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Permits

View and download application, renewal, and related forms for Air District Permit, Title V and Synthetic Minor programs.

Permit Application Forms

Form Name	Division	Document	table-mobile-only-column
Abatement Device	ENG	A (91 k PDF, 0 pgs)	Abatement Device Division: ENG Document: A (91 k PDF, 0 pgs)
Abatement Device - Word Format	ENG	A - Word Format (147 k DOC)	Abatement Device - Word Format Division: ENG Document: A - Word Format (147 k DOC)
Environmental Information	ENG	Appendix H (10 k PDF, 3 pgs)	Environmental Information Division: ENG Document: Appendix H (10 k PDF, 3 pgs)
Environmental Information - Word Format	ENG	Appendix H - Word Format (27 k DOC)	Environmental Information - Word Format Division: ENG Document: Appendix H - Word Format (27 k DOC)
Boiler Registration	ENG	Boiler Registration (108 k PDF, 2 pgs)	Boiler Registration Division: ENG Document: Boiler Registration (108 k PDF, 2 pgs)
Combustion Operations	ENG	C (108 k PDF, 2 pgs)	Combustion Operations Division: ENG Document: C (108 k PDF, 2 pgs)
Combustion Operations - Word Format	ENG	C - Word Format (145 k DOC)	Combustion Operations - Word Format Division: ENG Document: C - Word Format (145 k DOC)
Credit Card Payment Form	ENG	CC ADM Credit Card (215 k PDF, 1 pg)	Credit Card Payment Form Division: ENG Document: CC ADM Credit Card (215 k PDF, 1 pg)
Coater Data Worksheet	ENG	CD (14 k PDF, 2 pgs)	Coater Data Worksheet Division: ENG Document: CD (14 k PDF, 2 pgs)
Coater Data Worksheet - Word Format	ENG	CD - Word Format (73 k DOC)	Coater Data Worksheet - Word Format Division: ENG Document: CD - Word Format (73 k DOC)
Dry Cleaner - Use the New Permit Technology System	ENG	D (83 k PDF, 1 pg)	Dry Cleaner - Use the New Permit Technology System Division: ENG Document: D (83 k PDF, 1 pg)
Dry Cleaning Risk Screening Form - Use the New Permit Technology System	ENG	D -a (83 k PDF, 1 pg)	Dry Cleaning Risk Screening Form - Use the New Permit Technology System Division: ENG Document: D -a (83 k PDF, 1 pg)
Dry Cleaner Ventilation Guidelines	ENG	D Guidlines (93 k PDF, 7 pgs)	Dry Cleaner Ventilation Guidelines Division: ENG Document: D Guidlines (93 k PDF, 7 pgs)
Semiconductor Fabrication Area	ENG	F (31 k PDF, 4 pgs)	Semiconductor Fabrication Area Division: ENG Document: F (31 k PDF, 4 pgs)
Semiconductor Fabrication Area - Word Format	ENG	F - Word Format (99 k DOC)	Semiconductor Fabrication Area - Word Format Division: ENG Document: F - Word Format (99 k DOC)
Semiconductor Fabrication Worksheet	ENG	F Worksheet (101 k PDF, 6 pgs)	Semiconductor Fabrication Worksheet Division: ENG Document: F Worksheet (101 k PDF, 6 pgs)
Semiconductor Fabrication Worksheet - Word Format	ENG	F Worksheet - Word Format (326 k DOC)	Semiconductor Fabrication Worksheet - Word Format Division: ENG Document: F Worksheet - Word Format (326 k DOC)
