
STATE USE ONLY Office of Environmental Compliance AI Number: USTRD – Financial Services Reviewed by: Post Office Box 4303 Baton Rouge, LA 70821-4303 Date Reviewed: Approved: A. PERSONAL Name: (last, first, and middle) Ms. Mr. Deficiencies: Date of Birth: Mailing Address (street name, P.O. Box or rural route and box number) City/Town: State: Zip Code: Daytime Telephone Number: E-Mail Address: ( ) B. TYPE OF CERTIFICATION REQUESTED: Installation/Repair Closure Installation/Repair/Closure.
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How to fill out the LA UST-CC-1 online
The LA UST-CC-1 form is essential for individuals seeking certification as an underground storage tank worker. This guide provides clear, step-by-step instructions to help you navigate the online application process effectively.
Follow the steps to complete the LA UST-CC-1 application form online.
- Click ‘Get Form’ button to access the application form and open it in your preferred online editor.
- Fill out Section A - Personal Information. Include your name, date of birth, mailing address, daytime telephone number, and email address. Ensure all fields are completed accurately to avoid application rejection.
- Proceed to Section B - Type of Certification Requested. Select the specific type of certification you are applying for (installation/repair, closure, or a combination). Input the test date if applicable.
- Explore Section C - Work Experience. List your employment history, starting with your most recent position. For each job, provide the date of employment, employer's details, position title, and a brief description of your duties along with the percentage of time spent on each duty. Remember that detailed descriptions aid in demonstrating your qualifications.
- Continue completing Section C with additional employment entries as necessary, copying Section C if you require more space.
- In Section D - Underground Storage Tank Job References, provide details of at least five UST jobs you have participated in, ensuring they align with the certification type you are applying for.
- If applicable, complete Section F - Education Substitution. Indicate whether you are utilizing an engineering degree for certification and attach relevant documentation.
- Finally, review and sign Section G - Certification, confirming that all provided information is true and accurate.
- Once all sections are completed, save changes to your application. You may then download, print, or share the completed form as needed.
Start filling out the LA UST-CC-1 online today to advance your certification process.
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