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Click ‘Get Form’ to open the cdph 5000a in the editor.
Begin by entering the Facility Name, Request Date, License Number, and contact details including Phone Number, Address, City, State, and Zip Code.
In the Notification of Emergency Tent Use section, confirm that you have obtained written approval from the local fire authority and check the appropriate boxes regarding emergency declarations.
For the Approval Request section, select all applicable requests such as Tent use or Space conversion by checking the corresponding boxes.
Provide a detailed description of your problem and explain why program flexibility is needed. Include alternative methods or personnel that will be utilized during the emergency.
Finally, ensure to sign and print your name in the designated areas before submitting. Attach any additional documentation if necessary.
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What is the CDPH California Tobacco Prevention Program?
The California Tobacco Control Program (CTCP) is a program of the California Department of Public Health. For nearly 30 years, CTCP has led the fight to keep tobacco out of the hands of youth, help tobacco users quit, and ensure that all Californians can live, work, play, and learn in tobacco-free environments.
Who may conduct a lead inspection in California?
Anyone who receives compensation (pay) for conducting lead inspections, lead risk assessments, lead clearance inspections, or any other lead hazard evaluation in any public or residential buildings in California, is required, by State law, to be a Certified Lead Inspector/Assessor.
What does a sampling technician do?
Collect and study samples from one type of source such as water, soil and air, or collect and study multiple types of sources at multiple locations. Test samples that have been previously collected in a laboratory environment using specialized equipment and procedures.
What is the CDPH standard?
The Standard Method for the Testing and Evaluation of Volatile Organic Chemical Emissions From Indoor Sources Using Environmental Chambers, an expanded standard for what is commonly known as California Specification 01350, is one of the most widely used standards to evaluate building and interior products for low
What does a CDPH sampling technician do?
(Such individuals typically do inspections, take samples, and interpret test results.) Sampling Technician: An individual who collects samples under the supervision of a certified inspector/assessor.
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Temporary Permission for Program Flexibility and for - CDPH
Initial approval may be given verbally by the local DO; however, a signed written approval must be distributed (faxed) to the facility and filed in the
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