G and Process Codes	ENG	G and Process Codes (45 k PDF, 7 pgs)	G and Process Codes Division: ENG Document: G and Process Codes (45 k PDF, 7 pgs)
G and Process Codes - Word Format	ENG	G and Process Codes - Word Format (193 k DOC)	G and Process Codes - Word Format Division: ENG Document: G and Process Codes - Word Format (193 k DOC)
Vehicle Fueling Station Located at a Permitted Plant (Not for a stand-alone gas dispensing facilities (GDFs))	ENG	G-101B (98 k PDF, 5 pgs)	Vehicle Fueling Station Located at a Permitted Plant (Not for a stand-alone gas dispensing facilities (GDFs)) Division: ENG Document: G-101B (98 k PDF, 5 pgs)
Vehicle Fueling Station Located at a Permitted Plant (Not for a stand-alone gas dispensing facilities (GDFs)) - Word Format	ENG	G-101B - Word Format (128 k DOC)	Vehicle Fueling Station Located at a Permitted Plant (Not for a stand-alone gas dispensing facilities (GDFs)) - Word Format Division: ENG Document: G-101B - Word Format (128 k DOC)
EPA Notification for Paint Stripping and Miscellaneous Coating	ENG	HHHHHH (28 k PDF, 5 pgs)	EPA Notification for Paint Stripping and Miscellaneous Coating Division: ENG Document: HHHHHH (28 k PDF, 5 pgs)
Instructions and Summary for EPA Initial Notification for Paint Stripping and Miscellaneous Coating Operations for HHHHHH	ENG	HHHHHH Instructions (69 k PDF, 2 pgs)	Instructions and Summary for EPA Initial Notification for Paint Stripping and Miscellaneous Coating Operations for HHHHHH Division: ENG Document: HHHHHH Instructions (69 k PDF, 2 pgs)
Health Risk Screening Analysis	ENG	HRSA (266 k PDF, 4 pgs)	Health Risk Screening Analysis Division: ENG Document: HRSA (266 k PDF, 4 pgs)
Health Risk Screening Analysis - Word Format	ENG	HRSA - Word Format (669 k DOC)	Health Risk Screening Analysis - Word Format Division: ENG Document: HRSA - Word Format (669 k DOC)
Internal Combustion Engines	ENG	ICE (42 k PDF, 2 pgs)	Internal Combustion Engines Division: ENG Document: ICE (42 k PDF, 2 pgs)
Internal Combustion Engines - Word Format	ENG	ICE - Word Format (198 k DOC)	Internal Combustion Engines - Word Format Division: ENG Document: ICE - Word Format (198 k DOC)
Material Code Reference List Alphabetical	ENG	Material Codes (57 k PDF, 21 pgs)	Material Code Reference List Alphabetical Division: ENG Document: Material Codes (57 k PDF, 21 pgs)
Emission Point (stacks, vents)	ENG	P (10 k PDF, 1 pg)	Emission Point (stacks, vents) Division: ENG Document: P (10 k PDF, 1 pg)
Emission Point (stacks, vents) - Word Format	ENG	P - Word Format (22 k DOC)	Emission Point (stacks, vents) - Word Format Division: ENG Document: P - Word Format (22 k DOC)
Application for Authority to Construct/Permit to Operate	ENG	P-101B (196 k PDF, 2 pgs)	Application for Authority to Construct/Permit to Operate Division: ENG Document: P-101B (196 k PDF, 2 pgs)
Application for Authority to Construct/Permit to Operate - Word Format	ENG	P-101B - Word Format (241 k DOC)	Application for Authority to Construct/Permit to Operate - Word Format Division: ENG Document: P-101B - Word Format (241 k DOC)
