Permitting: Forms
A variety of documents are available to assist you in submitting information to the Division. The forms may be viewed as an Adobe Acrobat (.pdf) file or downloaded as a Word (or occasionally as WordPerfect 6.x) file compressed with WinZip.
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Small Source Exemption
| Registration |
Small source exemption registration form |
PDF |
ZIP |
| Instructions |
Instructions for completing the small source exemption registration form |
PDF |
ZIP |
| Attachment C |
List of hazardous air pollutants |
PDF |
ZIP |
| Attachment D |
Wood finisher worksheet |
PDF |
ZIP |
| Attachment E |
Printer worksheet |
PDF |
ZIP |
| Attachment F |
Auto body Refinisher Worksheet |
PDF |
ZIP |
| Fact sheet |
How to Calculate Hazardous Air Pollutant Emissions |
PDF |
ZIP |
New Source Review
| NOI Guide |
How to prepare a notice of intent (NSR application) |
PDF |
ZIP |
| AO Boilerplate Conditions |
WordPerfect file used to construct an Approval Order |
PDF |
ZIP |
| Landfill capacity |
Landfill design capacity form |
PDF |
ZIP |
| Landfill emissions |
Landfill NMOC emission rate report |
PDF |
ZIP |
| Form 1 |
General Information |
PDF |
ZIP |
| Form 1a |
Standard Industrial Classification Codes |
PDF |
ZIP |
| Form 1b |
BACT Instructions |
PDF |
ZIP |
| Form 1c |
Permit name change |
PDF |
ZIP |
| Form 1d |
Emissions information |
PDF |
ZIP |
| Form 2 |
Process Information |
PDF |
ZIP |
Process-specific forms
| Form 3 |
Afterburner |
PDF |
ZIP |
| Form 4 |
Flare |
PDF |
ZIP |
| Form 5 |
Adsorption Unit |
PDF |
ZIP |
| Form 6 |
Cyclone |
PDF |
ZIP |
| Form 7 |
Condenser |
PDF |
ZIP |
| Form 8 |
Electrostatic Precipitator |
PDF |
ZIP |
| Form 9 |
Scrubber / Wet Collector |
PDF |
ZIP |
| Form 10 |
Fabric Filter (baghouse) |
PDF |
ZIP |
| Form 11 |
Internal Combustion Engine |
PDF |
ZIP |
| Form 12 |
Incinerator |
PDF |
ZIP |
| Form 13 |
Spray Booth |
PDF |
ZIP |
| Form 14 |
Concrete Batch Plant |
PDF |
ZIP |
| Form 15 |
Rock Crushing and Screening |
PDF |
ZIP |
| Form 15a |
Notice of Temporary Relocation of Portable Equipment |
PDF |
ZIP |
| Form 15b |
Equipment Registration Form for Generic Portable Equipment |
PDF |
ZIP |
| Form 15c |
General Permit Application for Portable Equipment |
PDF |
ZIP |
| Form 16 |
Soil/Groundwater Hydrocarbon Remediation |
PDF |
ZIP |
| Form 17 |
Diesel Powered Standby Generator |
PDF |
ZIP |
| Form 17a |
Natural Gas Powered Standby Generator |
PDF |
ZIP |
| Form 18 |
Portable Hot Mix Drum Asphalt Plant |
PDF |
ZIP |
| Form 19 |
Fuel Burning Equipment (Boilers, Heater, Steam Generators) |
PDF |
ZIP |
| Form 20 |
Organic Liquid Storage Tank |
PDF |
ZIP |
| Form 21 |
Solvent Metal Cleaning (Degreaser) |
PDF |
ZIP |
| Form 22 |
Combustion Turbine |
PDF |
ZIP |
| Form 23 |
Rotary Kiln |
PDF |
ZIP |
Operating Permits
| Operating Permit application form |
Application for a Title V operating permit |
PDF |
ZIP |
| OP application instructions |
Instructions and support information for the OP application form |
PDF |
ZIP |
| OP application checklist |
Completeness checklist for the OP application form |
PDF |
ZIP |
| Sample permit deviation report |
Sample form for reporting deviations from permit conditions |
PDF |
ZIP |
| Sample monitoring report |
Sample form for the six-month monitoring report |
PDF |
ZIP |
| Sample compliance certification |
Sample form with list of permit conditions that need certification in each annual report |
PDF |
ZIP |
| OP renewal cross-referencing info |
Information on what may or may not be cross-referenced in an operating permit renewal application. |
PDF |
— |
Dust Control Plan, Tax Exemption, Variance Request
| Dust Control Plan—Form |
PDF |
ZIP |
| Dust Control Plan—Instructions |
PDF |
ZIP |
| Sales Tax Exemption Guideline |
PDF |
— |
| Sales Tax Exemption Application Form |
PDF |
ZIP |
| Variance Request—Request Special Variance From Rules or Permits |
PDF |
ZIP |
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