Protecting Public Health and the Environment.

Air Quality Permitting Forms and Checklists

Permit to Construct

Note: Forms on this page open best in Internet Explorer. For Mozilla Firefox users, you may get a “Please Wait” message and will need to click on the “Open with Different Viewer” prompt on the top right of the screen if the document does not display properly.

Form or Checklist Descriptor and Link
Form GI General Information 
Checklist 004 15-Day Pre-Permit Construction Approval Application Completeness Checklist
Checklist 005 Exemption Criteria and Reporting Requirements for Toxic Air Pollutant (TAP) Emissions Checklist
Checklist 006 Toxic Air Pollutant (TAP) Preconstruction Compliance Application Completeness Checklist
Checklist 007 Dispersion Modeling Protocol Checklist
  Air Impact Modeling Analysis Report Template Form
To help expedite DEQ’s review of the permit application, use this form to submit modeling results and a detailed description of the analyses to DEQ as part of the permit application.
Checklist 008 Minor Source Permit to Construct Application Completeness Checklist
Checklist 009 Small Wood-Fired Boiler Permit to Construct Application Checklist
Form EXPT Exemption Form EXPT
The purpose of Form EXPT is to assist facilities in preparing and maintaining documentation for the equipment or activity for which a PTC exemption is desired. This form may be used to document a self-exemption analysis or may be submitted to DEQ for an exemption concurrence (at no cost to the applicant).
  Guidance for Remediation of Petroleum Contaminated Media:
Includes forms for calculating VOC emissions from projects using soil vapor extraction or air stripping to remove petroleum contamination from the ground and ground water.

General Permit to Construct for Automotive Coating Operations

Note: Forms on this page open best in Internet Explorer. For Mozilla Firefox users, you may get a “Please Wait” message and will need to click on the “Open with Different Viewer” prompt on the top right of the screen if the document does not display properly.

Form Descriptor and Link
Form GI General Information
Form EU6 Automotive Spray Paint Booth

General Permit to Construct for Concrete Batch Operations

Note: Forms on this page open best in Internet Explorer. For Mozilla Firefox users, you may get a “Please Wait” message and will need to click on the “Open with Different Viewer” prompt on the top right of the screen if the document does not display properly.

Form Descriptor and Link
Form GCBP General Concrete Batch Plant Application Form
Form PERF Portable Equipment Relocation Form

General Permit to Construct for Hot Mix Asphalt Plants

Note: Forms on this page open best in Internet Explorer. For Mozilla Firefox users, you may get a “Please Wait” message and will need to click on the “Open with Different Viewer” prompt on the top right of the screen if the document does not display properly.

Form Descriptor and Link
Form GI General Information
Form HMAP Hot Mix Asphalt Plant
Form FRA Federal Requirements Applicability
Form PERF Portable Equipment Relocation Form

Permit by Rule for Crop Residue Burning

Note: Forms on this page open best in Internet Explorer. For Mozilla Firefox users, you may get a “Please Wait” message and will need to click on the “Open with Different Viewer” prompt on the top right of the screen if the document does not display properly.

Form Descriptor and Link
Registration Form PDF  |  Online Registration

Permit by Rule for Dairy Farms

Note: Forms on this page open best in Internet Explorer. For Mozilla Firefox users, you may get a “Please Wait” message and will need to click on the “Open with Different Viewer” prompt on the top right of the screen if the document does not display properly.

Form Descriptor and Link
Registration Form and Instructions Word  |  PDF  |  Online

Permit by Rule for Rock Crushers

Note: Forms on this page open best in Internet Explorer. For Mozilla Firefox users, you may get a “Please Wait” message and will need to click on the “Open with Different Viewer” prompt on the top right of the screen if the document does not display properly.

Form Descriptor and Link
Registration Form

Word  |  PDF

Form PERF

Portable Equipment Relocation Form

 

Electrical Generator Monitoring Form
Track number of hours operated per month and year-to-date.

 

Control Strategy Trigger Monitoring Form
Record control strategy triggers and corrective actions taken.

 

Complaint Receipt Monitoring Form
Record fugitive dust complaints received and corrective actions taken.

Tier I (Title V) Operating Permit

Note: Forms on this page open best in Internet Explorer. For Mozilla Firefox users, you may get a “Please Wait” message and will need to click on the “Open with Different Viewer” prompt on the top right of the screen if the document does not display properly.

