Finance - (CUPA) Business Activities Notification Form

CUPA Business Activities Notification Form

Any business that handles threshold amounts of hazardous materials, generates any amount of hazardous waste, and/or plans to install, operate, or remove an underground storage tank is required to obtain a CUPA permit. The CUPA is responsible for regulating businesses that handle hazardous materials, generate hazardous waste, and/or operate an underground storage tank.

Please complete the following CUPA Business Activities Notification Form and submit it to the CUPA office. A program representative will contact you if a CUPA permit is necessary.

Business Name or DBA:
Contact Person:
Business Address Number and Street:
City
State:
Zip Code:
Business Phone:
E-mail:
Will the operations of your business result in any of the following activities? (Please check the activities that apply.)
	Handling of Hazardous Materials.
	Generation of Hazardous Waste.
	Operation of an Underground Storage Tank.
	Installation of Removal of an Underground Storage Tank.

Thank you for taking the time to complete this form and if you have any questions or need assistance please contact the CUPA office at (310) 458-8916 Ext. 2.

City of Santa Monica CUPA Office
Environmental Programs Division
200 Santa Monica Pier, Suite C
Santa Monica, CA 90401
Phone: (310) 458-4971
Fax: (310) 393-1279
CUPA Website
E-Mail: cupa@forms.smgov.net