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 the browser you use and the type of file. It is suggested you use the first method as it will give you more control.
All forms are in "fillable" PDF format, enabling you to print a blank form and fill it out by hand or type into the PDF form fields and print the forms completed. 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 indicate a fee is to be submitted for processing. In 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. You may also call us at 805-781-5912 to pay your filing fees over the phone with a credit card.
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 ($220 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 ($105 filing fee). That form should also be used to record a change in business name that doesn't involve a change in responsibility ($105 filing 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|
|Change of Ownership/Name|
|Gasoline Dispensing Facilities --- Please call APCD for more information|
|Portable Engine Permit Application (Process Form not needed)|
|Prime Use Diesel Engine Permit Application (Process Form not needed)|
|Standby Diesel Engine Permit Application (Process Form not needed)|
|Winery Permits Application (Process Form not needed)|
|Breakdown/Upset -Initial Breakdown Upset Form|
|Breakdown/Upset forms Breakdown Upset Follow-up Report|
|Agricultural Engine Registration Forms|
|Ag Engine Registration App. Form (AG-1)|
|Ag Engine Registration App. Instructions (AG-2)|
|Ag Engine Change Notification Form (AG-3)|
|Ag Engine Location Change Policy Memo|
|Abrasive Blasting Equipment|
|Concrete and Mineral Processing|
|Dry Cleaning Equipment|
|Fuel Combustion Processes|
|Internal Combustion Engine Processes|
|Organic Liquid Storage - Internal Floating Roof Tank Fittings|
|Surface Coating Operations|
These forms gather usage data that is used by the District to calculate 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 facilities receive a letter annually but smaller facilities 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 can 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 email@example.com. If you have any questions or need assistance obtaining or submitting the required forms, please contact Alyssa Roslan at (805) 781-5759 or firstname.lastname@example.org.
|(01) Data Certification Form|
|(02) Fuel Combustion|
|(03) Industrial Paint and Solvent Usage|
|(04) Other Solvent and Organic Compound Sources|
|(05) Auto Bodyshop VOC Calculations|
|(06) Dry Cleaning|
|(07) Wastewater Treatment|
|(09) Asphaltic Concrete Batch Plants|
|(10) Concrete Batch and Block Plants|
|(11) Rock and Sand Processing Plants|
|(12) Feed and Grain Mills|
|(13) Gasoline Dispensing Facilities|
|(14) Petroleum Loading of Tank Trucks (Including Gasoline)|
|(17) Petroleum Refining Process|
|(18) Oil and Gas Production|
|(19og) Fugitive Emissions - Oil & Gas Production and Oil Transfer/Pumping|
|(19rf) Fugitive Emissions - Petroleum Refinery and Coke Plant|
|(20) Storage of Organic Liquids - Tank and Material Characteristics|
|(21) Storage of Organic Liquids - External Floating Roof Tank Fittings|
|(23) Coke Processing|
|(27) Ethylene Oxide Sterilizers|
|(28) Retail Gasoline Bulk Plants|
|(29) Commercial Printing|
|(31) Coffee Roasters|
|(32) Standby Backup Generators|
|(34) Agriculture Engines|
|(35) Car Crush|
|(36) Portable IC Engine|
|Guidelines for Title V Permit Forms|
|Applicable Requirements Form||Word|
|Operational Flexibility Form||Word|
|Compliance Plan and Certification Form||Word|
|Annual Compliance Certification Form||Word|
|Asbestos Demo / Renovation Info & Notification|
|Document Subscription/ Copy Request Form|
|Public Information Request Form|
|Compliance Customer Satisfaction Survey|
|Request for Taxpayer Identification (W-9)|
Contact us for more information on this topic.