Outline
The California DCA GSR 1 form plays a crucial role in the state's efforts to improve air quality by certifying Smog Check stations as Gold Shield facilities. These certified stations are permitted to provide state-subsidized emissions-related repairs and perform inspections on vehicles that are identified as gross polluters. To obtain this certification, applicants must meet specific qualifications outlined in the form, including demonstrating a successful repair history and compliance with various regulatory requirements. The application process is straightforward: it requires no fee, and applicants must complete and sign the form before mailing it to the Bureau of Automotive Repair. Importantly, this application is only valid for the quarter in which it is submitted, emphasizing the need for timely and accurate submissions. Furthermore, the form includes a series of questions regarding the criminal and professional history of the station's owners and employees, ensuring that only qualified individuals are involved in emissions testing and repair. Adherence to these requirements is essential, as any deficiencies can lead to a rejection of the application, necessitating reapplication in the following quarter. Ultimately, the GSR 1 form is not just a bureaucratic step; it is a vital instrument in California’s commitment to reducing vehicle emissions and promoting environmental health.
Sample - California Dca Gsr 1 Form
Bureau of Automotive Repair
Licensing Unit – Gold Shield Program
10240 Systems Parkway, Sacramento, CA 95827
P 916.255.3145 F 916.255.4482 | www.smogcheck.dca.ca.gov
GOLD SHIELD STATION CERTIFICATION APPLICATION
INSTRUCTIONS:
1. There is no fee required with this application.
2. Read all information contained on this application including the Gold Shield Qualification Requirements (GSR-2).
3. Complete and sign the application.
4. Mail the completed application to the address above.
Please note: This application is only valid for the quarter in which you’ve applied.
STATION NAME
PHONE NUMBER
STREET ADDRESS
CITY
STATE
CA
ZIP CODE
SMOG CHECK STATION
LICENSE NUMBER:
________________
OWNERSHIP TYPE:
SOLE PROPRIETOR PARTNERSHIP
CORPORATION LLC
OWNER(S) NAME(S):
____________________________
____________________________
____________________________
____________________________
Gold Shield stations shall provide the following services to the public:
• State subsidized emissions-related repairs, except stations located in a Change of Ownership area.
• Certification of vehicles identified as gross polluters.
• After repair certification of vehicles that were directed to, initially tested, and failed inspection at a Test-Only station.
• Inspections for new and used car dealers on vehicles registered in Enhanced areas that have been wholesaled to car
dealers who subsequently offer them for retail sale in Basic and Change of Ownership areas.
• Initial inspection of vehicles directed to Test-Only station.
Please answer the following questions. If “YES,” please provide an explanation in the space provided; attach additional paper if
necessary.
Have you or any of your partners, corporate officers, directors, trustees, LLC members, or your Smog Check station managers or
technician(s),
1. Ever been convicted of a crime? (For the purposes of this question, “crime” does
YES NO
not apply to minor traffic violations.)
2. Been found liable in a civil proceeding for any act or any omission as an Automotive Repair
YES NO
Dealer, Smog Check Station, or Smog Check Technician, or in a related business?
3. Ever had any license denied, suspended, revoked, or placed on probation by the Bureau of
YES NO
Automotive Repair?
4. Been issued a citation by the Bureau of Automotive Repair within the last year?
YES NO
GSR-1 (Rev. 12/08) C:\Documents and Settings\hqsarms\My Documents\Dev\PUB
WEB\gs_app.doc
GSR-1 (Rev. 12/08) C:\Documents and Settings\hqsarms\My Documents\Dev\PUB
WEB\gs_app.doc
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.
SIGNATURE (all partners and all members of a LLC must sign)
TITLE (Sole Proprietor, Partner, Corporate Officer, Trustee,
LLC Member, etc.)
DATE
SIGNATURE (all partners and all members of a LLC must sign)
TITLE (Sole Proprietor, Partner, Corporate Officer, Trustee,
LLC Member, etc.)
DATE
SIGNATURE (all partners and all members of a LLC must sign)
TITLE (Sole Proprietor, Partner, Corporate Officer, Trustee,
LLC Member, etc.)
