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Dental Amalgam Compliance Certification Form The completed form should be sent to: Environmental Services Division Attn: Commercial Section 2474 S 22nd Avenue, Building 31 Phoenix, AZ 85009 Facility

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How to fill out dental amalgam compliance certification

01

Obtain the necessary dental amalgam compliance certification form from your local dental regulatory authority.

02

Fill in all required fields on the form, including practice name, address, and contact information.

03

Provide details about the amalgam separator in use at your dental facility, including make and model number.

04

Include information about how often the amalgam separator is inspected and maintained.

05

Sign and date the certification form to verify the accuracy of the information provided.

06

Submit the completed form to the appropriate regulatory authority by the specified deadline.

Who needs dental amalgam compliance certification?

01

Dental professionals and facilities that generate or handle dental amalgam waste materials are required to obtain dental amalgam compliance certification.

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What is dental amalgam compliance certification?

Dental amalgam compliance certification is a certification required by the Environmental Protection Agency (EPA) for dental offices that use or remove dental amalgam.

Who is required to file dental amalgam compliance certification?

Dental offices that use or remove dental amalgam are required to file dental amalgam compliance certification.

How to fill out dental amalgam compliance certification?

Dental amalgam compliance certification can be filled out online through the EPA's Electronic Reporting Tool.

What is the purpose of dental amalgam compliance certification?

The purpose of dental amalgam compliance certification is to monitor and reduce the discharge of mercury from dental offices into the environment.

What information must be reported on dental amalgam compliance certification?

Information such as the number of amalgam separators installed, compliance with Best Management Practices, and the disposal method of amalgam waste must be reported on dental amalgam compliance certification.

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