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County of Orange  >  Health Care Agency  >  Public Health Services   >  CUPA

HCA Certified Unified Program Agency (CUPA)

 

Unified Program Consolidated Forms
Certified Unified Program Agency (CUPA)

About downloading files

General Forms

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Business Activity

Download Business Activity form PDF version Download Business Activity form Microsoft Word version

Business Owner/Operator Identification

Download Business Owner/Operator Identification form PDF version Download Business Owner/Operator Identification form Microsoft Word version

Hazardous Materials

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Legislative Requirements

Download Legislative Requirements PDF version

Business Emergency Plan

Download Business Emergency Plan form PDF version Download Business Emergency Plan form Microsoft Word version

California Annotated Site Map

Download California Annotated Site Map PDF version

Inventory/Chemical Description

Download Inventory/Chemical Description form PDF version Download Inventory/Chemical Description form Microsoft Word version

Underground Storage Tanks

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Phase II EVR / ISD Installations Notice Updated

Download Phase II EVR / ISD Installations Notice PDF version Download Phase II EVR / ISD Installations Notice Microsoft Word version

Certification of Financial Responsibility
(State of California Water Resources Control Board form)

Download Cerfication of Financial Responsibility PDF version Download Cerfication of Financial Responsibility Word version

UST Facility Modification Application

Download UST Facility Modification Application form PDF version Download UST Facility Modification Application form Microsoft Word version

Facility Information (form A)

Download Facility Information (form A) PDF version Download Facility Information (form A) Microsoft Word version

Tank Information/Piping (form B)

Download Tank Information/Piping (form B) PDF version Download Tank Information/Piping (form B) Microsoft Word version

Installation/Certificate of Compliance (form C)

Download Certificate of Compliance (form C) PDF version Download Certificate of Compliance (form C) Microsoft Word version

Underground Storage Tank Program Tools

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Designated UST Operator Statement

download Designated UST Operator Statement-PDF version  download Designated UST Operator Statement-Word format

UST Response Plan

UST Response Plan-PDF version UST Response Plan-Word version

UST Monitoring Plan

UST Monitoring Plan-pdf version UST Monitoring Plan-Word Format

Monitoring Site Plot Plan

Monitoring Site Plot Plan-pdf version Monitoring Site Plot Plan-Word version

Aboveground Petroleum Storage Tanks

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Aboveground Storage Tank Facility Statement

Download APST_Tank_Facility_Statement- PDF version Download APST_Tank_Facility_Statement- Word version

Hazardous Waste

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Requirements for Hazardous Waste Tank Systems
California CUPA Forum

Requirements for Hazardous Waste Tank Systems - PDF version

Tank Closure Certification

Download Tank Closure Certification form PDF version Download Tank Closure Certification form Microsoft Word version

Remote Waste Consolidation Site/Annual Notification

Download Waste Consolidation / Annual Notification form PDF version Download Waste Consolidation / Annual Notification form Microsoft Word version

Recyclable Materials

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Recycling Activity/Recyclable Material Information

Download Recyclable Materials report PDF version Download Recyclable Materials report Microsoft Word version

Tiered Permitting

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Requirements for Hazardous Waste Tank Systems
California CUPA Forum

Requirements for Hazardous Waste Tank Systems - PDF version

Certificate of Financial Assurance

Download Certificate of Financial Assurance PDF version Download Certificate of Financial Assurance Microsoft Word version

Treatment Notification/Facility Page

Download Treatment Notification permit PDF version Download Treatment Notification permit Microsoft Word version

Waste and Treatment Process Combinations

  • Conditionally Exempt Small Quantity Treatment (CESQT) Page

  • Conditionally Exempt-Specified Wastestreams (CESW) Page

  • Conditionally Authorized (CA) Page

  • Permit by Rule Page

  • Conditionally Exempt-Limited (CEL) Page

Download Waste Treatment Notification PDF version Download Waste Treatment Notification Microsoft Word version

  

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