Motorists Stations Repair Industry Contact Us

Station Information Update Form

For minor station updates, complete the appropriate field(s) below. Only the station owner or authorized representative can sign the completed form. If you have any questions or need help filling out this form, please email [email protected].

NOTE: Updates to station ownership or station address must be completed using the Station Certification Application.

Station ID GA*

Station Name*

GAS ID*

Station Email*

Industry Advisory Board:

By checking this box I give GCAF permission to forward my email address to the Industry Advisory Board (IAB) so that I may receive current IAB updates and membership information.

Ownership Information

Update to business/corporation name

Update Owner Email

Industry Advisory Board:

By checking this box I give GCAF permission to forward my email address to the Industry Advisory Board (IAB) so that I may receive current IAB updates and membership information.

Update Owner/CEO Home Address Line 1

Update Owner/CEO Home Address Line 2

Update Owner City

Update Owner State

Update Owner Zip Code

Update Owner Phone Number

Station Information

Update Station Name (include copies of business license and insurance)

Update Station Phone Number

Update Station Managers

New Station Manager 1

First Name

Last Name

Phone

Industry Advisory Board:

By checking this box I give GCAF permission to forward my email address to the Industry Advisory Board (IAB) so that I may receive current IAB updates and membership information.

New Station Manager 2

First Name

Last Name

Phone

Industry Advisory Board:

By checking this box I give GCAF permission to forward my email address to the Industry Advisory Board (IAB) so that I may receive current IAB updates and membership information.

New Station Manager 3

First Name

Last Name

Phone

Industry Advisory Board:

By checking this box I give GCAF permission to forward my email address to the Industry Advisory Board (IAB) so that I may receive current IAB updates and membership information.

Remove Station Manager

First Name

Last Name

Remove Station Manager

First Name

Last Name

Remove Station Manager

First Name

Last Name

Configuration Changes

Adding/Changing out a GAS*:

Yes (Completed Site Plan Diagram Attached)

Analyzer Make

Moving Analyzer within Station*:

Yes (Completed Site Plan Diagram Attached)

Change ACH banking information

Model Number

Serial Number

Static IP Address

Attach Files

Static IP Documentation: Required if you are changing your IP address or adding an analyzer.

Current W-9 for the Business: Download W-9 Form

Completed Site Plan: Required if you are adding, changing, or moving GAS.

Business Documentation with New Station Name: Required if you are changing the name of your station.

Attach More Files

Electronic Signature

As the applicant, I certify and represent, under the penalty of law, the information provided herein, and all accompanying documentation supplied with this application, is true, correct and authentic. I understand and acknowledge that submitting false information or fraudulent statements or writings in a matter under the jurisdiction of a state agency is a crime and can result in fines, imprisonment or both (O.C.G.A 16-10-20).

Further, by entering my name in the field below, I am authorized to bind the above referenced inspection station, and I fully authorize the Georgia Environmental Protection Division (EPD) and Opus Inspection Technologies, Inc. to accept it as the equivalent signature for any and all purposes, including civil and criminal enforcement actions.

Applicant or Registered Owner Signature (Electronic Signature)

First Name

Last Name

Date

Sep 4, 2026