Application for Certification Form
Consumer Complaint Form
Application for Certification
Facility Name:
Date:
Address:
Phone:
Email:
Years in Business:
Former Business name if any:
Principals Industry Experience (years)
Experience:
Background:
Sponsor Fill Out:
DMV REG #
Apparisers Lic#
Tax ID#
Equipment:
Frame Rack:
Brand:
Age:
Regualarly Serviced:
Frame Bench:
Brand:
Age:
Measuring System:
Computerized:
Brand:
Age:
Print Out:
Sublet Frame Service
Ability to Lift vehicle
for inspection
Lighting acceptable
for inspection and repair:
Spray Booth:
Brand:
Code Compliant:
Age:
Welding- Cutting Acetylene:
Mig:
Tig:
Spot:
Brazing:
Cutting:
Plazma:
Do you sublet 4 Wheel Alignments or in house:
4 Wheel Alignment Equip:
Brand
Age
Computerized
Printout Capable
Wheel Diagnostic
Balancing
Tire Changing
Engine Diagnostics
Brand
Age
Paint
Approved Paint System with computerized scale or VOC recording capable:
Facility:
Signage-Shop Name
State Required signage:
Entrance well marked:
Accessible:
Handicapped:
Restrooms:
Sufficient Parking-Storage:
Fenced or Secured Storage:
Lighted Exterior:
CCTV surveillance:
Customer Key Drop:
Insurance Garage Keepers:
Primary:
Legal:
Excess:
Worker Compensation:
Right to Know Training:
Waste Control:
Approved solid waste disposal system for metal, paper, plastic, cardboard
Approved Liquid waste disposal system and manifests kept:
Approved Lighting disposal and system for disposal records:
Approved Filter System for paint exhaust:
Approved Filter Disposal System:
DEC-EPA permits:
Operations
Estimating System:
Brand:
Computerized:
Contract for Repair:
Designated Representative Form:
Privacy Policy:
Prepared by:
Date:
