Version) |
| Disclosure of Hazardous Materials Information Bulletin HM-9243 |
| (HM-9243 includes Carcinogen & Reproductive Toxin Report and Highly Toxic Gases) |
| Remote Site Notification Form HM-9283 |
| Complete form and upload in CERS in the Emergency Response and Training Plans sections: |
| Consolidated Emergency Response/Contingency Plan |
|
| CalARP Forms
|
| Complete form and send to HMD (mail, email or fax): |
| CalARP Screening, Disclaimer and Deregistraion Guide HM-9220 |
| CalARP Screening, Disclaimer and Deregistration Form HM-9221 |
| How to Determine TQs & TPQs HM-9181 |
| CalARP Screening Worksheet HM-9223 |
| Risk Management Plan (RMP) Registration/ Work Plan HM-9240 |
For more information, go to the HMD’s CalARP Program page. For CalARP-related guidance documents, go to the HMD’s Publications and Guidance Documents page. |
| Hazardous Waste Forms |
| Non-RCRA and/or RCRA-Exempt Hazardous Waste Storage Extension Notification Form - Due to Covid-19 emergency, HMD is temporarily accepting electronic submittals of this notification in addition to your certified mail (with return receipt) request. |
| Remote Waste Consolidation Site Annual Notification Form HM-9714 |
| Complete form and upload in CERS in the Hazardous Waste Tank Closure Certification section: |
| Hazardous Waste Tank Closure
Certificate Hazardous Waste Tank Closure Notification |
| Complete form and upload in CERS in the Recyclable Materials Report Documentation section: |
| Recyclable Materials Report |
| Complete form and send to HMD (mail, email or fax): |
| Aerosol Can Processing - Notification HM-9284 |
| AST Certification & Engineering Assessment Exemption - Notification HM-9271 |
| Complete form and upload in CERS in the Emergency Response and Training Plans section” as “Miscellaneous State-Required Documents”: |
| Quick Reference Guide - QRG |
| If opting to use these forms for documentation requirements, complete them and keep onsite for inspection review: |
| Hazardous Waste Tank System Daily Inspection Log HM-9321 |
| Arrangements with Local Authorities HMF-3023 |
|
More information about Hazardous Waste and additional Hazardous Waste Guidance Documents
|
| Onsite Hazardous Waste Treatment - Tiered Permitting Forms |
| Complete in CERS in the Tiered Permitting section: |
| Hazardous Waste Treatment Notification-Facility Page |
| Hazardous Waste Treatment Notification-Unit Page |
| - Conditionally Authorized |
| - Conditionally Exempt - Limited |
| - Conditionally Exempt - Small Quantity Treatment |
| - Conditionally Exempt - Specified Waste Streams |
| - Permit By Rule |
| Certification of Financial Assurance |
| Plot Plan/Map |
| Prior Enforcement History |
| Tank and Container Certification |
| Local Agency Notification |
| Property Owner Notification |
| Estimate of Closure Costs |
| Financial Assurance Closure Mechanism |
| Complete and maintain on site (do not submit in CERS) |
| Waste Analysis Plan |
| Closure Plan |
| Phase 1 Assessment |
Additional Hazardous Waste Treatment Guidance Documents |
| Underground Storage Tank Plan Check Application Forms |
| Complete in CERS in the Underground Storage Tanks section: |
| UST Certificate of Installation / Modification |
| Complete form and send to HMD via email to USTNotifications.LUEG@sdcounty.ca.gov |
| Part I General project information HM-9311 |
| Part II Construct a UST facility HM-9312 |
| Part III Close a UST system HM-9313 |
| Part IV Modify existing UST site HM-9314 |
| Part V Interior coating/lining/repair UST HM-9315 |
Special Projects
Assistance Program - Application HM-9170
|
|
| Aboveground Petroleum Storage Act Forms |
|
Complete and implement the appropriate form: |
| Tier
I Facility Spill Prevention Control and Countermeasure
(SPCC) Plan Tier II Facility Spill Prevention Control and Countermeasure (SPCC) Plan Certification of the Applicability of the Substantial Harm Criteria (Required at all APSA facilities) |
For guidance on
selecting the correct SPCC Plan for your facility and for
more information about APSA, please visit our Aboveground
Petroleum Storage Program page.
Submit a completed Tank Facility Statement to the
Aboveground Petroleum Storage Act Documentation link in
the APSA section in CERS:
|
| Tank Facility Statement (APSA) |
(This form is optional if you rely on a submitted Hazardous Materials Business Plan (HMBP) in CERS to meet the annual Tank Facility Statement requirement.)
STI SP001 AST Record Monthly Checklist for TIUGA Facility with Less than 1,320 Gallons of Petroleum ( Word | PDF ) |
| Medical Waste Forms |
| Complete form and upload in CERS in the Hazardous Materials Inventory section under |
| Locally-Required Documentation: |
| Medical Waste Management Plan HMF-8005 |
| Complete form and send to HMD (mail, email or fax): |
| Application for Home-Generated Sharps Consolidation Point HM-9158 |
| Application for Onsite Medical Waste Treatment Permit HM-9188 |
| Limited Quantity Hauling
Exemption -Effective January 1, 2015, This form is no
longer required. If you are a small or large quantity
generator of medical waste, visit the CDPH
Medical Waste Generators website for additional
information. |
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