Form Descriptor and Link
Form GI General Information
  Application Completeness Checklist

Tier II Operating Permit

Note: Forms on this page open best in Internet Explorer. For Mozilla Firefox users, you may get a “Please Wait” message and will need to click on the “Open with Different Viewer” prompt on the top right of the screen if the document does not display properly.

Form Descriptor and Link
Form GI General Information
Checklist 007 Dispersion Modeling Protocol Checklist
  Application Completeness Checklist

Multiuse Permit Application Forms

Note: Forms on this page open best in Internet Explorer. For Mozilla Firefox users, you may get a “Please Wait” message and will need to click on the “Open with Different Viewer” prompt on the top right of the screen if the document does not display properly.

Form Descriptor and Link
Form AO Afterburner/Oxidizer
Form CA Carbon Adsorber
Form CYS Cyclone Separator
Form ESP Electrostatic Precipitator
Form EU0 General Emission Unit
Form EU1 Industrial Engine
Form EU2 Nonmetallic Mineral Processing Plant (fugitive dust only)
Form EU3 Spray Paint Booth
Form EU4 Cooling Towers
Form EU5 Boilers
Form HMAP Hot Mix Asphalt Plant
Form CPB Concrete Batch Plant
Form BCE Baghouses Control Equipment
Form SCE Scrubbers Control Equipment
Form CAM Compliance Assurance Monitoring
Form EI Emission Inventory Requirements & Forms
Form PP Plot Plan
Form FRA Federal Requirements Applicability

Compliance

Note: Forms on this page open best in Internet Explorer. For Mozilla Firefox users, you may get a “Please Wait” message and will need to click on the “Open with Different Viewer” prompt on the top right of the screen if the document does not display properly.

Form Descriptor and Link
Form CAM Compliance Assurance Monitoring
Form AQ-C1 Annual Compliance Certification Form  |  Instructions
Form AQ-C2

Annual Compliance Certification Table: Word  |  Excel  |  Instructions
Identify compliance methods, monitoring frequency, deviations and excess emissions, and compliance status during the reporting period. Attach to Annual Compliance Certification Form (AQ-C1).

Form AQ-C3

Semiannual Deviation Summary Table: Word  |  Excel  | Instructions
Describe deviations, cause(s), and corrective/preventative measures. Use only if facility experienced deviations from permit requirements during the reporting period. Attach to Semiannual Report Form (AQ-C4) or Annual Compliance Certification (Form AQ-C1).

Form AQ-C4 Semiannual Monitoring Report Form  |  Instructions
Form AQ-C5

Semiannual Monitoring Report Table: Word  |  Excel  |  Instructions
Describe monitoring activities during the reporting period. Attach to Semiannual Report Form (AQ-C4).

Annual Registration

Online Data Entry System

Excess Emissions

Note: Forms on this page open best in Internet Explorer. For Mozilla Firefox users, you may get a “Please Wait” message and will need to click on the “Open with Different Viewer” prompt on the top right of the screen if the document does not display properly.

Form Descriptor and Link
Form AQ-C9

Excess Emissions Initial Notification
Use this form to provide initial notification to DEQ:
• No later than 2 hours before startup, shutdown, or scheduled maintenance of equipment that is expected to result or results in excess emissions (IDAPA 58.01.01.133.01).
• No later than 24 hours after the beginning of an upset, breakdown, or safety measure that results in excess emissions (IDAPA 58.01.01.134.02).

Form AQ-C10

Excess Emissions Report
Use this form to provide detailed information to DEQ:
• No later than 15 days after the beginning of an excess emissions event (IDAPA 58.01.01.135.01).

Portable Equipment Relocation

Note: Forms on this page open best in Internet Explorer. For Mozilla Firefox users, you may get a “Please Wait” message and will need to click on the “Open with Different Viewer” prompt on the top right of the screen if the document does not display properly.

Form Descriptor and Link
Form PERF

Portable Equipment Relocation Form

For use by hot mix asphalt, rock crushing, and concrete batch plants to notify DEQ when relocating portable equipment. Submit form at least 10 days in advance of portable equipment relocation. 

 


Staff Contacts

Air Quality Permitting Hotline
1-877-5PERMIT (1-877-573-7648)
Call to set up a meeting or ask air quality permitting questions.

Related Pages

Permit to Construct

Permit by Rule for Dairies

Permit by Rule for Rock Crushers

Tier I Air Quality Operating Permit

Tier II Air Quality Operating Permit

Air Quality Dispersion Modeling

Small Business Environmental Solutions