Dental Practice Initial Compliance Report and Annual Certification

Initial Compliance Report for Dental Dischargers

All Dental Practices must submit an Initial Compliance Certification Report — even if the practice seems like it could be exempt from the required best management practices of the Dental Amalgam Rule.

This is a one-time form that will only need to be resubmitted if an office has a change in name, address, or ownership, or if its practices regarding dental amalgam change.

Initial Compliance Report Due Dates

If your practice opened after July 15, 2017, the report is due 30 days after the practice opened. If you purchased an existing practice, the new owner must submit the report within 30 days of taking ownership.

The EPA requires an original signature on this report.

Please mail the original form to:

City of Portland
Water Pollution Control Lab
Attn: Dental Amalgam Program
6543 N Burlington Ave.
Portland, OR 97203

Annual Certification

Only dental practices that are required to implement the BMPs must submit the Annual Certification. Follow the link below to complete the online Annual Certification form:

ADCM Annual Certification Form

Businesses must complete the online form no later than January 31 of each year, certifying that the business complied with all BMPs during the previous year.

If you have any issues completing the online form, please email BESADCM@portlandoregon.gov.

Program Fee

The annual program fee is currently $190. The annual fee assists in recovering costs associated with permitting, inspecting, and monitoring facilities that meet the City’s ADCM requirements. It is reassessed annually to account for changing program costs. The fee is billed at the start of the fiscal year in July.

Resources

Find more information in the Guide to the Dental Amalgam Rule or contact Alternative Discharge Control Mechanism Permitting at BESADCM@portlandoregon.gov.