California Dca Form Gsr 1 – Fill Out and Use This PDF

IMPORTANT INFORMATION:

YOU MUST PASS ALL THE REQUIREMENTS TO BE CERTIFIED AS A GOLD SHIELD STATION. FAILURE TO MEET ANY ONE OR MORE OF THE REQUIREMENTS WILL RESULT IN A DEFICIENT APPLICATION AND YOU WILL RECEIVE A NOTICE LISTING THE DEFICIENCIES. IF YOU RECEIVE A DEFICIENCY NOTICE FOR REQUIREMENTS 1, 2, 3, OR 8 AND HAVE CORRECTED THE DEFICIENCY, YOU MUST REAPPLY AT THE BEGINNING OF THE NEXT QUARTER.

BE ADVISED OF THE FOLLOWING:

•IF THE DEFICIENCIES ARE FOR REQUIREMENTS 1- 3, YOU MUST REAPPLY AT THE BEGINNING OF THE NEXT QUARTER.

•IF THE DEFICIENCY IS FOR REQUIREMENT 4, YOU MUST REAPPLY AFTER THE ONE-YEAR TIME FRAME FROM THE DATE OF YOUR CITATION.

•IF THE DEFICIENCY IS FOR REQUIREMENTS 5-6, YOU MUST REAPPLY AFTER THE THREE-YEAR TIME FRAME FROM THE DATE OF ACTION.

•IF THE DEFICIENCY IS FOR REQUIREMENT 7, YOU MUST REAPPLY UPON THE DECISION OF YOUR HEARING ON THIS MATTER.

•IF THE DEFICIENCY IS FOR REQUIREMENT 8, YOU MUST REAPPLY AT THE BEGINNING OF THE NEXT QUARTER.

I understand that my station will be evaluated according to the qualification requirements.

I certify under penalty of perjury under the laws of the State of California that all statements made in this application and all the attached supporting documents pertaining to this application are true and correct.

SECTION BELOW FOR BUREAU OF AUTOMOTIVE REPAIR USE ONLY

GOLD SHIELD QUALIFICATION REQUIREMENTS

A licensed Smog Check Test-and-Repair station seeking Gold Shield certification shall complete and file a Gold Shield Station Certification Application form (GSR-1 (Rev. 07/08)) and shall, as of the date the application is received by the Bureau of Automotive Repair, meet all of the following eligibility requirements:

1.The station’s Comparative Failure Rate (CFR) over the preceding quarter must meet or exceed the industry-wide failure rate for Test-Only stations, by Smog Check Program area, as calculated quarterly by the Bureau.

2.The station must have conducted a minimum of 10 successful emissions repairs in the preceding quarter. For the purposes of this section, a “successful emission repair” means:

A.The vehicle must have failed the emissions portion of a Smog Check in official test mode or pre-test mode at any Smog Check station within 60 days prior to the repair;

B.The Smog Check station must have repaired the vehicle and entered repair data into the Vehicle Information Database; and

C.The vehicle must have been issued a Certificate of Compliance at any Smog Check station within 10 days following the repairs made by the applicant Smog Check station.

3.The station’s repair performance in the preceding quarter must rate within the top 75% of test-and-repair stations in the same Smog Check Program area. A station’s repair performance is computed by comparing the final emission readings of each successful emission repair to the average passing emission readings for the same model-year and emission standards category of the vehicle repaired.

4.The station must not have been issued any citations pursuant to Section 44050(a) of the Health and Safety Code within the preceding one-year period, nor employ any technicians who have been issued any citations pursuant to Section 44050(b) of the Health and Safety Code within the preceding one-year period. Click here to verify a license.

5.Neither the current nor any previous registration nor license of the station owner, manager or licensed Smog Check technicians employed by the station:

•Been issued an order of suspension, a probationary order, or any other disciplinary order within the preceding three-year period. Be currently subject to suspension, probation or other disciplinary order. Click here to verify a license.

6.The station owner, manager and licensed Smog Check technicians or other employees of the station:

•Must not have been convicted of a crime within the preceding three-year period that is substantially related to the duties of a licensed Automotive Repair Dealer, Smog Check station, or Smog Check technician.

•Must not be serving a probationary period as a result of any such criminal proceeding.

•Must not have been found liable in a civil proceeding, excluding small claims matters, within the preceding three-year period, for acts or omissions that are substantially related to the duties of a licensed Automotive Repair Dealer, Smog Check station, or Smog Check technician.

7.The station must not have engaged in any conduct that would be cause for discipline of the station’s Automotive Repair Dealer registration or Smog Check station license.

8.The station must pass a Quality Assurance inspection administered by Bureau representative as part of the certification process. A Quality Assurance inspection consists of the following:

A.A verification of compliance with all licensure and license posting requirements.

B.A verification of compliance with all signage requirements.

C.A verification of compliance with all estimate, repair order, invoice and record keeping requirements.

D.A verification of possession of all required manuals and publications.

E.A verification of possession of all required tools and equipment and a verification of their proper working order.

F.Evaluations of licensed Smog Check technicians’ ability to perform complete Smog Check inspections, diagnoses, and repairs of failed vehicles.

Smog Check stations located in Change of Ownership areas need only meet requirements 4-7, to obtain Gold Shield certification.