DATE
SIGNATURE (all partners and all members of a LLC must sign)
TITLE (Sole Proprietor, Partner, Corporate Officer, Trustee,
LLC Member, etc.)
DATE
SIGNATURE (all partners and all members of a LLC must sign)
TITLE (Sole Proprietor, Partner, Corporate Officer, Trustee,
LLC Member, etc.)
DATE
SIGNATURE (all partners and all members of a LLC must sign)
TITLE (Sole Proprietor, Partner, Corporate Officer, Trustee,
LLC Member, etc.)
DATE
SECTION BELOW FOR BUREAU OF AUTOMOTIVE REPAIR USE ONLY
ENHANCED AREA STATION BASIC AREA STATION CHANGE OF OWNERSHIP AREA STATION
MET GOLD SHIELD PERFORMANCE CRITERIA
YES NO
INITIAL
DATE
PASSED ENFORCEMENT RECORD CHECK
YES NO
INITIAL
REAPPLY DATE
DATE
PASSED QUALITY ASSURANCE INSPECTION
YES NO
INITIAL
DATE
FINAL APPROVAL
YES NO
INITIAL
DATE
GSR-2 (Rev. 07/08) C:\Documents and Settings\hqsarms\My Documents\Dev\PUB
WEB\gs_app.doc
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.
Form Information
| Fact Name | Details |
|---|---|
| No Application Fee | There is no fee required when submitting the Gold Shield Station Certification Application (GSR-1). |
| Application Validity | This application is only valid for the quarter in which it is submitted, so timely submission is crucial. |
| Eligibility Requirements | Stations must meet specific criteria, including a minimum number of successful emissions repairs and compliance with performance standards. |
| Criminal History Disclosure | Applicants must disclose any criminal convictions or civil liabilities related to automotive repair within specified timeframes. |
| Quality Assurance Inspection | A Quality Assurance inspection is required as part of the certification process to ensure compliance with various standards. |
| Governing Laws | This form is governed by California's Health and Safety Code, specifically Section 44050. |
Detailed Guide for Filling Out California Dca Gsr 1
Completing the California DCA GSR 1 form is a crucial step in the certification process for Gold Shield stations. Make sure to follow the steps carefully to ensure your application is complete and accurate. Missing information could delay your application or result in a deficiency notice.
- Obtain the Form: Download the California DCA GSR 1 form from the Bureau of Automotive Repair website or acquire a physical copy.
- Read the Instructions: Carefully read all information included in the application, including the Gold Shield Qualification Requirements (GSR-2).
- Fill Out the Station Information: Provide your station name, phone number, street address, city, state, and ZIP code.
- Select Ownership Type: Indicate the ownership type of your Smog Check station by checking the appropriate box (Sole Proprietor, Partnership, Corporation, LLC).
- List Owner(s) Name(s): Write the names of all owners and partners in the space provided.
- Enter License Number: Fill in the license number associated with your station.
- Answer Questions: Respond to the questions regarding any past convictions, civil liabilities, license issues, or citations. If you answer "YES" to any question, provide an explanation in the space provided or attach additional paper if necessary.
- Sign the Application: All partners and members of an LLC must sign the application. Include their titles and the date of signing.
- Mail the Application: Send the completed application to the Bureau of Automotive Repair at the address listed on the form.
Once your application is submitted, it will be reviewed for compliance with the Gold Shield certification requirements. Be prepared to address any deficiencies if notified. Timely submission is essential, as the application is only valid for the quarter in which it is submitted.
Obtain Answers on California Dca Gsr 1
-
What is the purpose of the California DCA GSR 1 form?
The California DCA GSR 1 form is used to apply for Gold Shield Station Certification. This certification allows a Smog Check station to provide specific services, including state-subsidized emissions-related repairs and certification of vehicles identified as gross polluters. Completing this form is essential for any licensed Smog Check Test-and-Repair station seeking to participate in the Gold Shield Program.
-
What are the eligibility requirements for certification?
