Liberty Lake, WA · Spokane County
Critical And Hazardous Materials List
Businesses use this form to list chemicals intended for use or storage at a facility and submit the information to Liberty Lake’s Community Development Department.
What this form is
This form records critical and hazardous materials intended for use or storage at a facility in Liberty Lake. It asks for company and contact information, product names, maximum quantities, material classifications, supporting MSDS information, storage or use areas, and proposed storage methods. The property owner or an authorized representative signs and certifies that the information is true and correct.
Who needs it
A property owner or authorized representative completes this form to account for chemicals intended for use or storage at the referenced facility.
How to submit it
Return the completed form to the Community Development Department at 22710 E. Country Vista Drive, Liberty Lake, WA 99019, or email it to [email protected].
About notarization
This document is signed and dated without a notary; the signer certifies that the chemical information is true and correct.
How to submit this form
- 1
Download The Form
Download the Critical And Hazardous Materials List PDF.
- 2
Complete The Form
Enter company and contact details, then provide the requested information for each product or chemical.
- 3
Gather Supporting Information
Include MSDS information as applicable; the form allows additional pages and explanatory notes.
- 4
Sign And Date
The property owner or authorized representative signs, prints their name, and dates the form.
- 5
Submit To The City
Return the form to the Community Development Department or email it to [email protected].
Frequently asked questions
- Who fills out the Critical And Hazardous Materials List?
- The property owner or a person with full permission and authority to represent the property owner fills out and signs the form.
- What information does the form request?
- It requests company and contact details, product names, maximum quantities, material classifications, MSDS information, storage or use areas, and proposed storage methods.
- Do I need a notary for the Critical And Hazardous Materials List?
- No. The document has no notary block; the signer signs and dates it and certifies that the chemical information is true and correct.
- How do I submit the Critical And Hazardous Materials List?
- Return it to the Community Development Department at the address on the form or email it to [email protected].
Need something notarized?
This Critical And Hazardous Materials List doesn’t need a notary — but if you have another Liberty Lake form that does, a commissioned online notary can help.