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THE CERTIFIED UNIFIED PROGRAM AGENCIES
OF LOS ANGELES COUNTY
UNIFIED PROGRAM (UP) FORM
CITY OF EL SEGUNDO
FIRE DEPARTMENT
CITY OF GLENDALE
FIRE DEPARTMENT
CITY OF LONG BEACH
CITY OF LOS ANGELES
FIRE DEPARTMENT
COUNTY OF LOS ANGELES
FIRE DEPARTMENT
CITY OF SANTA FE SPRINGS
FIRE DEPARTMENT
CITY OF SANTA MONICA
FIRE DEPARTMENT
HEALTH DEPARTMENT
CITY OF VERNON
TABLE OF CONTENTS
INTRODUCTION
What is a CUPA? 3
Offices of CUPAs in Los Angeles County 3
Participating Agencies of the LA County CUPA 4
Reporting Policy 5
What Do I Report? 6
Basic Instructions 7
Form Organization 7
Flow Chart 8
FACILITY INFORMATION SECTION
Business Activities Page 11
Business Owner/Operator Identification Page (FORMERLY OES FORM 2730) 13
Consolidated Contingency Plan 15
HAZARDOUS MATERIALS SECTION
A. Hazardous Materials Inventory - Chemical Description Page (FORMERLY OES FORM 2731) 27
B. Regulated Substance Registration (Cal ARP) (FORMERLY OES FORM 2735.6) 28
UNDERGROUND STORAGE TANK (UST) SECTION
UST Operating Permit Application—Facility Page……………………………………...………………………………..35
UST Operating Permit Application Tank Page 37
UST Installation Certification of Installation / Modification 39
UST Monitoring Plan……………………………………………………………………………………………………… 44
UST Response Plan…………………………………………………………………………………………………………49
HAZARDOUS WASTE SECTION
Recyclable Materials Biennial Report Pages (per HSC Section 25143.10) 56
Onsite Hazardous Waste Treatment Notification- Facility (FORMERLY DTSC FORM 1772) 60
Onsite Hazardous Waste Treatment Notification- Unit (FORMERLY DTSC FORM 1772) 64
(1) CESQT - Waste and Treatment Process Combination 66
(2) CESW - Waste and Treatment Process Combination 68
(3) CEL - Waste and Treatment Process Combination 70
(4) CA - Waste and
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