Looking for a California Legal Forms And Templates? Download it for free!

Shasta County Department of Resource Management

Environmental Health Division-Certified Unified Program Agency

1855 Placer Street, Suite 201, Redding, CA 96001, Telephone (530) 225-5787, FAX (530) 225-5413

ehd.co.shasta.ca.us

HAZARDOUS MATERIALS BUSINESS PLAN CERTIFICATION/ UPDATE FORM

Assessor's Parcel Number: ___ ___ ___ - ___ ___ ___ - ___ ___ ___

Date

ID #

Reporting Period

* Business Name & Address

Mailing Address

Pursuant to Section 25508.2 of the California Health & Safety Code (H&SC), the Hazardous Materials Business

Plan (HMBP) Certification described below is hereby submitted for the business indicated above*.

I certify that: (CHECK THE APPROPRIATE BOX after thoroughly reviewing your current HMBP)

I have personally reviewed the Hazardous Materials Business Plan currently on file with your agency and

certify that:

$ The information contained in the most recently submitted Hazardous Materials Inventory Forms, Facility

Map, Owner Identification and Business Activities Pages is complete, accurate, and up-to-date; and

$ There has been no change in the quantity of hazardous material(s) as reported in the most recently submitted

Hazardous Materials Inventory Forms; and

$ No hazardous materials subject to the inventory reporting requirements of H&SC '25503.5(a), are being

handled that are not listed in the most recently submitted HMBP; and

$ No substantial changes in operations have occurred which require revision to the training or emergency

response/contingency plan sections of the HMBP; and

This business is not utilizing the submission of this certification to meet the annual inventory submission

requirements of EPCRA('11022 of Title 42, U.S. Code)

Only applicable to facilities which handle quantities

equal to or greater than the federal threshold planning quantity of an extremely hazardous substance listed in Appendix

A, Part 355, Title 40, CFR, or 10,000 lbs of any hazardous material

Revisions to all or part of the Hazardous Materials Business Plan are necessary. The HMBP as revised has

been implemented and a copy of the revisions (or new HMBP) has been included with this Certification.

CERTIFICATION

: Based on my inquiry of those individuals responsible for obtaining the information, I certify that I

have personally examined and am familiar with the Hazardous Materials Business Plan (HMBP) information submitted

and believe the information is true, accurate, and complete. Furthermore, I understand that state law requires HMBP

reporting information to be reported to the California Environmental Reporting System (CERS). I approve of the Shasta

County Environmental Health Division (SCEHD) submitting this information, on behalf of this facility, to CERS. I also

understand that it is the facility owner’s responsibility to ensure compliance with these state reporting requirements and

that SCEHD is not responsible for reporting HMBP information to CERS for any facility. I understand the SCEHD will

attempt to create our facility in CERS and transfer our reported HMBP facility and inventory information to CERS, and

notify us if successful. This does not preclude me from completing this reporting to CERS, nor does it relieve the facility

owner of the requirement to complete HMBP reporting to CERS.

Name:

Signature

________________________________________

:__________________________________________

Type or Print

Title

Date

:__________________________________________

:______________________________________________

Please see separate page for more information on CERS

Hazardous Materials Business Plan Certification/ Update Form - Shasta County Department Of Resource Management

Related Articles

Related forms

Related Categories