Section
Application Information
Check
Section 2
In Section 2(a),ย Applicant Information completed
If a corporation - In Section 2(b), name of a corporation completed
If a corporation - In Section 2(b), list of officers and directors provided
If a corporation - In Section 2(b), certificate of incorporation provided
Section 3
Section 3(a) completed with Senior Person in Charge Information
Section 3(b) completed with Responsible Person in Charge Information
Section 3(d) completed with Persons Authorized to Place Orders
Section 4
If individual applicant, security clearance application attached
If a corporation, security clearance application attached for all officers and directors
Senior Person in Charge security clearance application attached
Responsible person in Charge security clearance application attached
Alternate Person (s) in Charge security clearance application attached
Section 5
Activities and Substances - Information provided
Equivalency factor and method- Information provided
Section 6
Site information provided
Aerial view of the proposed site within the radius of 500 meters
The legal zoning of the proposed site and adjacent lots
An up-to-date building locations survey prepared and certified by a qualified surveyor
Section 7
Ownership of Propertyย - Applicant and Site Owner - Signature in Section 7(a)
Ownership of Property - Applicant NOT Site Ownerย - Appendix A attached and signed
Section 8
Proposed Site and Physical Security - Description attached
Proposed Site and Physical Security - Plan of the site attached
Proposed Site and Physical Security - Floor plan for the building attached
Proposed Site and Physical Security- Storage area floor plans attached
Section 9
Notice to local government attached
Notice to local police force attached
Notice to local fire authority attached
Declaration of notice provided signed by Senior Person in Charge
Section 10
QA Pre-licensing Report - Detailed description of the QA person's qualification provided
QA Pre-licensing Report - Building, equipment and sanitation program provided
QA Pre-licensing Report - Document signed and dated by QA person
Section 11
Record Keeping - Detailed description of the proposed methods
Record Keeping - Detailed description of the information to be captured
Section 12
Declaration and Attestations signed by the Senior Person in Charge