Auburn, WA · King County
Hazardous Materials Inventory Statement
Businesses use this statement to report hazardous materials handled or stored on site to the Valley Regional Fire Authority Fire Prevention Bureau.
What this form is
The statement records hazardous materials handled or stored by a business and is returned to the Valley Regional Fire Authority Fire Prevention Bureau. It asks for business and contact details, a signed declaration, and information about each material, including its hazard class, quantity, storage, and annual waste. The form also includes instructions and definitions to help classify materials.
Who needs it
A business owner, operator, or designated representative completes and signs the statement to report hazardous materials associated with the business.
How to submit it
Return the completed form to the Valley Regional Fire Authority Fire Prevention Bureau at 914 D St. N.E. #102, Auburn, WA 98002, or fax it to 253-288-5970. Call 253-288-5870 for assistance.
About notarization
No notary is required; the owner, operator, or designated representative signs and dates the declaration, which is made under penalty of perjury.
How to submit this form
- 1
Download the Statement
Download the Hazardous Materials Inventory Statement PDF.
- 2
Complete Business Details
Enter the business name, address, and contact phone number.
- 3
List Hazardous Materials
Provide the requested material, quantity, storage, and hazard information for each item.
- 4
Sign and Date
Have the owner, operator, or designated representative sign and date the declaration.
- 5
Return the Form
Mail it to the Fire Prevention Bureau address shown on the form or fax it to 253-288-5970.
Frequently asked questions
- What does the Hazardous Materials Inventory Statement report?
- It records business details and information about hazardous materials, including hazard class, chemical name, quantity on hand, storage, days on site, SARA class, and annual waste.
- Who signs the Hazardous Materials Inventory Statement?
- The form says it must be signed by the owner, operator, or a designated representative. The signer also dates the declaration made under penalty of perjury.
- Do I need a notary for the Hazardous Materials Inventory Statement?
- No. The form has no notary block; the owner, operator, or designated representative signs and dates the declaration under penalty of perjury.
- How do I submit the Hazardous Materials Inventory Statement?
- Return it to the Valley Regional Fire Authority Fire Prevention Bureau at 914 D St. N.E. #102, Auburn, WA 98002, or fax it to 253-288-5970.
Need something notarized?
This Hazardous Materials Inventory Statement doesn’t need a notary — but if you have another Auburn form that does, a commissioned online notary can help.