California certification underground 2026

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certification of financial responsibility Preview on Page 1

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  1. Click ‘Get Form’ to open the California Certification of Financial Responsibility for Underground Storage Tanks in the editor.
  2. In Section A, check the appropriate box to indicate the required coverage amount, either $500,000 per occurrence or $1 million annual aggregate.
  3. In Section B, enter the full name of the tank owner or operator. Ensure this is accurate as it certifies compliance with state regulations.
  4. For Section C, specify the mechanism type used to demonstrate financial responsibility. List all names and addresses of issuers along with their respective mechanism numbers.
  5. Indicate the coverage amount and period for each mechanism in Section C. Make sure that total coverage equals 100% of financial responsibility.
  6. Complete Section D by providing all facility names and addresses associated with your underground storage tanks.
  7. Finally, sign and date in Section E. Include printed names and titles for both the tank owner/operator and witness/notary.

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