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Unified Program Forms for Regulated Businesses

A business that handles hazardous materials and/or generates hazardous waste must submit unified program consolidated forms (UPCF) to the Health Hazardous Materials Division (HHMD). There are short and long versions of the UPCF. Both versions contain the Business Activities form, the Business Owner/Operator Identification form, the Contingency Plan, the Hazardous Materials Inventory-Chemical Description form and the Regulated Substances Registration form. But the long version contains the forms needed for facilities that have any of the following activities: underground storage tanks, onsite hazardous waste treatment, and the management of recyclable materials.

The complete versions of UPCF and the individual unified program forms are listed after the description of the unified programs. Click here for the unified program forms.

Hazardous Materials

Any business that handles a hazardous material and/or hazardous waste of quantities at any one time during a year equal to, or greater than a total volume of 55 gallons, a total weight of 500 pounds, or 200 cubic feet of a compressed gas is a handler and must submit the short version UPCF.

  • Handling of a 100% increase in the quantity of a previously disclosed material; or
  • Handling of a hazardous material that was not previously disclosed.
In the event of a substantial change, a handler shall submit the short version UPCF to HHMD within 30 days. A substantial change includes the following:

  • Implementing a new operation that involves the handling of hazardous materials and entails an emergency response procedure which was not documented on a previous business plan; or
  • A change of ownership and business name; or
  • Structural changes to an existing site that involves the handling of hazardous materials.
A handler must annually report its hazardous materials inventory to the HHMD. Each year, the HHMD sends the following documents to each handler:

  • Cover page;
  • Hazardous Materials Inventory Statement (inventory statement);
  • Owner/operator identification sheet; and
  • Site Map.
If there are no changes to the handler’s hazardous materials inventory or to the owner/operator identification sheet, the handler needs to send only the cover sheet back to HHMD. The handler needs to follow these procedures:
  • Check the applicable boxes on the cover sheet;
  • Sign the cover sheet to certify that the information is complete, accurate, and current;
  • Send the original cover sheet to the headquarters of HHMD (the handler is recommended to use certified mail), or personally deliver it to a satellite office and obtain a receipt, by the last day of the calendar year (December 31).; and
  • Keep copies of the cover sheet, the inventory statement, and the owner/operator identification sheet.
If there are changes to the handler’s hazardous materials inventory or to the owner/operator identification sheet, the handler needs to follow these procedures:

  • Check the applicable boxes on the cover sheet;
  • Sign the cover sheet to certify that the information is complete, accurate, and current;
  • Document changes on the inventory statement to update the hazardous materials inventory;
  • Complete and submit the Site Map;
  • Document changes on the owner/operator information page, and then sign it to certify that the information is correct;
  • Send the original cover sheet, inventory statement, site map and owner/operator identification sheet to the headquarters of HHMD (the handler is recommended to use certified mail), or personally deliver it to a satellite office and obtain a receipt, by the last day of the calendar year (December 31);
  • Keep current copies of the cover sheet, inventory statement, site map, and owner/operator identification sheet at the business.
California Accidental Release Prevention (Cal ARP)

Any business that has a process involving a regulated substance that meets or exceeds the state threshold quantity listed in Table 3 of Section 2770.5 in Title 19 must submit the Business Activities form, the Business Owner/Operator Identification form, a Regulated Substance Registration form and a Hazardous Material Inventory—Chemical Description form.

Hazardous Waste

An owner or operator is required to determine if the waste generated at a business is hazardous. The business owner or operator may use a certified laboratory to make this determination.

A hazardous waste generator must submit the Business Activities form, the Business Owner/Operator Identification form, and a Hazardous Waste Generator form.

However, an owner or operator who treats hazardous waste at the business must submit the applicable onsite treatment of hazardous waste forms that are obtained in the long version UPCF.

Underground Storage Tank (UST)

Any business that stores hazardous materials in underground storage tanks is required to submit the long version UPCF. This packet includes the UST forms. The UST program is implemented by Participating Agencies.

Aboveground Petroleum Storage Tank (APST)

Any business that stores aviation and automotive fuels, lubricating oils, mineral spirits, Stoddard solvent, and any type of high-flash aromatic naphtha in aboveground storage tanks, with a total capacity for the facility greater than 1,320 gallons, is required to submit the short version UPCF and to complete a Spill Prevention Countermeasure Control (SPCC) Plan. The SPCC must be implemented it by October 31, 2007. The plan is approved by the Regional Water Quality Control Board and is maintained at the tank location. For more information visit US EPA Oil Program.

Unified Program Forms

To just view or print these forms you can use MS Word Viewer. Get MS Word Viewer


NEW 2008 Haz Mat Reporting Form

INSTRUCTIONS FOR COMPLETION OF UNIFIED PROGRAM (UP) FORMS

  • Instructions for Completion of UP Forms MS Word - Instructions for Completion of UP Forms
  • Sample UP Form MS Word - Sample UP Form


COMPLETE VERSIONS OF THE UP FORMS

  • UP Form (Full Version) MS Word - UP Form (Full Version) pdf logo
  • UP Form (Short Version) MS Word - UP Form (Short Version) pdf logo

Note: The short version of the UP Form is only for use by businesses with activities limited to handling of hazardous materials and generation of hazardous waste.


INDIVIDUAL PAGES OF THE UP FORMS

FACILITY INFORMATION

    • Business Activities MS Word - Business Activities
    • Business Owner/Operator Identification MS Word - Business Owner/Operator Identification
    • Consolidated Contingency Plan MS Word - Consolidated Contingency Plan


HAZARDOUS MATERIALS

    • Hazardous Materials Inventory MS Word - Hazardous Materials Inventory
    • Cal ARP: Regulated Substance Registration MS Word - Cal ARP: Regulated Substance Registration


UNDERGROUND STORAGE TANKS (USTs)

    • UST Facility Page MS Word - UST Facility Page
    • UST Tank Page MS Word - UST Tank Page
    • UST Installation Page MS Word - UST Installation Page


HAZARDOUS WASTE

    • Recyclable Materials Biennial Report MS Word - Recyclable Materials Biennial Report
    • Remote Waste Consolidation Site Notification MS Word - Remote Waste Consolidation Site Notification
    • Hazardous Waste Tank Closure Certification MS Word - Hazardous Waste Tanke Closure Certification
    • Hazardous Waste Generator MS Word - Hazardous Waste Generator


ONSITE HAZARDOUS WASTE TREATMENT (TIERED PERMITTING)

    • Facility Information MS Word - Facility Information
    • CESQT Attachment MS Word - CESQT Attachment
    • CESW Attachment MS Word - CESW Attachment
    • CEL Attachment MS Word - Cel Attachment
    • Unit Information MS Word - Unit Information
    • CA Attachment MS Word - CA Attachment
    • PBR Attachment MS Word - PBR Attachment
    • Certification of Financial Assurance MS Word - Certification of Financial Assurance
 


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