Instructions for Application for Authority to Construct/Permit to Operate	ENG	P-101B Instructions (9 k PDF, 1 pg)	Instructions for Application for Authority to Construct/Permit to Operate Division: ENG Document: P-101B Instructions (9 k PDF, 1 pg)
Application for Emission Reduction Credits (Banking)	ENG	P-401 (16 k PDF, 2 pgs)	Application for Emission Reduction Credits (Banking) Division: ENG Document: P-401 (16 k PDF, 2 pgs)
Application for Emission Reduction Credits (Banking) - Word Format	ENG	P-401 - Word Format (84 k DOC)	Application for Emission Reduction Credits (Banking) - Word Format Division: ENG Document: P-401 - Word Format (84 k DOC)
Emission Reduction Credits Transfer of Ownership	ENG	P-402 (44 k PDF, 1 pg)	Emission Reduction Credits Transfer of Ownership Division: ENG Document: P-402 (44 k PDF, 1 pg)
Emission Reduction Credits Transfer of Ownership - Word Format	ENG	P-402 - Word Format (110 k DOC)	Emission Reduction Credits Transfer of Ownership - Word Format Division: ENG Document: P-402 - Word Format (110 k DOC)
Printed Circuit Board Data Worksheet	ENG	PC (7 k PDF, 1 pg)	Printed Circuit Board Data Worksheet Division: ENG Document: PC (7 k PDF, 1 pg)
Printed Circuit Board Data Worksheet - Word Format	ENG	PC - Word Format (21 k DOC)	Printed Circuit Board Data Worksheet - Word Format Division: ENG Document: PC - Word Format (21 k DOC)
Surface Coating / Solvent Source Operations	ENG	S (33 k PDF, 2 pgs)	Surface Coating / Solvent Source Operations Division: ENG Document: S (33 k PDF, 2 pgs)
Surface Coating / Solvent Source Operations - Word Format	ENG	S - Word Format (57 k DOC)	Surface Coating / Solvent Source Operations - Word Format Division: ENG Document: S - Word Format (57 k DOC)
Solvent Cleaning Operations	ENG	SC (48 k PDF, 2 pgs)	Solvent Cleaning Operations Division: ENG Document: SC (48 k PDF, 2 pgs)
Solvent Cleaning Operations - Word Format	ENG	SC - Word Format (86 k DOC)	Solvent Cleaning Operations - Word Format Division: ENG Document: SC - Word Format (86 k DOC)
Printer Material Usage Information	ENG	SS (10 k PDF, 1 pg)	Printer Material Usage Information Division: ENG Document: SS (10 k PDF, 1 pg)
Printer Material Usage Information - Word Format	ENG	SS - Word Format (28 k DOC)	Printer Material Usage Information - Word Format Division: ENG Document: SS - Word Format (28 k DOC)
Stand-Alone Gasoline Dispensing Station	ENG	Stand-Alone Gasoline Dispensing Facilities (GDFs) (85 k PDF, 1 pg)	Stand-Alone Gasoline Dispensing Station Division: ENG Document: Stand-Alone Gasoline Dispensing Facilities (GDFs) (85 k PDF, 1 pg)
Organic Liquid Loading/Storage	ENG	T (26 k PDF, 1 pg)	Organic Liquid Loading/Storage Division: ENG Document: T (26 k PDF, 1 pg)
Organic Liquid Loading/Storage - Word Format	ENG	T - Word Format (39 k DOC)	Organic Liquid Loading/Storage - Word Format Division: ENG Document: T - Word Format (39 k DOC)

