Request for Remediation Plan Review

Request for Remediation Plan Review
Submissions must be in accordance with Utah Code Title 19–19-6-904
(1) Certified Decontamination Specialist is required to report any property that is the subject of decontamination work prior to commencement of the decontamination work.

(2) The report under Sec (1) shall include:
(a) sufficient information to allow the HD to investigate and verify the location of the property, including the address and description of the property.
(b) a proposed work plan for decontaminating the property.

(3) Upon completion of the decontamination process, a report certifying that the property is decontaminated shall be submitted to the HD within 30 days.
Type of contamination:*
Facility to be inspected
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Owner Name

First NameLast Name
Contact Person

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does this report need to be submitted to another agency?

YesNo
Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
File Upload*

Please upload, Tax ID, County Plat, Lab test results for room (s), Abatement & Disposal Plan & UDAQ Permit/Approval if needed.
Cancelof

My Products

Plan Review Fee

$100.00

Total

$0.00