Protecting our blue skies for a healthy community!
Downloadable Forms

Downloadable Forms

Downloading Instructions

To download a copy of a form Right-Click the link and use Save Link/Target As... to copy the file to your computer. Clicking on a form link will open, view, or offer to download a file depending on hte browser you use and the type of file. It is sugegsted you use the first method as it will give you more control.

All forms are in PDF format and/or Microsoft Word format as indicated. With Microsoft Word files you may fill in required information on your computer and print the form. With PDF versions you can print a blank form and fill it out by hand. Some PDF forms are "fillable" which means you can type into the PDF form fields. If you are using the latest PDF readers you should be able to fill in the form and save it to disk and then email the resulting file to us - no need to make a printed version.

Some forms state a fee is to be submitted for processing. For those cases 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(EI) Forms for Reporting 2015 Emissions Data

These forms gather usage data that is used by the District to calulate emissions data for reporting to the California Air Resource Board. Some forms gather data related to your Permit requirements.

You are only required to submit these forms when the person designated as the EI Contact (or Owner if an EI Contact is not designated) receives a letter indicating which forms are required from you. Most Facilites receive a letter annually but smaller Facilites may only be required to report every third year.

See Downloading Instructions above for downloading "fillable" PDF files that can be saved locally. Local files an be filled in using a PDF reader, saved to disk with the data, and submitted as attachments. If your PDF reader does not work for entering and saving data check for later versions of the reader. FoxIt and Adobe readers have been tested with these PDF files. (Not all forms on this page are fillable - all of the EI forms should be fillable.)

After completing the required forms, please fax, mail, or email them to the District office by March 31, 2016.  Forms may be faxed to (805) 781-1002 or emailed to  If you have any questions or need assistance obtaining or submitting the required forms, please contact Alyssa Roslan at (805) 781-5759 or

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

Title V

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.