Permit Renewal Forms

Form Name	Division	Document	table-mobile-only-column
Device Data Update	ENG	DDU (80 k PDF, 2 pgs)	Device Data Update Division: ENG Document: DDU (80 k PDF, 2 pgs)
Device Data Update - Word Format	ENG	DDU - Word Format (119 k DOC)	Device Data Update - Word Format Division: ENG Document: DDU - Word Format (119 k DOC)
Data Update Instructions	ENG	DU (223 k PDF, 14 pgs)	Data Update Instructions Division: ENG Document: DU (223 k PDF, 14 pgs)
Facility Information Update	ENG	FIU (190 k PDF, 2 pgs)	Facility Information Update Division: ENG Document: FIU (190 k PDF, 2 pgs)
Facility Information Update - Word Format	ENG	FIU - Word Format (134 k DOC)	Facility Information Update - Word Format Division: ENG Document: FIU - Word Format (134 k DOC)
Additional Information	ENG	X (16 k PDF, 2 pgs)	Additional Information Division: ENG Document: X (16 k PDF, 2 pgs)
Additional Information - Word Format	ENG	X - Word Format (40 k DOC)	Additional Information - Word Format Division: ENG Document: X - Word Format (40 k DOC)

Title V and Synthetic Minor Forms

Form Name	Division	Document	table-mobile-only-column
Detailed Emission Report	ENG	Detailed Emission Report (10 k PDF, 1 pg)	Detailed Emission Report Division: ENG Document: Detailed Emission Report (10 k PDF, 1 pg)
Detailed Emission Report - Word Format	ENG	Detailed Emission Report - Word Format (96 k DOC)	Detailed Emission Report - Word Format Division: ENG Document: Detailed Emission Report - Word Format (96 k DOC)
Exempt Source List	ENG	Exempt Source List (12 k PDF, 2 pgs)	Exempt Source List Division: ENG Document: Exempt Source List (12 k PDF, 2 pgs)
Exempt Source List - Word Format	ENG	Exempt Source List - Word Format (86 k DOC)	Exempt Source List - Word Format Division: ENG Document: Exempt Source List - Word Format (86 k DOC)
Abatement Devices	ENG	Abatement Devices (9 k PDF, 1 pg)	Abatement Devices Division: ENG Document: Abatement Devices (9 k PDF, 1 pg)
Abatement Devices - Word Format	ENG	Abatement Devices - Word Format (89 k DOC)	Abatement Devices - Word Format Division: ENG Document: Abatement Devices - Word Format (89 k DOC)
Instructions for Application Package for Major Facility Review	ENG	Instructions for Application Package for Major Facility Review (15 k PDF, 6 pgs)	Instructions for Application Package for Major Facility Review Division: ENG Document: Instructions for Application Package for Major Facility Review (15 k PDF, 6 pgs)
Instructions for Application Package for Major Facility Review - Word Format	ENG	Instructions for Application Package for Major Facility Review - Word Format (54 k DOC)	Instructions for Application Package for Major Facility Review - Word Format Division: ENG Document: Instructions for Application Package for Major Facility Review - Word Format (54 k DOC)
Applicable Requirements and Compliance Summary	ENG	Applicable Requirements and Compliance Summary (81 k PDF, 1 pg)	Applicable Requirements and Compliance Summary Division: ENG Document: Applicable Requirements and Compliance Summary (81 k PDF, 1 pg)
Applicable Requirements and Compliance Summary - Word Format	ENG	Applicable Requirements and Compliance Summary - Word Format (111 k DOC)	Applicable Requirements and Compliance Summary - Word Format Division: ENG Document: Applicable Requirements and Compliance Summary - Word Format (111 k DOC)
Certification Statement	ENG	Certification Statement (8 k PDF, 1 pg)	Certification Statement Division: ENG Document: Certification Statement (8 k PDF, 1 pg)
Certification Statement - Word Format	ENG	Certification Statement - Word Format (46 k DOC)	Certification Statement - Word Format Division: ENG Document: Certification Statement - Word Format (46 k DOC)
Compliance Certification Schedule	ENG	Compliance Certification Schedule (8 k PDF, 1 pg)	Compliance Certification Schedule Division: ENG Document: Compliance Certification Schedule (8 k PDF, 1 pg)
Compliance Certification Schedule - Word Format	ENG	Compliance Certification Schedule - Word Format (79 k DOC)	Compliance Certification Schedule - Word Format Division: ENG Document: Compliance Certification Schedule - Word Format (79 k DOC)
Operating Scenarios	ENG	Operating Scenarios (7 k PDF, 1 pg)	Operating Scenarios Division: ENG Document: Operating Scenarios (7 k PDF, 1 pg)
Operating Scenarios - Word Format	ENG	Operating Scenarios - Word Format (54 k DOC)	Operating Scenarios - Word Format Division: ENG Document: Operating Scenarios - Word Format (54 k DOC)
