Permit Application Forms

How to view or obtain permit application forms

The permit application forms below are available on-line in PDF format (PDF version 1.4 or 1.5). Some are also available in Microsoft Word 97-2003 (Word) format and/or WordPerfect 6-10 (WP) format. These and other application forms are also available from the District in paper form. (See contact information.)

If a document does not download correctly when you click on it, try this:

  1. Right-click on the link, choose "Save Target As..." or "Save Link As..." (or similar option, depending on your web browser),
  2. Save the document somewhere convenient, and
  3. Open it from the appropriate program (e.g., Adobe Reader).

Note that some documents may appear differently on different computers depending on the fonts installed and other settings.

General Construction and Operating Permits

These are the permit application forms to apply for a permit to construct, reconstruct, install, modify or operate a process or air pollution control device. These new permit application forms supercede Form 201 and the AP-xx08 forms which APCD no longer accepts. Carefully read the instructions below before starting to fill out forms. If you are new to air permitting, see Permits for a description of APCD's permitting process including how to get started.

For quicker processing, please submit reports and applications for emissions-based permits to airpermits @ Any submissions e-mailed will need to also be submitted either as hardcopy, faxed, or on physical electronic media (CD, floppy, flash drive).

Description PDF Microsoft Word Revision Date
Instructions Instructions (PDF) Instructions (Word) August 2011
Administrative Information 100A (PDF) 100A (Word) July 2014
Emission Unit Definition 100B (PDF) 100B (Word) March 2014
Request for Temporary Exemption 101X (PDF) 101X (Word) March 2014
Generic Process 200A (PDF) 200A (Word) March 2014
Abrasive Blasting 200B (PDF) 200B (Word) March 2014
Grain Elevator 200C (PDF) 200C (Word) March 2014
Silo 200D (PDF) 200D (Word) March 2014
Combustion Source 200E (PDF) 200E (Word) March 2014
Crematory 200F (PDF) 200F (Word) March 2014
Printing Operation 200G (PDF) 200G (Word) March 2014
Coating Operation 200H (PDF) 200H (Word) March 2014
Engine or Generator 200J (PDF) 200J (Word) March 2014
Used Oil Heater 200K (PDF) 200K (Word) March 2014
Asphalt Plant 200L (PDF) 200L (Word) March 2014
Dry Cleaning 200M (PDF) 200M (Word) March 2014
VOC Storage Tank 200N (PDF) 200N (Word) March 2014
Parts Washer 200P (PDF) 200P (Word) March 2014
Cooling Tower 200R (PDF) 200R (Word) March 2014
Control Devices
Generic Control Equipment 300A (PDF) 300A (Word) March 2014
Baghouse 300B (PDF) 300B (Word) March 2014
Cyclone 300C (PDF) 300C (Word) March 2014
Settling Chamber 300D (PDF) 300D (Word) March 2014
Electrostatic Precipitator 300E (PDF) 300E (Word) March 2014
Chemical Scrubber 300F (PDF) 300F (Word) March 2014
Reducing Systems 300G (PDF) 300G (Word) March 2014
Condenser 300H (PDF) 300H (Word) March 2014
Vapor-Liquid Separator 300J (PDF) 300J (Word) March 2014
Adsorber 300K (PDF) 300K (Word) March 2014
Thermal Oxidizer 300L (PDF) 300L (Word) March 2014
Flare 300M (PDF) 300M (Word) March 2014
Venturi Scrubber 300N (PDF) 300N (Word) March 2014
Major Source Operating Permits – Title V and FEDOOP
Emission Data 100C (PDF) 100C (Word) March 2014
Stack Data 100D (PDF) 100D (Word) March 2014
Potential to Emit 100E (PDF) 100E (Word) March 2014
Plantwide Emission Summary 100F (PDF) 100F (Word) March 2014
Alternative Operating 100G (PDF) 100G (Word) March 2014
Applicable Requirements 100H (PDF) 100H (Word) March 2014
Compliance Monitoring 100J (PDF) 100J (Word) March 2014
Compliance Status 100K (PDF) 100K (Word) March 2014
Compliance Schedule 100L (PDF) 100L (Word) March 2014
Risk Management Plan 100M (PDF) 100M (Word) March 2014
Episode Action Plans 100N (PDF) 100N (Word) March 2014
Insignificant Activities 100P (PDF) 100P (Word) March 2014
Production Rate 150B (PDF) 150B (Word) March 2014
Certified Progress Report 900B (PDF) 900B (Word) March 2014
Emission Reduction Credit 900C (PDF) 900C (Word) March 2014
Registered Sources
Registration Request 500A (PDF) 500A (Word) March 2014
Minor Source Certification 500B (PDF) 500B (Word) April 2014

See also:

Asbestos Permits

Description PDF Microsoft Word or WordPerfect
Asbestos demolition and renovation notification form Form 272 (PDF) Form 272 (Word)
Blanket Permit monthly reporting form Form 272E (PDF) Form 272E (WP)
Demolition release form Demolition Release Form (PDF) Demolition Release Form (Word)

Gasoline Dispensing (Stage I / Stage II) Permits

Description PDF Microsoft Word
Application to change the owner or operator of a facility or update information for renewal Form APG-A (PDF) Form APG-A (Word)
Application for permit to modify or construct a facility Form APG-C (PDF) Form APG-C (Word)

Open Burning Permits

Description PDF Microsoft Word
Recreational fire Rec. Fire App. (PDF) Rec. Fire App. (Word)
Agricultural burn Ag. Burn App. (PDF) Ag. Burn App. (WP)
Fire training fire Training Fire App. (PDF) Training Fire App (Word)
Fire training blanket  Training Blanket App. (PDF) Training Blanket App. (Word)

Useful Documents for Preparing Permit Applications