Get Part Xi Special Regulations

Filling out the Part XI Special Regulations form is essential for licensing concrete testing laboratories in Massachusetts. This guide will assist you in completing the form accurately while ensuring you understand the requirements and implications of each section.

Follow the steps to successfully complete the Part XI Special Regulations form.

1. Click ‘Get Form’ button to obtain the Part XI Special Regulations form and open it for editing.
2. Begin by entering your laboratory's name and address in the designated fields. Ensure all information is accurate as it will be used for official correspondence.
3. Provide the registration number issued by the BBRS if your laboratory has been previously registered. If this is a new application, indicate this accordingly.
4. Detail the scope of your laboratory's services, describing the types of concrete testing you will perform. This information will clarify the laboratory’s capabilities.
5. Complete the section requiring information about management personnel qualified under 780 CMR 110.R1.4. Include names, titles, and qualifications.
6. Attach evidence of compliance with equipment requirements as stipulated in 780 CMR 110.R1.2. Provide documentation that details your laboratory's capacity to perform the necessary tests.
7. Calculate and include the required licensing fee, currently set at $150, in the appropriate section of the form.
8. Review the completed form for accuracy and completeness before submitting. Check all signatures and required documentation are included.
9. Submit the form through the designated online submission process. Ensure you receive confirmation of submission to maintain records.
10. Once the form is submitted, save any email confirmations and documents for future reference. Also, check back periodically for the licensing status from the BBRS.

Complete the Part XI Special Regulations form online today to ensure your laboratory meets Massachusetts’ licensing requirements.