Permit Shield (Type A)	ENG	Permit Shield (Type A) (7 k PDF, 1 pg)	Permit Shield (Type A) Division: ENG Document: Permit Shield (Type A) (7 k PDF, 1 pg)
Permit Shield (Type A) - Word Format	ENG	Permit Shield (Type A) - Word Format (94 k DOC)	Permit Shield (Type A) - Word Format Division: ENG Document: Permit Shield (Type A) - Word Format (94 k DOC)
Sources Not In Compliance	ENG	Sources Not In Compliance (9 k PDF, 1 pg)	Sources Not In Compliance Division: ENG Document: Sources Not In Compliance (9 k PDF, 1 pg)
Sources Not In Compliance - Word Format	ENG	Mfr_sources_not_in_compliance - Word Format (96 k DOC)	Sources Not In Compliance - Word Format Division: ENG Document: Mfr_sources_not_in_compliance - Word Format (96 k DOC)
Application for Synthetic Minor Operating Permit (SMOP)	ENG	Application for Synthetic Minor Operating Permit (SMOP) (161 k PDF, 2 pgs)	Application for Synthetic Minor Operating Permit (SMOP) Division: ENG Document: Application for Synthetic Minor Operating Permit (SMOP) (161 k PDF, 2 pgs)
Application for Synthetic Minor Operating Permit (SMOP) - Word Format	ENG	Application for Synthetic Minor Operating Permit (SMOP) - Word Format (96 k DOC)	Application for Synthetic Minor Operating Permit (SMOP) - Word Format Division: ENG Document: Application for Synthetic Minor Operating Permit (SMOP) - Word Format (96 k DOC)
Total Proposed Emissions for Facility (SMOP)	ENG	Total Proposed Emissions for Facility (SMOP) (8 k PDF, 2 pgs)	Total Proposed Emissions for Facility (SMOP) Division: ENG Document: Total Proposed Emissions for Facility (SMOP) (8 k PDF, 2 pgs)
Total Proposed Emissions for Facility (SMOP) - Word Format	ENG	Total Proposed Emissions for Facility (SMOP) - Word Format (82 k DOC)	Total Proposed Emissions for Facility (SMOP) - Word Format Division: ENG Document: Total Proposed Emissions for Facility (SMOP) - Word Format (82 k DOC)
Permitted Sources and Maximum Emissions (SMOP)	ENG	Permitted Sources and Maximum Emissions (SMOP) (144 k PDF, 1 pg)	Permitted Sources and Maximum Emissions (SMOP) Division: ENG Document: Permitted Sources and Maximum Emissions (SMOP) (144 k PDF, 1 pg)
Permitted Sources and Maximum Emissions (SMOP) - Word Format	ENG	Permitted Sources and Maximum Emissions (SMOP) - Word Format (97 k DOC)	Permitted Sources and Maximum Emissions (SMOP) - Word Format Division: ENG Document: Permitted Sources and Maximum Emissions (SMOP) - Word Format (97 k DOC)
List of Exempt Sources or Activities (SMOP)	ENG	List of Exempt Sources or Activities (SMOP) (127 k PDF, 1 pg)	List of Exempt Sources or Activities (SMOP) Division: ENG Document: List of Exempt Sources or Activities (SMOP) (127 k PDF, 1 pg)
List of Exempt Sources or Activities (SMOP) - Word Format	ENG	List of Exempt Sources or Activities (SMOP) - Word Format (97 k DOC)	List of Exempt Sources or Activities (SMOP) - Word Format Division: ENG Document: List of Exempt Sources or Activities (SMOP) - Word Format (97 k DOC)
Stationary Source Summary - page 1	ENG	Stationary Source Summary - page 1 (11 k PDF, 1 pg)	Stationary Source Summary - page 1 Division: ENG Document: Stationary Source Summary - page 1 (11 k PDF, 1 pg)
Stationary Source Summary - page 1 - Word Format	ENG	Stationary Source Summary - page 1 - Word Format (60 k DOC)	Stationary Source Summary - page 1 - Word Format Division: ENG Document: Stationary Source Summary - page 1 - Word Format (60 k DOC)
Stationary Source Summary - page 2	ENG	Stationary Source Summary - page 2 (20 k PDF, 1 pg)	Stationary Source Summary - page 2 Division: ENG Document: Stationary Source Summary - page 2 (20 k PDF, 1 pg)
Stationary Source Summary - page 2 - Word Format	ENG	Stationary Source Summary - page 2 - Word Format (61 k DOC)	Stationary Source Summary - page 2 - Word Format Division: ENG Document: Stationary Source Summary - page 2 - Word Format (61 k DOC)
Total Stationary Source Emissions	ENG	Total Stationary Source Emissions (9 k PDF, 1 pg)	Total Stationary Source Emissions Division: ENG Document: Total Stationary Source Emissions (9 k PDF, 1 pg)
Total Stationary Source Emissions - Word Format	ENG	Total Stationary Source Emissions - Word Format (90 k DOC)	Total Stationary Source Emissions - Word Format Division: ENG Document: Total Stationary Source Emissions - Word Format (90 k DOC)

