Protecting our blue skies for a healthy community!  
Downloadable Forms

Downloadable Forms

Downloading Instructions

Click on the form you wish to download and save the file to your hard drive. All forms are in PDF format and/or Microsoft Word format as indicated.

With Microsoft Word files, fill in the required information on your computer and print the form. With PDF versions, print a blank form and fill it out by hand.

Mail the completed form, along with a check or money order, to the San Luis Obispo County Air Pollution Control District, 3433 Roberto Court, San Luis Obispo, CA 93401.

Authority to Construct & Permit to Operate Application Forms

An Authority to Construct/Permit To Operate (ATC/PTO) Application form, plus applicable specific equipment supplemental forms, should be submitted for any new or modified equipment ($195 filing fee).

A Change of Ownership/Name form should be submitted if the equipment hasn't changed but the responsible person has or will change ($95 filing fee). That form should also be used to record a change in business name that doesn't involve a change in responsibility (no fee).

A Permit to Operate is not transferable from one location to another, from one piece of equipment to another, or from one person to another. If equipment will soon be moved to a new address, an ATC/PTO Application form should be submitted.

 

General Forms File Format
Authority to Construct / Permit to Operate Application PDF Word
Contacts Form PDF Word
Change of Ownership/Name PDF Word
Gasoline Dispensing Facilities --- Please call APCD for more information    
Portable Engine Permit Application (Process Form not needed) PDF Word
Prime Use Diesel Engine Permit Application (Process Form not needed) PDF Word
Standby Diesel Engine Permit Application (Process Form not needed) PDF Word
Winery Permits Application (Process Form not needed) PDF Word
Breakdown/Upset -Initial Breakdown Upset Form PDF Word
Breakdown/Upset forms Breakdown Upset Follow-up Report PDF Word
Agricultural Engine Registration Forms  
Ag Engine Registration App. Form (AG-1) PDF Word
Ag Engine Registration App. Instructions (AG-2) PDF Word
Ag Engine Change Notification Form (AG-3) PDF Word
Ag Engine Location Change Policy Memo PDF  
Process Forms  
Abrasive Blasting Equipment PDF  
Concrete and Mineral Processing PDF  
Degreasing Operations PDF  
Dry Cleaning Equipment PDF  
Fuel Combustion Processes PDF Word
General Processes PDF  
Internal Combustion Engine Processes PDF Word
Organic Liquid Storage - Internal Floating Roof Tank Fittings PDF  
Surface Coating Operations PDF Word

Emissions Inventory Forms for Year 2014

Downloading a PDF form via the provided link may not result in a fillable form due to varous browser and virus protect restrictions. If your PDF form does not have form fields download this ZIP file: All_EI_Forms.zip

Form Name(#)  
(01) Data Certification Form PDF WORD
(02) Fuel Combustion PDF WORD
(03) Industrial Paint and Solvent Usage PDF WORD
(04) Other Solvent and Organic Compound Sources PDF WORD
(05) Auto Bodyshop VOC Calculations PDF WORD
(06) Dry Cleaning PDF WORD
(07) Wastewater Treatment PDF WORD
(08) Crematories PDF WORD
(09) Asphaltic Concrete Batch Plants PDF WORD
(10) Concrete Batch and Block Plants PDF WORD
(11) Rock and Sand Processing Plants PDF WORD
(12) Feed and Grain Mills PDF WORD
(13) Gasoline Dispensing Facilities PDF WORD
(14) Petroleum Loading of Tank Trucks (Including Gasoline) PDF WORD
(17) Petroleum Refining Process PDF WORD
(18) Oil and Gas Production PDF WORD
(19og) Fugitive Emissions - Oil & Gas Production and Oil Transfer/Pumping PDF WORD
(19rf) Fugitive Emissions - Petroleum Refinery and Coke Plant PDF WORD
(20) Storage of Organic Liquids - Tank and Material Characteristics PDF WORD
(21) Storage of Organic Liquids - External Floating Roof Tank Fittings PDF WORD
(23) Coke Processing PDF WORD
(27) Ethylene Oxide Sterilizers PDF WORD
(28) Retail Gasoline Bulk Plants PDF WORD
(29) Commercial Printing PDF WORD
(30) Landfills PDF WORD
(31) Coffee Roasters PDF WORD
(32) Standby Backup Generators PDF WORD
(33) Winery PDF WORD
(33) Agriculture Engines PDF WORD
(35) Car Crush PDF WORD
(36) Portable IC Engine PDF WORD

Title V

Instructions  
Guidelines for Title V Permit Forms PDF  
Form Name  
Applicable Requirements Form PDF Word
Operational Flexibility Form PDF Word
Compliance Plan and Certification Form PDF Word
Annual Compliance Certification Form PDF Word

Other Forms

Asbestos Demolition/Renovation General Information and Notification Form
Document Subscription/Copying Request Form
Public Information Request Form
Complaint Form
Compliance Assistance Customer Satisfaction Survey 

Contact us for more information on this topic.