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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 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.

Asbestos Forms 

NESHAP Demolition/Renovation Notification Form PDF
NOA Construction and Grading Project/Exemption Form PDF

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 ($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 PDF
Contacts Form PDF
Change of Ownership/Name PDF
Cannabis Application PDF
Gasoline Dispensing Facilities --- Please call APCD for more information  
Portable Engine Permit Application (Process Form not needed) PDF
Prime Use Diesel Engine Permit Application (Process Form not needed) PDF
Standby Diesel Engine Permit Application (Process Form not needed) PDF
Winery Permits Application (Process Form not needed) PDF
Breakdown/Upset -Initial Breakdown Upset Form PDF
Breakdown/Upset forms Breakdown Upset Follow-up Report PDF
Agricultural Engine Registration Forms  
Ag Engine Registration App. Form (AG-1) PDF
Ag Engine Registration App. Instructions (AG-2) PDF
Ag Engine Change Notification Form (AG-3) PDF
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
General Processes PDF
Internal Combustion Engine Processes PDF
Organic Liquid Storage - Internal Floating Roof Tank Fittings PDF
Surface Coating Operations PDF

Burn Permit Application Forms 

For more information on Agricultural and Backyard Burning click here. Please note that the e-pay option listed below is only for individuals who held a backyard or agricultural burn permit within the past two burn seasons. Your previous burn permit number or Assessor's Parcel Number (APN) will be required to complete this process. If you select the PDF Application Form, please be sure to follow instructions listed on the form to complete your Application.  

Agricultural Burn Permit Application  PDF E-Pay 
Backyard Burn Permit Application PDF E-Pay

Emissions Inventory (EI) Forms for Reporting 2017 Emissions Data

These forms gather usage data that is used by the District to calculate emissions data for reporting to the California Air Resources Board. This annual reporting is a condition of your Permit to Operate.  While most facilities are required to submit this reporting each year, some smaller facilities may only need to submit forms every third year.  Please contact the office if you are unsure if you are required to submit this reporting, and have not received a request for emissions inventory.

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, 2018. 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 Brian Aunger at (805) 781-4666.

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  
(40) Methyl Bromide Fumigation 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

Form Name  
Document Subscription/ Copy Request Form PDF  
Compliance Customer Satisfaction Survey PDF  
Complaint Form PDF  
Request for Taxpayer Identification (W-9) PDF  
Petition for Variance by the APCD Hearing Board PDF  


Contact us for more information on this topic.