Air Permit Fact Sheets and Forms

Within this section you can obtain information and application forms that the Bureau of Air Management has prepared for air permitting and some compliance/monitoring activities associated with air permitting.

File formats include one or more of the following: Microsoft Word; PDF print only; and PDF fill-and-print. With the PDF fill-and-print format you must complete your editing work and print the form right away. Look through the relevant form categories (for example, General, Emission Unit/Source Specific, etc.), then click on the format link.

Application Materials


Form
File Format
GENERAL
4530-100 Facility Identification    
Fill & Print PDF
4530-101 Facility Plot Plan
Word
PDF
 
4530-102 Source and Site Descriptions
Word
PDF
 
4530-103 Stack Identification
Word
PDF
 
4530-127 Facility HAP Summary
Word
   
4530-129 Facility Emissions Summary
Word
   
4530-134 Signature Page/Index
Word
   
4530-135 Supplemental Information
Word
   
4530-136 Permit Revision or Renewal Request
Word
   
4530-137 Minor Permit Revision
Word
   
EMISSION UNIT/SOURCE SPECIFIC
4530-104 Boiler or Furnace Operation
Word
PDF
 
4530-105 Storage Tanks
Word
PDF
 
4530-106 Incineration
Word
PDF
 
4530-107 Printing Operations
Word
PDF
 
4530-108 Painting and Coating
Word
PDF
 
4530-109 Miscellaneous Processes
Word
PDF
 
4530-126 Emission Unit HAP Summary
Word
   
4530-128 Emission Unit Summary
Word
   
4530-155 112(j) MACT Combined Parts 1 and 2  
PDF
 
CONTROL DEVICES
4530-110 Control Equipment Miscellaneous
Word
PDF
 
4530-111 Condensers
Word
PDF
 
4530-112 Adsorbers
Word
PDF
 
4530-113 Catalytic or Thermal Oxidation
Word
PDF
 
4530-114 Cyclone/Settling Chambers  
PDF
 
4530-115 Electrostatic Precipitator
Word
PDF
 
4530-116 Wet Collection Systems
Word
PDF
 
4530-117 Baghouse/Fabric Filters
Word
PDF
 
MISCELLANEOUS COMPLIANCE-RELATED FORMS
4530-025 Portable Source Relocation Notification  
PDF
 
4530-118 Compliance Certification - Monitoring and Reporting Methods
Word
PDF
 
4530-119 Continuous Emission Monitoring
Word
   
4530-120 Period Emission Monitoring Using Portable Monitors
Word
   
4530-121 Monitor Control System Parameters or Process Operating Parameters
Word
   
4530-122 Monitoring Maintenance Procedures
Word
   
4530-123 Stack Testing
Word
   
4530-124 Fuel Sampling and Analysis
Word
   
4530-125 Recordkeeping
Word
   
4530-130 Emission Requirements and Status of Unit
Word
   
4530-131 Emission Unit Compliance Plan
Word
   
4530-132 Emissions Requirements and Status of Facility
Word
   
4530-133 Facility Compliance Plan
Word
   
4530-170 Compliance Certification - more info here
Word
   
4530-171 Air Operation Permit Deviation Summary Report - more info here
Word
   

REGISTRATION/GENERAL PERMITS EXEMPTIONS AND PETITIONS


Form
File Format
Contact
4530-141-144 Crushers General Operation Permits (GOP) A, B, C & Index Word    
Joe Brehm 608.267.7541
4530-157 Permit & Order Revocation for Registration or General Permits    
Fill & Print PDF
Kristin Hart 608.273.5605
4530-163 Asphalt Plant General Construction Permit (GCP)/GOP (Draft) Word    
Joe Brehm 608.267.7541
4530-169 General and Registration Permit Petition   PDF  
David Panofsky 608.267.2016
4530-173 Printer General Construction/ Operation Permit (GCP/GOP) Application (Draft)   PDF  
David Panofsky 608.267.2016
4530-174 NOI and Claim of Actual Emission Exemptions from Operation and Construction Permits (Draft) Word    
Kristin Hart 608.273.5605
Online Application Submittals
4530-156 Type A Registration Construction & Operation Permit    
start application process by clicking here
Kristin Hart 608.273.5605
4530-172 Printer Type C Registration Construction & Operation Permit    
start application process by clicking here
Kristin Hart 608.273.5605

Last Revised: Thursday April 08 2010