Stand-alone Gasoline Dispensing Facilities - Permit Application Forms

Form Name	Division	Document	table-mobile-only-column
Facility Creation and Contacts Form	ENG	Must be submitted for all new facilities (300 k PDF, 5 pgs)	Facility Creation and Contacts Form Division: ENG Document: Must be submitted for all new facilities (300 k PDF, 5 pgs)
Application Cover Form	ENG	Must be submitted for all permit applications (335 k PDF, 5 pgs)	Application Cover Form Division: ENG Document: Must be submitted for all permit applications (335 k PDF, 5 pgs)
GDF Form and Equipment Worksheet	ENG	For all permit applications except permit condition change requests (712 k PDF, 12 pgs)	GDF Form and Equipment Worksheet Division: ENG Document: For all permit applications except permit condition change requests (712 k PDF, 12 pgs)
Permit Condition Change Request Form	ENG	To request changes to existing permit conditions (228 k PDF, 2 pgs)	Permit Condition Change Request Form Division: ENG Document: To request changes to existing permit conditions (228 k PDF, 2 pgs)
Health Risk Screening Analysis (HRSA) Form	ENG	For new GDFs or requests to increase annual throughput (1 Mb PDF, 6 pgs)	Health Risk Screening Analysis (HRSA) Form Division: ENG Document: For new GDFs or requests to increase annual throughput (1 Mb PDF, 6 pgs)
Emission Point Form	ENG	To be submitted if an HRSA form is required (298 k PDF, 4 pgs)	Emission Point Form Division: ENG Document: To be submitted if an HRSA form is required (298 k PDF, 4 pgs)
Fleet ORVR Exemption Form	ENG	To be submitted if you are claiming this exemption (316 k PDF, 4 pgs)	Fleet ORVR Exemption Form Division: ENG Document: To be submitted if you are claiming this exemption (316 k PDF, 4 pgs)
Startup Notification Form	ENG	Must be submitted when you begin operation (241 k PDF, 2 pgs)	Startup Notification Form Division: ENG Document: Must be submitted when you begin operation (241 k PDF, 2 pgs)
How to Declare Confidential/Trade Secret Information	ENG	Guidance for declaring confidential/trade secret information (77 k PDF, 1 pg)	How to Declare Confidential/Trade Secret Information Division: ENG Document: Guidance for declaring confidential/trade secret information (77 k PDF, 1 pg)

Auto Bodies and Dry Cleaners - Permit Application Forms

Form Name	Division	Document	table-mobile-only-column
Auto Body Form	ENG	Only One Form Per Facility (785 k PDF, 3 pgs)	Auto Body Form Division: ENG Document: Only One Form Per Facility (785 k PDF, 3 pgs)
Facility Creation and Contacts Form	ENG	Must be submitted for all new facilities (300 k PDF, 5 pgs)	Facility Creation and Contacts Form Division: ENG Document: Must be submitted for all new facilities (300 k PDF, 5 pgs)
Application Cover Form	ENG	Must be submitted for all permit applications (335 k PDF, 5 pgs)	Application Cover Form Division: ENG Document: Must be submitted for all permit applications (335 k PDF, 5 pgs)
Dry Cleaner Form	ENG	Must be submitted for each dry cleaning machine (321 k PDF, 2 pgs)	Dry Cleaner Form Division: ENG Document: Must be submitted for each dry cleaning machine (321 k PDF, 2 pgs)
Permit Condition Change Request Form	ENG	To request changes to existing permit conditions (228 k PDF, 2 pgs)	Permit Condition Change Request Form Division: ENG Document: To request changes to existing permit conditions (228 k PDF, 2 pgs)
How to Declare Confidential/Trade Secret Information	ENG	Guidance for declaring confidential/trade secret information (77 k PDF, 1 pg)	How to Declare Confidential/Trade Secret Information Division: ENG Document: Guidance for declaring confidential/trade secret information (77 k PDF, 1 pg)

Stand-alone Auto Body, Gasoline Dispensing and Dry Cleaner Facilities - Information Update and Maintenance Forms

