CUPA Forms & Handouts
Certified Unified Program Agency (CUPA) – Forms and Handouts
CUPA is a consolidated program; therefore there are several forms that are required. The type of hazardous materials or waste operations present at the facility determines which forms are required. Few facilities will need to complete all of the forms. For example, a facility will not need to complete the Underground Storage Tank forms if there are no underground tanks. Each form is provided with additional instructions.
Every facility must complete the Business Activities Page and the Business Owner/Operator Identification form. The Business Activities Page will assist you in determining which additional forms are required for your business. All of the forms are available as .DOC or .PDF files.
Permit Fee Schedule
- CUPA Fee Schedule
Effective May 1, 2018
Aboveground Storage Tanks
- AST Installation and Modification Permit Application
- Article 79 AST Guidance Document
- Petroleum Aboveground Storage Tank (AST) Facility Statement
Hazardous Materials (Business Plan)
A separate inventory page must be submitted for each individual hazardous material where the aggregate total is equal to or greater than 55 gallons, 500 pounds or 200 cubic feet. A separate inventory page must also be submitted for applicable radioactive materials.
- File Review Request Form
- Site Map
- Carbon Dioxide Guidance
- Carbon Dioxide Checklist
- CUPA Hazardous Materials Program
- CUPA Programa de Materiales Peligrosos
- Frequently Asked Business Plan Questions
Hazardous Waste Generators
Facilities must provide their EPA ID# on the Business Activities Page. Facilities should report each hazardous waste on a Hazardous Material Inventory-Chemical Description form, regardless of quantity.
- CESQG Emergency Response Plan
- Emergency Contingency and Training Plan
- Business Owner/Operator Identification
- Site Map
Hazardous Waste Treatment (Tiered Permitting)
- Phase 1 Environmental Assessment Checklist
- Phase 1 Environmental Assessment Instructions
- Requirements for Hazardous Waste Tank Systems
Underground Storage Tanks
Facilities must also submit (and maintain onsite) UST Monitoring Procedures, a Response Plan, and a UST Plot Plan (the Site Map required for the Business Plan may satisfy the UST Plot plan requirements if it shows the location of the USTs and identifies all UST monitoring sensors).
Please contact Oxnard Fire/CUPA to request UST closure requirements, including sampling and analytical requirements, UST installation requirements, and secondary containment testing requirements.
- UST Closure Permit
- Sampling site map template
- UST Certification of Financial Responsibility
- Hazardous Waste Tank Closure Certification Form
only for facilities closing USTs
- UST Modification or Repair Permit
- UST Closure Analytical Requirements
California Accidental Release Prevention (CalARP) Program