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San Bernardino County Fire Department
Hazardous Materials Division
620 South "E" Street
San Bernardino, CA 92415-0153
Phone:  909.386.8401
Fax:  909.386.8460
 

Please call to obtain any forms that are not currently available online or if you have any difficulty downloading these forms.  Most forms require Adobe Acrobat Reader, unless otherwise noted.
 

Note that saving changes to Adobe pdf files requires full Adobe Acrobat or Acrobat Approval. 

Waste Collection Facility Publications (Household Hazardous Waste & CESQG)

• Household Hazardous Waste Flyer

• CESQG Brochure

• Free Recycled Latex Paint Flyer

 CUPA Forms

Hazardous Materials Emergency Response Plans and Inventory (Business Plan)

• CUPA Wastewater Example Business Plan

• Business Emergency/Contingency Plan Forms and Guidelines [MS Word Format]

• Business Emergency/Contingency Plan & CUPA Permit Exemption Form [MS Word Format]

• EPCRA Equivalency Letter

• EPCRA Fact Sheet

• Release Notification Guidance from OES

• Release Reporting Form from Title 19 [MS Word Format]

California Accidental Release Prevention Program (CalARP)

• San Bernardino County CUPA CalARP Submission Process

• Changes to the Chemical Accident Prevention Rule (Risk Management Program) in 2004

• FAQ: 5 Year RMP Resubmissions

• EPA Checklist for Resubmitting RMP's

• Accident Prevention Program Deregistration

• CalARP Deadline Change!

• California Accidental Release Prevention Program Registration Form [MS Word Format]

• Flammable Fuels Exemption Form

• Basic RMP Work Plan [MS Word Format]

• CalARP Statute - CA Health and Safety Code 25531-25543

• CalARP Regulations from CCR Title 19

• EPA Guidance documents (link to EPA download site)  

• EPA Guidance for Offsite Consequence Analysis

• EPA Clean Air Act General Duty Clause

• Sample Seismic Walkdown Forms [MS Word Format]

Underground Storage Tank (UST) 

UST System Required Documents
The following documents must be submitted by the UST owner/operator to the UST Compliance Program of the Hazardous Materials Division and updated within 30 days of a change in information. They also must be kept on site available for inspection. The State Water Resource Control Board forms are available in current versions and may have additional electronic format options at: http://www.waterboards.ca.gov/cwphome/ust/forms/index.html

• 1 UST Facility Form [MS Word Format]
• 1 UST Tank Form (2 pages) Per Tank or Compartment of a Tank [MS Word Format] 
• UST Certificate of Financial Responsibility
  • Sample Ceritificate of Financial Responsibility
  • Sample Chief Financial Officer Letter
• Leak Detection/Monitoring Plan [MS Word Format] 
• Response Plan
• Designated Operator Statement [MS Word Format]
• UST Monthly Designated Operator Statement [MS Word Format]

• Business Emergency/Contingency Plan Guidelines and Forms

UST System Construction and Testing

• Verifying UST Contractor Licensing & Certifications
• UST Construction Guidelines
• UST Installation Certificate of Compliance [MS Word Format]
• UST January 2003 Upgrade Requirements
• Expectations for UST Inspections
• Healy ISD Requirements
• UST Monitoring System Certification Form [MS Word Format]
• UST Monitoring System Certification Form Addendum for Vacuum/Pressure Interstitial Sensors [MS Word Format]
• UST Secondary Containment Testing Report Form [MS Word Format]
• UST Spill Bucket Testing Form [MS Word Format]

UST System Removal

• UST Removal Guidelines
• UST Hazardous Waste Tank Closure Certification Form [MS Word Format]
• UST Unauthorized Release Form
• UST Unauthorized Release Form Instructions

Hazardous Wastes

• Hazardous Waste Storage Weekly Inspection Checklist [MS Word Format]

• Hazardous Waste AST Daily Inspection Checklist [MS Word Format ]

• Hazardous Waste AST Daily Inspection Checklist - Monthly View [MS Word Format]

• Hazardous Waste Training Requirements

• Hazardous Waste Employee Training Record Example Form [MS Word Format]

• DTSC EPA ID Number Determination

• DTSC Fact Sheet – Accumulating Hazardous Waste

• DTSC Fact Sheet – EPA ID Number

• California ID Number Application Form - DTSC 1358

• Recyclable Materials Reporting Form [MS Word Format]

• Remote Waste Consolidation Notification Form [MS Word Format]

Universal Waste

• Managing Universal Waste Fact Sheet

• CRT Material Handlers and/or Recyclers located in San Bdno County

• Notice of Intent to Handle Universal Waste Electronic Devices (UWEDs) and/or Cathode Ray Tube (CRT) Materials

• Notice of Intent to Handle and Treat or Recycle Universal Waste Electronic Devices (UWEDs) and/or Cathode Ray Tube (CRT) Materials

• Summary Table of Universal Waste Requirements

• Best Management Practices for Managing Spent Fluorescent Lamps - Jan 2005

• Fluorescent Light Tube Fact Sheet - Jan 2005

• Universal Waste Rule in San Bernardino County

• Universal Waste Definitions

Tiered Permitting Forms

• Tiered Onsite Treatment Notification - Facility [MS Word Format]

• Tiered Onsite Treatment Notification - Unit [MS Word Format]

• Tiered Process Form - CA [MS Word Format]

• Tiered Process Form - CEL [MS Word Format]

• Tiered Process Form - CESQT [MS Word Format]

• Tiered Process Form - CESW [MS Word Format]

• Tiered Process Form - PBR [MS Word Format]

• Tiered Permitting Certificate of Financial Assurance [MS Word Format]

General Resources

• Compliance Made Easy / La Conformidad Es Fácil

• Customer Service Survey [MS Word Format]

• Fee Schedule

• Request for Certified Hazardous Materials Record Search Findings

• Procedures for Certified Hazardous Materials Record Search Findings Request

• File Review Request

• NFPA 704 Placarding Requirements for County Fire Jurisdiction Areas

• Dept of Toxic Substances Control Hazardous Waste Hauler List

The Hazardous Materials Division maintains lists of consultants who provide various services, please call (909) 386-8401 to obtain an appropriate list.

Disaster-Related Hazardous Waste Information

• Ash and Debris Cleanup Guidance

• Hazardous Waste Fire Assistance

• Residential Fire Victims Special Notice Fire Damaged Household Hazardous Waste / Noticia Especial a las Victimas del Incendio

• FEMA Disaster Information

• Red Cross Repairing Your Flooded Home"

• US EPA Flood Cleanup Information

• US EPA Mold Information

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