Form Name	Division	Document	table-mobile-only-column
Device and Facility Shutdown Form	ENG	To surrender permits (252 k PDF, 2 pgs)	Device and Facility Shutdown Form Division: ENG Document: To surrender permits (252 k PDF, 2 pgs)
Facility Contacts Form	ENG	To update current facility contacts (249 k PDF, 3 pgs)	Facility Contacts Form Division: ENG Document: To update current facility contacts (249 k PDF, 3 pgs)
Facility Name and NAICS Code Change Form	ENG	To update facility name or NAICS code. Do not use this form for changes of owning entity (ownership) (236 k PDF, 2 pgs)	Facility Name and NAICS Code Change Form Division: ENG Document: To update facility name or NAICS code. Do not use this form for changes of owning entity (ownership) (236 k PDF, 2 pgs)
Transfer of Ownership Form	ENG	To transfer permits from one owner (owning entity) to another (490 k PDF, 2 pgs)	Transfer of Ownership Form Division: ENG Document: To transfer permits from one owner (owning entity) to another (490 k PDF, 2 pgs)

Form Name	Division	Document	table-mobile-only-column
Facility Creation and Contacts Form - Gasoline Dispensing Stations	ENG	Must be submitted for all new facilities. (186 k PDF, 3 pgs)	Facility Creation and Contacts Form - Gasoline Dispensing Stations Division: ENG Document: Must be submitted for all new facilities. (186 k PDF, 3 pgs)
Instructions - Facility Creation and Contacts Form	ENG	Instructions - Facility Creation and Contacts (new facilities only) (133 k PDF, 2 pgs)	Instructions - Facility Creation and Contacts Form Division: ENG Document: Instructions - Facility Creation and Contacts (new facilities only) (133 k PDF, 2 pgs)
Application Cover Form - Gasoline Dispensing Station	ENG	Must be submitted for all permit applications (201 k PDF, 3 pgs)	Application Cover Form - Gasoline Dispensing Station Division: ENG Document: Must be submitted for all permit applications (201 k PDF, 3 pgs)
Instructions Permit Application Cover & CEQA Worksheet	ENG	Instructions - Applicaton Cover and CEQA Worksheet (137 k PDF, 2 pgs)	Instructions Permit Application Cover & CEQA Worksheet Division: ENG Document: Instructions - Applicaton Cover and CEQA Worksheet (137 k PDF, 2 pgs)
GDF Form and Equipment Worksheet - Gasoline Dispensing Station	ENG	Must be submitted for all permit applications. (221 k PDF, 3 pgs)	GDF Form and Equipment Worksheet - Gasoline Dispensing Station Division: ENG Document: Must be submitted for all permit applications. (221 k PDF, 3 pgs)
Instructions Gas Dispensing Facility & GDF Equipment Worksheet	ENG	Instructions - GDF Equipment Worksheet (103 k PDF, 1 pg)	Instructions Gas Dispensing Facility & GDF Equipment Worksheet Division: ENG Document: Instructions - GDF Equipment Worksheet (103 k PDF, 1 pg)
Permit Condition Change Request Form - Gasoline Dispensing Station	ENG	To request changes to existing permit conditions (139 k PDF, 1 pg)	Permit Condition Change Request Form - Gasoline Dispensing Station Division: ENG Document: To request changes to existing permit conditions (139 k PDF, 1 pg)
Instructions Permit Condition Change Request Form	ENG	Instructions - Permit Condition Change Request (100 k PDF, 1 pg)	Instructions Permit Condition Change Request Form Division: ENG Document: Instructions - Permit Condition Change Request (100 k PDF, 1 pg)
HRSA Form - Gasoline Dispensing Station	ENG	For new GDFs or requests to increase annual throughput (169 k PDF, 1 pg)	HRSA Form - Gasoline Dispensing Station Division: ENG Document: For new GDFs or requests to increase annual throughput (169 k PDF, 1 pg)
Instructions Health Risk Screening Analysis (HRSA) Form	ENG	Instructions - HRSA (1 Mb PDF, 5 pgs)	Instructions Health Risk Screening Analysis (HRSA) Form Division: ENG Document: Instructions - HRSA (1 Mb PDF, 5 pgs)
Emission Point Form - Gasoline Dispensing Station	ENG	To be submitted if an HRSA form is required (198 k PDF, 2 pgs)	Emission Point Form - Gasoline Dispensing Station Division: ENG Document: To be submitted if an HRSA form is required (198 k PDF, 2 pgs)
Instructions Emission Point Form	N/A	Instructions - Emission Point (111 k PDF, 2 pgs)	Instructions Emission Point Form Division: N/A Document: Instructions - Emission Point (111 k PDF, 2 pgs)
Fleet ORVR Exemption Form - Gasoline Dispensing Station	ENG	To be submitted if you are claiming this exemption (217 k PDF, 2 pgs)	Fleet ORVR Exemption Form - Gasoline Dispensing Station Division: ENG Document: To be submitted if you are claiming this exemption (217 k PDF, 2 pgs)
Instructions Fleet Onboard Refueling Vapor Recovery (ORVR) Exemption Form	N/A	Instructions - Fleet ORVR Exemption (106 k PDF, 1 pg)	Instructions Fleet Onboard Refueling Vapor Recovery (ORVR) Exemption Form Division: N/A Document: Instructions - Fleet ORVR Exemption (106 k PDF, 1 pg)
Startup Notification Form - Gasoline Dispensing Station	ENG	Must be submitted when you begin operation (152 k PDF, 1 pg)	Startup Notification Form - Gasoline Dispensing Station Division: ENG Document: Must be submitted when you begin operation (152 k PDF, 1 pg)
Instructions Startup Notification Form	ENG	Instructions - Start Up Notification (104 k PDF, 1 pg)	Instructions Startup Notification Form Division: ENG Document: Instructions - Start Up Notification (104 k PDF, 1 pg)
How to Declare Confidential/Trade Secret Information	ENG	Guidance for declaring confidential/trade secret information (77 k PDF, 1 pg)	How to Declare Confidential/Trade Secret Information Division: ENG Document: Guidance for declaring confidential/trade secret information (77 k PDF, 1 pg)

