What does the hazardous waste statement ask?

It asks whether the project site is on the identified hazardous waste sites list and requests applicant, site, parcel, regulatory identification, and list-date information.

Who completes this form?

The project applicant completes the statement for permit types other than building permits, providing information about the project site and its status on the identified list.

Do I need a notary for the hazardous waste statement?

No. The document has a signature and date line but no notary block; it does not identify any notarized attachment or related step.

Visalia, CA · Tulare County

No notary required

Hazardous Waste and Substances Statement for Entitlement Applications

This form lets a development project applicant state whether the project site is on an identified hazardous waste sites list and provide project and applicant details.

What this form is

Applicants use this statement to report whether a project site is on the identified hazardous waste sites list and to specify any applicable list. The form requests applicant and site details, assessor’s book, page, and parcel number, regulatory identification number, and the list date. The document says to complete it for all types of permits except building permits.

Who needs it

Applicants for permits other than building permits complete this statement with information about the project site and its status on the identified hazardous waste sites list.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

This statement is signed and dated without a notary; the form does not identify any notarized attachment or related step.

How to submit this form

1
Download the Form
Download the Hazardous Waste and Substances Statement for Entitlement Applications.
2
Complete the Statement
Enter applicant and project site details, review the identified hazardous waste sites list, and indicate whether the site is listed.
3
Add List Information
Specify any applicable list and provide the requested regulatory identification number and list date.
4
Sign and Submit
Sign and date the certification, then submit the form to the city department named on the form.

Frequently asked questions

What does the hazardous waste statement ask?: It asks whether the project site is on the identified hazardous waste sites list and requests applicant, site, parcel, regulatory identification, and list-date information.
Who completes this form?: The project applicant completes the statement for permit types other than building permits, providing information about the project site and its status on the identified list.
Do I need a notary for the hazardous waste statement?: No. The document has a signature and date line but no notary block; it does not identify any notarized attachment or related step.
How do I submit the hazardous waste statement?: Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Hazardous Waste and Substances Statement for Entitlement Applications doesn’t need a notary — but if you have another Visalia form that does, a commissioned online notary can help.