HUD-312 State Installation Program Certification Form

State Installation Program Certification Form

U.S. Department of Housing and Urban Development Office of Manufactured Housing

OMB Approval No. 2502-xxxx expires xx/xx/xxxx

Pursuant to 42 U.S.C. § 5404(c)(2) (section 605(c)(2) of the National Manufactured Housing Construction and Safety Standards Act of 1974), HUD will implement an installation program in each state that does not have a program meeting the requirements of 42 U.S.C. § 5404(c)(3). This State Installation Program Certification form will be used for each state to self-certify the adequacy of its installation program, and for HUD to review that self-certification. Your answers to the following questions are necessary for a proper review, although some questions are for informational purposes only. Please answer each question completely, but concisely. Additional pages may be used if necessary, identifying each item by number. At the end of the form, please certify the responses as full and accurate. Public reporting burden for this collection is estimated to average 0.50 hours per response including the time for reviewing the instructions, searching existing data sources, gathering and maintaining the data as needed, and completing and reviewing the collection of information. Response to the information collection is mandatory. This agency may not collect this information, and no one is required to complete this form, unless the form displays a currently valid OMB approval number.

Part A – Contact Information

1. Name, address, telephone number, email address, and functional area of responsibility for each state agency responsible for administering any component (i.e., installation standards, licensing and training of installers, and inspections of installations) of the state’s installation program:

2. Name and title of the administrator or director in charge of each state agency identified above:

3. Name, title, address, telephone number, and email address of each person responsible for administering each component of the state’s installation program, listed by component area:

Part B –State Certification
B1. Describe the state’s installation program, citing state laws and regulations that establish requirements for: (a) installation standards; (b) training of installers; (c) licensing of installers; and (d) inspection of manufactured home installations.
B2. Does the state require that the installation of manufactured homes comply with specific standards?	YES NO
B3. If yes to question B2, do these installation standards provide residents protection that, as required by 42 U.S.C. § 5404(c)(3)(A), equals or exceeds the protection provided either: (i) by standards established by HUD; or (ii) by designs and instructions that have been determined by the Secretary of HUD or DAPIA to provide protection to residents that equals or exceeds the protection that would be provided by HUD standards for the applicable installations?	YES NO
B4. Does the state require that at least the installation standards referenced in item 3, above, apply in all areas and jurisdictions within the state?	YES NO
If no to question B4, please identify each area or jurisdiction in the state to which state law does UnotU apply to the installation standards, and explain why, as a matter of federal law, the state believes it should be exempt from applying the installation standards in each of those areas and jurisdictions.
B5. Describe how the state has determined that its installation standards provide protection that equals or exceeds the protection provided by HUD’s installation standards, as required by 42 U.S.C. § 5404(c)(3)(A).
B6. Does the state’s manufactured home installation standards address the following items identified in 24 CFR 3286.505?
a. Site location with respect to home design and construction conditions?	YES NO
b. Consideration of site-specific conditions?	YES NO
c. Site preparation and grading for drainage?	YES NO
d. Foundation construction?	YES NO
e. Anchorage?	YES NO
f. Installation of optional features, including comfort cooling systems?	YES NO
g. Completion of ductwork, plumbing and fuel supply systems?	YES NO
h. Electrical Systems?	YES NO
i. Exterior and interior close-up?	YES NO
j. Skirting, if installed?	YES NO
k. Completion of operational checks and adjustments?	YES NO
B7. Describe how the state’s manufactured home installation program addresses the training of installers in accordance with 42 U.S.C. § 5404(c)(3)(B). Please provide information on the amount of training required, both initially and on a continuing basis.
B8. Describe how the state’s manufactured home installation program addresses the licensing of, or other certification process for, installers in accordance with 42 U.S.C. § 5404(c)(3)(B).
B9. Does the state provide adequate funding and personnel to support its installation program?	YES NO
B10. Does the state have a method for inspecting the initial installations of new manufactured homes in accordance with 42 U.S.C. § 5404(c)(3)(C)?	YES NO
B10a. If yes to question B10, what portion or percentage of the installation of initially sited manufactured homes is inspected?	YES NO
B10b. If the answer to question B10a is less than one hundred percent of the installation of initially sited manufactured homes, what sampling plan is used to provide a reasonable likelihood of detecting problems with any installer and to ensure that overall program quality can be assured with statistical confidence?
B11. Does the state review or track the inspection of manufactured home installations?	YES NO
B12. If yes to question B11, explain what information the state tracks and how the state uses the information.
B14. Does the state have a mechanism for revoking or suspending an installer’s license or certification?	YES NO
B15. If yes to question B14, briefly explain the procedure and when it would be used:
Part C – Compliance Certification
I hereby certify that the state certification information above is true and accurate to the best of my knowledge and belief.

By: _____________________________________________ Date: ____________________

(Signature)

_____________________________________________

(Print or type name and official capacity of signatory)

_____________________________________________

(Print or type name of state)

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Distribution: Form HUD - 312

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