The California DCA GSR-1 form is the application required for Smog Check stations seeking certification as a Gold Shield Station under the Bureau of Automotive Repair's Gold Shield Program. This certification allows stations to provide state-subsidized emissions-related repairs and other essential services to the public. Completing this form accurately is crucial for compliance with the program's qualification requirements.
To fill out the form, click the button below.
The California DCA GSR 1 form plays a crucial role in the Gold Shield Program, which aims to enhance the quality of emissions-related services provided by Smog Check stations. This application is designed for licensed Smog Check Test-and-Repair stations seeking certification as Gold Shield stations. The form requires applicants to provide basic information about their station, including the ownership type, contact details, and the names of owners or partners. Notably, there is no fee associated with submitting this application. However, applicants must meet specific qualifications to be eligible for certification. These qualifications include a satisfactory comparative failure rate, a minimum number of successful emissions repairs, and a clean disciplinary record. Additionally, the form includes a series of questions regarding past convictions and citations, which must be answered truthfully. The completed application must be mailed to the Bureau of Automotive Repair, and it is important to note that the application is only valid for the quarter in which it is submitted. Ensuring all requirements are met is essential, as any deficiencies will result in a notice outlining the issues that need correction before reapplying in the subsequent quarter.
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
ZIP CODE
CA
SMOG CHECK STATION
OWNERSHIP TYPE:
OWNER(S) NAME(S):
____________________________
LICENSE NUMBER:
SOLE PROPRIETOR
PARTNERSHIP
________________
CORPORATION
LLC
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
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
Automotive Repair?
4.
Been issued a citation by the Bureau of Automotive Repair within the last year?
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,
DATE
LLC Member, etc.)
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
INITIAL
PASSED ENFORCEMENT RECORD CHECK
REAPPLY DATE
PASSED QUALITY ASSURANCE INSPECTION
FINAL APPROVAL
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.
GSR-2 (Rev. 07/08)
Completing the California DCA GSR 1 form is an important step for those seeking Gold Shield Station Certification. The process involves gathering the necessary information and ensuring that all sections of the form are accurately filled out. Follow the steps below to ensure your application is complete and ready for submission.
After submitting your application, it will be reviewed by the Bureau of Automotive Repair. You will receive a notice listing any deficiencies if your application does not meet the requirements. If corrections are needed, be sure to address them promptly according to the guidelines provided in the application instructions.
What is the purpose of the California DCA GSR 1 form?
The California DCA GSR 1 form is an application for certification as a Gold Shield Station under the Bureau of Automotive Repair. This certification allows eligible Smog Check stations to provide specific services, including state-subsidized emissions-related repairs and the certification of vehicles identified as gross polluters. The form ensures that stations meet the necessary qualifications and performance standards set by the Bureau.
What are the eligibility requirements for Gold Shield certification?
To qualify for Gold Shield certification, a Smog Check station must meet several criteria. These include maintaining a Comparative Failure Rate that meets or exceeds the industry-wide rate, conducting a minimum of ten successful emissions repairs in the preceding quarter, and achieving a repair performance rating within the top 75% of similar stations. Additionally, the station and its personnel must not have any recent disciplinary actions or criminal convictions related to their duties. A Quality Assurance inspection must also be passed as part of the certification process.
Is there a fee associated with submitting the GSR 1 form?
No, there is no fee required when submitting the GSR 1 form for Gold Shield certification. However, applicants must carefully complete and sign the application and mail it to the specified address. It is important to note that the application is only valid for the quarter in which it is submitted, so timely submission is essential.
What happens if my application is deficient?
If the application is found to be deficient, the Bureau will issue a notice listing the specific deficiencies. Applicants must address these issues and reapply at the beginning of the next quarter. Different requirements have varying timelines for reapplication. For example, if deficiencies relate to certain criminal citations, applicants may need to wait up to one year before reapplying. It is crucial to meet all requirements to avoid delays in certification.
Filling out the California DCA GSR 1 form can be straightforward, but mistakes can lead to delays or even rejection of your application. One common error is not reading the instructions carefully. The form includes specific guidelines that must be followed. Ignoring these can result in incomplete submissions.
Another frequent mistake is failing to sign the application. All partners and members of an LLC must provide their signatures. Omitting even one signature can cause the application to be deemed invalid. Ensure that everyone involved has signed before mailing the form.
People often overlook the requirement to provide accurate contact information. Missing or incorrect phone numbers and addresses can hinder communication. This could lead to missed notifications about the status of the application or additional requirements.
Not providing detailed explanations for "yes" answers to the criminal history questions is another pitfall. If any of the partners or technicians have a relevant history, you must explain it in the space provided. Failing to do so can lead to assumptions and further complications.
Some applicants mistakenly think that all information must be provided on the form itself. If there isn’t enough space, it’s acceptable to attach additional paper. Not doing so can make the application look incomplete or rushed.
Another mistake is misunderstanding the application’s validity period. The application is only valid for the quarter in which it is submitted. If you miss the deadline, you will need to reapply, which can delay your certification.
Additionally, people sometimes neglect to verify their eligibility against the Gold Shield qualification requirements. The application requires meeting specific criteria, such as the Comparative Failure Rate and successful emissions repairs. Not checking these before applying can lead to an automatic deficiency notice.
Some applicants forget to double-check for any typos or errors in their information. Small mistakes can lead to big issues, especially when it comes to legal documents. A simple misspelling of a name or incorrect license number can cause significant delays.
Lastly, failing to keep a copy of the submitted application is a common oversight. Having a record of what was submitted can be invaluable if any questions arise later. Always keep a copy for your records before sending the application.
The California DCA GSR 1 form is a vital document for automotive repair stations seeking Gold Shield certification. This certification allows stations to provide specific emissions-related services to the public. Alongside the GSR 1 form, several other documents are commonly used in the application process. Understanding these documents can help streamline the certification journey.
In summary, while the California DCA GSR 1 form is essential for Gold Shield certification, it works in conjunction with several other documents. Each of these forms plays a critical role in ensuring that automotive repair stations comply with state regulations and maintain high standards of service.
When filling out the California DCA GSR-1 form, it is important to follow specific guidelines to ensure your application is processed smoothly. Here are four things you should and shouldn't do:
There are several misconceptions about the California DCA GSR 1 form that can lead to confusion. Here are six common misunderstandings:
Understanding these points can help you navigate the application process more effectively. Be sure to read all instructions carefully and ensure compliance with the requirements.
Filling out and using the California DCA GSR 1 form requires attention to detail and adherence to specific guidelines. Here are key takeaways to keep in mind:
Following these guidelines will help ensure a smoother application process and increase the likelihood of certification.