Quality Office of Environmental Compliance Reviewed by: USTRD - Financial Services Post Office Box 4303 Date Reviewed: Approved: Baton Rouge, LA 70821-4303 A. PERSONAL Name (last, first and middle) Ms. Mr. Deficiencies: Social Security Number: Date of Birth Mailing Address (street name, P. O. Box or rural route and box number) City/Town State: Daytime Telephone Number: Zip Code: E-Mail B. ( ) TYPE OF CERTIFICATION REQUESTED: Installation/Repair Closure C. WORK EXPERIENCE Ins.

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How to fill out the LA UST-CC-1 online

This guide provides users with a clear and supportive walkthrough on how to fill out the LA UST-CC-1 form online for Underground Storage Tank Worker Certification. By following each step carefully, you can ensure a complete and accurate submission.

Follow the steps to complete your application effectively.

  1. Press the ‘Get Form’ button to obtain the LA UST-CC-1 form and open it in your preferred online editor.
  2. In Section A, enter your personal details, including your name, social security number, date of birth, mailing address, daytime telephone number, and email. Ensure all fields are filled to avoid rejection.
  3. In Section B, select the type of certification you are requesting: installation/repair or closure. Be sure to mark your choice clearly.
  4. Proceed to Section C, where you will document your work experience. Start with your most recent job. Provide employment dates, employer's name and address, position title, and detailed descriptions of duties performed, including the percentage of time spent on each duty.
  5. If using UST related work to qualify for certification, complete the subsection regarding how your past roles align with UST work.
  6. Continue to list your prior experience in the remaining sections of Section C, ensuring completeness of each entry as instructed.
  7. Move to Section D, where you will list underground storage tank job references if applicable. Ensure you have five distinct job references listed, meeting the criteria set forth in the instructions.
  8. In Section E, confirm if you are using a civil or mechanical engineering degree for qualification and attach appropriate documentation if applicable.
  9. In Section F, review the certification statement, ensuring all information is true and accurate before signing and dating the application.
  10. Finally, save your changes, download a copy of the application, and print it to send along with the examination fee of $132 to the specified address for the Department of Environmental Quality.

Ensure your application is complete and submit it online to proceed with the certification process!

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