N.H. Code Admin. R. Env-A 1811.05

Current through Register No. 25, June 20, 2024

Section Env-A 1811.05 - Information Required for Licensure Applications

The applicant shall provide, on the "Application for Asbestos Disposal Site Contractor License" form, the information required by Env-A 1811.04(a) shall be as follows:

(a) The applicant's name, mailing address, physical address if other than the mailing address, e-mail address, fax number, and daytime telephone number;

(b) Whether the applicant is an individual or an entity, and, if an entity, whether the applicant is a corporation, partnership, political subdivision, or other kind of association or organization;

(c) If the applicant is an individual, the applicant's date of birth;

(d) If the applicant is an entity, the applicant's legal name, state of incorporation or formation, as applicable, and address of its principal place of business;

(e) If the applicant is an entity, then for each of its responsible persons, the individual's:

(1) Name and title;

(2) Date of birth; and

(3) Address;

(f) The name, title, mailing address, email address, fax number, and daytime telephone number of the individual affiliated with and designated by the applicant to be contacted regarding the application;

(g) The name of each responsible person who fulfills the licensing requirement specified in Env-A 1811.10(b), plus the following additional information about each such individual:

(1) Title and principal duties;

(2) Mailing address;

(3) Telephone number;

(4) Date of birth; and

(5) Current certificate number;

(h) Identification of all certifications and licenses, both past and present, issued to the applicant pursuant to He-P 5000 or Env-A 1800;

(i) A list of all state or federal enforcement actions, both past and pending, against the applicant, including its responsible persons, with regard to environmental, health or safety activities, and the current status of each such enforcement action;

(j) A list of all individuals currently employed or otherwise associated with the applicant who, under the authority of the applicant's license, if issued, will perform work relating to the disturbance of asbestos at asbestos disposal sites, including the following information about each individual:

(1) Name;

(2) Date of birth;

(3) Position title;

(4) Business mailing address;

(5) Business telephone number;

(6) If the individual is certified pursuant to Env-A 1812, the certificate number and expiration date;

(7) If the individual is not certified pursuant to Env-A 1812, the date application for certification was or will be made, and the date training in accordance with Env-A 1813 was or will be obtained; and

(8) Whether the individual meets the requirements of a competent person, as specified in 29 CFR 1926.1101, or an on-site supervisor, as specified in 29 CFR 1910.120, or both.

N.H. Code Admin. R. Env-A 1811.05

(See Revision Note at chapter heading for Env-A 1800) #9298, eff 10-21-08

Amended by Volume XXXVII Number 19, Filed May 11, 2017, Proposed by #12172, Effective 5/5/2017, Expires 5/5/2027.