Form Name	Division	Document	table-mobile-only-column
Device and Facility Shutdown Form - Gasoline Dispensing Station	ENG	To surrender permits (186 k PDF, 1 pg)	Device and Facility Shutdown Form - Gasoline Dispensing Station Division: ENG Document: To surrender permits (186 k PDF, 1 pg)
Instructions Device & Facility Shutdown Form	ENG	Instructions Device and Facility Shutdown (102 k PDF, 1 pg)	Instructions Device & Facility Shutdown Form Division: ENG Document: Instructions Device and Facility Shutdown (102 k PDF, 1 pg)
Facility Contacts Form - Gasoline Dispensing Stations	ENG	To update current facility contacts (151 k PDF, 2 pgs)	Facility Contacts Form - Gasoline Dispensing Stations Division: ENG Document: To update current facility contacts (151 k PDF, 2 pgs)
Instructions Facility Contacts Form	ENG	Instructions - Contacts (105 k PDF, 1 pg)	Instructions Facility Contacts Form Division: ENG Document: Instructions - Contacts (105 k PDF, 1 pg)
Facility Name and NAICS Code Change Form - Gasoline Dispensing Station	ENG	To update facility name or NAICS code. Do not use this form for changes of owning entity (ownership) (142 k PDF, 1 pg)	Facility Name and NAICS Code Change Form - Gasoline Dispensing Station Division: ENG Document: To update facility name or NAICS code. Do not use this form for changes of owning entity (ownership) (142 k PDF, 1 pg)
Instructions Facility Name & North American Industry Classification System (NAICS) Code Change Form	ENG	Instructions - Facility Name and NAICS Change (106 k PDF, 1 pg)	Instructions Facility Name & North American Industry Classification System (NAICS) Code Change Form Division: ENG Document: Instructions - Facility Name and NAICS Change (106 k PDF, 1 pg)
Transfer of Ownership Form - Gasoline Dispensing Station	ENG	To transfer permits from one owner (owning entity) to another (490 k PDF, 1 pg)	Transfer of Ownership Form - Gasoline Dispensing Station Division: ENG Document: To transfer permits from one owner (owning entity) to another (490 k PDF, 1 pg)
Instruction Transfer of Ownership Form	ENG	Instructions - Transfer of Ownership Form (100 k PDF, 1 pg)	Instruction Transfer of Ownership Form Division: ENG Document: Instructions - Transfer of Ownership Form (100 k PDF, 1 pg)

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