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ADM-275A NEW JERSEY DEPARTMENT OF ENVIRONMENTAL PROTECTION EXAMINATIONS LICENSING MAIL CODE 401-04E PO BOX 420 TRENTON NJ 08625-0420 APPLICATION FOR CERTIFICATION OF FIRM UNDER THE PROVISIONS OF P. L. 1991 C. 123 UNDERGROUND STORAGE TANK CERTIFICATION PROGRAM TYPE OF APPLICATION INITIAL RENEWAL MODIFICATION This form supersedes and negates all previous forms submitted. It must be notarized and completed in its entirety with all current information. NOTHING WILL BE PROCESSED WITHOUT THIS FORM AND A PHOTOCOPY OF THE FIRM S CERTIFICATE OF LIABILITY INSURANCE Firm Name Street Address No. Street Physical Location of Firm City State County Zip Code Mailing Address If different from above Owner s Email Address Telephone Number Certification Category Closure Tank Testing Subsurface Evaluation UST Installation check only one Entire UST System Release Detection Monitoring System ONLY UST Corrosion Protection Systems Analyst check only one Cathodic Protection Specialist Additional Business Office....

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How to fill out the Adm 275a Form online

The Adm 275a Form is essential for certification under the underground storage tank certification program in New Jersey. This guide provides clear and comprehensive instructions to help you fill out the form accurately and efficiently online.

Follow the steps to complete the Adm 275a Form online

  1. Click ‘Get Form’ button to access the Adm 275a Form and open it in your preferred editor.
  2. Begin by entering the firm name and the physical location details, including street address, city, state, county, and zip code. Ensure all information is accurate and current.
  3. If your mailing address differs from the physical location, fill in the mailing address section with the required details.
  4. Provide the owner's email address and telephone number to ensure effective communication regarding the application.
  5. Select the certification category by checking one of the options: Closure, Tank Testing, or Subsurface Evaluation. Only one option can be selected.
  6. For UST installation, check either 'Entire UST System' or 'Release Detection Monitoring System ONLY.' This selection is mandatory based on your application type.
  7. If applicable, select the UST corrosion protection systems analyst option by checking one of the choices: Cathodic Protection Specialist or Cathodic Protection Tester ONLY.
  8. List additional business offices and their addresses if applicable, ensuring each has a separate certificate generated and displayed at the location.
  9. Calculate the total fees by adding the initial or renewal fee and any additional business office certificates requested, according to the provided formula.
  10. Fill in the certifying officer(s) section with the names, titles, UST License numbers, signatures, and the dates. Ensure compliance with the requirements for certifying officers.
  11. The form must be notarized. Include the date of notarization and the notary public's seal and signature at the bottom of the form.
  12. Once all fields are filled out, review the document for accuracy. You can then save any changes, download, print, or share the completed form as necessary.

Start completing your Adm 275a Form online today to ensure timely certification for your firm.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232