To qualify for Gold Shield certification, a station must meet several criteria:
- The station’s Comparative Failure Rate (CFR) must meet or exceed the industry-wide failure rate for Test-Only stations.
- At least 10 successful emissions repairs must have been conducted in the preceding quarter.
- The station must rank within the top 75% of test-and-repair stations in its Smog Check Program area.
- No citations should have been issued to the station or its technicians within the last year.
- There should be no disciplinary actions against the station owner or technicians within the last three years.
- The station must pass a Quality Assurance inspection conducted by a Bureau representative.
-
Is there a fee associated with submitting the GSR 1 form?
No, there is no fee required when submitting the GSR 1 form. This allows stations to apply for certification without incurring additional costs. However, ensure that the application is completed accurately and submitted on time to avoid delays in processing.
-
What happens if my application is deficient?
If your application does not meet the necessary requirements, you will receive a deficiency notice outlining the issues. You must correct these deficiencies and reapply at the beginning of the next quarter if they relate to specific requirements. For other deficiencies, different timelines apply, so it is crucial to address any issues promptly to avoid delays in certification.
Common mistakes
Filling out the California DCA GSR 1 form can be straightforward, but many applicants make common mistakes that can delay the certification process. One frequent error is failing to read all the instructions thoroughly. The form contains vital information regarding the Gold Shield Qualification Requirements. Ignoring this can lead to incomplete applications.
Another common mistake is not providing complete contact information. Applicants often forget to include the phone number or the full street address. Missing these details can hinder communication from the Bureau of Automotive Repair, leading to unnecessary delays.
Many applicants also overlook the requirement for signatures. All partners and members of an LLC must sign the application. Omitting a signature is a simple yet significant error that can render the application invalid.
Inaccurate information regarding ownership type is another mistake. Whether it's a sole proprietorship, partnership, corporation, or LLC, the ownership type must be clearly indicated. Misclassification can lead to confusion and potential rejection of the application.
Providing incorrect answers to the eligibility questions can also be problematic. Applicants sometimes misunderstand the questions or fail to provide complete explanations when answering "yes." This can result in a deficiency notice, requiring additional time and effort to correct.
Some applicants neglect to attach necessary supporting documents. If there are explanations or additional details required, it’s essential to include them. Failing to do so may lead to a determination that the application is incomplete.
Another frequent oversight is not checking for compliance with the Gold Shield performance criteria. Applicants should ensure that their station meets the required standards before submitting the form. This includes checking the Comparative Failure Rate and ensuring that at least ten successful emissions repairs have been conducted.
Many people also miss the deadline for submission. The application is only valid for the quarter in which it is submitted. If it’s sent late, applicants will have to wait until the next quarter to reapply, causing further delays.
Lastly, some individuals do not keep a copy of their completed application. This can be a problem if questions arise later or if proof of submission is needed. Keeping a copy ensures that applicants have a reference point for any future communications.
By avoiding these common mistakes, applicants can streamline the process of obtaining Gold Shield certification and ensure a smoother experience with the California DCA GSR 1 form.
Documents used along the form
The California DCA GSR 1 form is essential for those seeking certification as a Gold Shield station. Along with this form, several other documents and forms may be required or beneficial in the certification process. Below is a list of these documents, each briefly described for clarity.
- GSR-2 Form: This form outlines the qualification requirements for Gold Shield certification. It provides detailed criteria that must be met to ensure compliance with state regulations.
- Business License: A valid business license is necessary to operate legally. This document confirms that the business is authorized to provide services in California.
- Proof of Insurance: This document demonstrates that the station has the required liability insurance coverage, protecting against potential claims arising from operations.
- Repair Order Records: These records detail previous repairs conducted by the station. They are important for verifying the station's experience and success rate in emissions-related repairs.
- Quality Assurance Inspection Report: This report is generated after a Quality Assurance inspection. It confirms that the station meets all operational standards set by the Bureau of Automotive Repair.
- Training Certificates: Certificates showing that technicians have completed required training programs can support the application. They highlight the skills and qualifications of staff members.
- Background Check Documentation: This includes any necessary background checks for the owners and key personnel. It ensures that all individuals meet the ethical and legal standards required for operation.
