Get Emergency Spill Response Provider

This guide serves as a comprehensive and user-friendly resource for completing the Emergency Spill Response Provider form. It provides step-by-step instructions to help you navigate each section effectively and ensure your application meets the necessary requirements.

Follow the steps to fill out the form accurately and efficiently.

1. Press the ‘Get Form’ button to access the Emergency Spill Response Provider form and open it in your editing application.
2. Begin by entering your company's name, address, business phone number, fax number, 24-hour contact number, and email address in the specified fields.
3. Indicate your business location by providing the actual mileage and accurate directions to the nearest Turnpike Interchange.
4. List the names of the owner(s), partner(s), and principal officer(s) if applicable.
5. Select the form of ownership from the options provided: individual proprietorship, partnership, registered business corporation, or other.
6. Specify if you own or lease the facility and provide additional details as required.
7. If leased, provide the owner's name, address, and lease expiration date, and attach a copy of the lease.
8. State how long your business has been operating at this location.
9. Confirm if your organization has PEMA certification under Act 1990-165 and provide certification dates if applicable.
10. Detail your experience in HAZMAT response, including any past violations, the capacity to handle large HAZMAT incidents, and the types of hazardous waste your operation can manage.
11. Ensure you provide the required insurance information and indicate whether your operation maintains proper worker’s compensation and liability insurance.
12. Complete additional applicable sections concerning licenses, environmental permits, and safety equipment.
13. Finally, review your application for accuracy, save your changes, and select options to download, print, or share the completed form.

Get started on your application and complete the Emergency Spill Response Provider form online today.