Current through Register No. 50, December 12, 2024
Section Env-C 310.04 - Application for Initial or Renewal Approval of TPAOs(a) In order to be approved by the department, a TPAO shall submit the information specified in (b), below, on a "Third Party Assessor Organization Application (TPAO) for Approval" form NHDES-W-03-201, dated 12-17-2019 and available at https://onlineforms.nh.gov/?FormTag=NHDES-W-03-201, to the department electronically.(b) A complete application for TPAO approval shall include the following: (1) The legal name, mailing address, street address, billing address, daytime telephone number, and fax number of the TPAO and, if available, the e-mail address and website address of the TPAO;(2) Whether the TPAO is a business entity or a government entity;(3) If the TPAO is a business entity, the following:a. The type of business entity, such as corporation, general or limited partnership, sole proprietorship, or limited liability company, and the legal name of the business entity, if other than the legal name of the TPAO;b. The date the TPAO registered with the New Hampshire secretary of state and the business identification number assigned by the secretary of state's office;c. If the TPAO is a corporation, the date and state of incorporation; andd. The name and title of each principal official of the business entity, such as corporate officers or general partners;(4) If the TPAO is a federal, state, county, or local agency, the name and primary mailing address of the agency, if different from the information provided pursuant to (b)(1), above;(5) The name, daytime telephone number, extension number, if applicable, and e-mail address of the individual at the TPAO who is the contact for purposes of the application;(6) The name and title of the individual authorized by the TPAO to sign the application;(7) The full legal name of each current and former affiliated and parent organization;(8) The geographic area(s) in which the TPAO provides service, both domestic and foreign;(9) The name, title, and qualifications of each individual TPA employed or otherwise used by the TPAO for laboratory accreditation assessments;(10) Documentation that the TPAO meets the criteria specified in Env-C 310.05(a);(11) An affidavit signed as specified in (12), below, that the TPAO:a. Certifies that the statements regarding the TPAO's qualifications, systems, approved assessor lists, and supporting documentation provided on or with the application are true, complete, and not misleading to the best of the applicant's knowledge and belief;b. Understands that application forms and supplemental application documentation and materials are considered public data;c. Acknowledges receipt of a copy of the Tennessen Warnings provided with the application package and has read and understands the contents;d. Acknowledges that all current or former relationships, associations, or investments that may influence or appear to influence the applicant's judgment, discretion, or impartiality with laboratories applying to or accredited by the program have been disclosed, and that if a conflict of interest is confirmed, the TPAO will not knowingly access records of those laboratories for personal gain and will again declare the conflict of interest to the department if is the applicant assigned duties where a conflict may be perceived to affect the applicant's judgment; ande. Agrees to comply with all applicable requirements of the state of New Hampshire and the NH ELAP related to assessment of environmental laboratories and protection of the data obtained while preparing, performing, or supervising the assessment activities; and(12) The affidavit required by (10), above, shall be:a. Signed by the individual authorized by the TPAO to sign the application; andb. Notarized by a notary public in the jurisdiction in which the affidavit is executed.(c) The TPAO shall submit a renewal application prior to expiration of its existing approval.N.H. Admin. Code § Env-C 310.04
(See Revision Note at chapter heading for Env-C 300) #12065, eff 1-1-17
Amended by Volume XXXVII Number 2, Filed January 12, 2017, Proposed by #12065, Effective 1/1/2017, Expires 1/1/2027.Amended by Volume XLI Number 49, Filed December 9, 2021, Proposed by #13291, Effective 11/23/2021, Expires 11/23/2031