Form ECY020-28 "Notice of Action Required" - Washington

What Is Form ECY020-28?

This is a legal form that was released by the Washington State Department of Ecology - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2016;
  • The latest edition provided by the Washington State Department of Ecology;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form ECY020-28 by clicking the link below or browse more documents and templates provided by the Washington State Department of Ecology.

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Download Form ECY020-28 "Notice of Action Required" - Washington

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Notice of Action Required
Western Washington (800) 272-3780
Eastern Washington (509) 329-3491
Facility:
Shop No:
Date:
The Department of Ecology Emission Check staff has recently conducted a Technical Assistance visit at your facility. Your
facility has a deficiency that will temporarily exclude your shop from the Authorized Emission Specialist Program.
Repair invoice/receipts dated after date above will not be accepted at an Emission Check test station to obtain a waiver from
further testing.
Failure to notify your customers of your temporary removal from the Emission Check program could result in continued
removal from the program.
The requirement(s) your facility does not meet and the required corrective action(s) are listed in the checked items below:
Employ an Authorized Emission Specialist to perform all emission related repairs, diagnoses, and/or adjustments on
vehicles that fail an Emission Check test
Action required: Hire an Authorized Emission Specialist. If you wish to have a current employee become an
Authorized Emission Specialist call your Ecology Representative for class information.
Maintain an OBDII compliant scanner in good working order meeting the accuracy checks of the Department.
Action Required: Repair your OBDII scanner to meet accuracy requirements. Call your Ecology Representative to
schedule a Technical Assistance visit.
Other
Manager/Owner Information
First Name:
Last Name:
Position:
Acknowledgment of Receipt Statement
I have read and understand these requirements.
Signature
Date
For Official Use Only
Ecology Staff
Date
To request ADA accommodation, call (360) 407-6800, 711 (relay service), or (877) 833-6341 (TTY).
ECY 020-28 (Rev. 10/2016)
Page 1
Notice of Action Required
Western Washington (800) 272-3780
Eastern Washington (509) 329-3491
Facility:
Shop No:
Date:
The Department of Ecology Emission Check staff has recently conducted a Technical Assistance visit at your facility. Your
facility has a deficiency that will temporarily exclude your shop from the Authorized Emission Specialist Program.
Repair invoice/receipts dated after date above will not be accepted at an Emission Check test station to obtain a waiver from
further testing.
Failure to notify your customers of your temporary removal from the Emission Check program could result in continued
removal from the program.
The requirement(s) your facility does not meet and the required corrective action(s) are listed in the checked items below:
Employ an Authorized Emission Specialist to perform all emission related repairs, diagnoses, and/or adjustments on
vehicles that fail an Emission Check test
Action required: Hire an Authorized Emission Specialist. If you wish to have a current employee become an
Authorized Emission Specialist call your Ecology Representative for class information.
Maintain an OBDII compliant scanner in good working order meeting the accuracy checks of the Department.
Action Required: Repair your OBDII scanner to meet accuracy requirements. Call your Ecology Representative to
schedule a Technical Assistance visit.
Other
Manager/Owner Information
First Name:
Last Name:
Position:
Acknowledgment of Receipt Statement
I have read and understand these requirements.
Signature
Date
For Official Use Only
Ecology Staff
Date
To request ADA accommodation, call (360) 407-6800, 711 (relay service), or (877) 833-6341 (TTY).
ECY 020-28 (Rev. 10/2016)
Page 1