- Financial Statements: Providing financial statements can demonstrate the station's stability and ability to operate effectively within the industry.
- Compliance Records: These records show adherence to previous citations or disciplinary actions. They are crucial for proving that the station has rectified past issues.
Gathering these documents will streamline the application process and enhance the chances of obtaining Gold Shield certification. Each document plays a role in demonstrating compliance with state requirements and the station's commitment to quality service.
Similar forms
The California DCA GSR-1 form is a certification application for the Gold Shield Program, aimed at Smog Check stations. Several other documents share similarities with the GSR-1 form in terms of purpose, requirements, and procedures. Below are six such documents:
- California Smog Check Station License Application: This application is essential for any Smog Check station seeking to operate legally. Like the GSR-1, it requires detailed information about ownership, station location, and compliance with state regulations.
- Automotive Repair Dealer Application: This form is used by businesses seeking to become licensed automotive repair dealers. Similar to the GSR-1, it includes questions about the owners' backgrounds and requires adherence to specific qualifications.
- Quality Assurance Inspection Checklist: This document outlines the criteria for a Quality Assurance inspection, which is also a requirement for Gold Shield certification. Both documents emphasize compliance with state standards and operational practices.
- Emissions Repair Certification Application: This application is for stations that perform emissions-related repairs. Like the GSR-1, it requires documentation of successful repairs and adherence to performance metrics.
- Change of Ownership Notification Form: When a Smog Check station changes ownership, this form must be submitted to the Bureau of Automotive Repair. It shares similarities with the GSR-1 in that it requires verification of compliance with licensing requirements.
- Smog Check Technician Certification Application: This application is for individuals seeking certification as Smog Check technicians. Similar to the GSR-1, it requires background checks and proof of qualifications related to emissions testing and repair.
Dos and Don'ts
When filling out the California DCA GSR 1 form, consider the following guidelines to ensure a smooth application process.
- Do read all instructions carefully before starting the application.
- Do provide accurate and complete information in all sections of the form.
- Do sign the application where required and ensure all partners or members of the LLC also sign.
- Do mail the completed application to the correct address listed on the form.
- Don't submit the application without reviewing it for errors or omissions.
- Don't forget to attach any necessary additional documents if required.
- Don't assume that the application will be accepted without meeting all qualification requirements.
- Don't delay mailing the application, as it is only valid for the quarter in which it is submitted.
Misconceptions
Misconceptions about the California DCA GSR 1 form can lead to confusion among applicants. Here are four common misunderstandings:
- No fee is required for the application. Some believe that there might be hidden costs associated with submitting the GSR 1 form. In reality, there is no fee required when applying for Gold Shield Station certification.
- All applications are valid indefinitely. A frequent misconception is that once submitted, the application remains valid until approved. However, this application is only valid for the quarter in which it is submitted. Applicants must reapply if they do not receive certification within that timeframe.
- Failure to meet one requirement does not affect the application. Many applicants assume that meeting some requirements will suffice. In fact, all requirements must be met for certification. A deficiency in any one area will result in a notice detailing the specific deficiencies.
- Previous citations do not impact eligibility. Some believe that past citations or license issues do not affect their current application. However, any citations issued within the last year can disqualify the station or its technicians from certification.
Key takeaways
The California DCA GSR-1 form is essential for Smog Check stations seeking Gold Shield certification.
There is no fee required when submitting this application, making it financially accessible for eligible stations.
Before filling out the form, it is crucial to read all instructions and the Gold Shield Qualification Requirements detailed in the GSR-2 form.
Applicants must complete and sign the form, ensuring that all partners or LLC members also provide their signatures.
The completed application should be mailed to the Bureau of Automotive Repair at the address provided on the form.
This application is only valid for the quarter in which it is submitted, emphasizing the importance of timely submission.
Gold Shield stations must provide specific services, including state-subsidized emissions-related repairs and certification for gross polluters.
If deficiencies are identified, applicants will receive a notice listing the issues, and they must reapply at the beginning of the next quarter after corrections are made.