A person shall apply to the department for initial or renewal company certification on an application form obtained from the department. The applicant shall submit the following to the department:

1. (1) The fully and accurately completed department application form signed and dated by the applicant, which shall include the following:

   1. (a) Company name, mailing address, physical address of records required under s. DHS 159.19 (7), telephone, and other contact information.
   2. (b) If the applicant is not a sole proprietorship, the applicant’s federal employer identification number; if the applicant is a sole proprietorship, the applicant’s social security number or a signed statement made under oath or affirmation that the applicant does not have a social security number.
   3. (c) Company type: asbestos or exterior asbestos company.
   4. (d) Office type: primary or satellite office, and if applying for satellite office certification, the primary office company certification number.
   5. (e) Whether the company is exempt from paying the certification fee as a state or local government agency or a K-12 public school.
   6. (f) Name of one or more individuals authorized to represent the company, including department certification number for each representative certified under subch. II.
   7. (g) Signature of an authorized company representative, identifying any company violations of federal, state or local asbestos regulations within the past three years and verifying the truth and accuracy of the information provided on the application.

2. (2) The applicable fee.

   Note: Under s. 254.115, Stats., the department is required to deny certification to an applicant who does not provide either a federal employer identification number or a social security number or signed statement that the individual does not have a social security number.

   Note: Application forms are available on the department’s website at www.dhs.wi.gov/asbestos or may be obtained from the Asbestos and Lead Unit: plicasbstoslead@dhs.state.wi.us; 608-261-6876; 1 W. Wilson St, Room 137, PO Box 2659, Madison, WI 53701-2659.

   Note: Submit application and fee to Asbestos and Lead Unit: 1 W. Wilson St, Room 137, PO Box 2659, Madison, WI 53701-2659; (fax) 608-266-9711; plicasbestoslead@dhs.state.wi.us. For application submitted by fax or email payment may be made only by credit or debit charge to a VISA or MasterCard.

History

History: CR 08-036: cr. Register February 2009 No. 638, eff. 5-1-09.