Forms and Applications

In this section...

*IMPORTANT NOTICE*

The Air Quality Management Division is hosting a series of workshops to provide further understanding of revisions to the District Board of Health Regulations Governing Air Quality Management, CHAPTER 030 - Source Permitting and Operation. Workshops will be held both in-person and virtually - Register for upcoming workshops or view recordings of previous workshops.

Stationary Source Permit to Construct / Permit to Operate
Applications and Guidance Documents

Be sure to include the appropriate emissions unit and/or control device worksheet(s) linked below. Visit the Source Permitting page for more information. The Permitting Program can be contacted at 775-784-7200 or AQMDPermitting@nnph.org. 

Minor / Synthetic Minor Source
Application for
Permit to 
Construct

 Minor / Synthetic Minor Source
Application for
Permit to 
Operate
(in development)		 Title V
General Permit Application		 Title V
Part 70 Permit Application		 Confidentiality
Request Form
PTE/Emissions Inventory Spreadsheet Emissions
Calculation
Guidance
(in development) 		 Process Flow
Diagram Example		 Facility Location Mapping
Instructions		 Miscellaneous
Fuel Burning Equipment
Inventory

 Stationary Source Emissions Unit and Control Device Worksheets

These forms shall be submitted as supplemental documents to an Application for Permit to Construct / Permit to Operate.

Baghouse
Worksheet		 Cyclone
Worksheet		 Emissions
Control Device
Worksheet		 Flare
Worksheet		 Scrubber
Worksheet
Asphalt Plant Worksheet Boiler
Worksheet 		 Concrete Plant Worksheet
 Cooling Tower Worksheet Drilling / Blasting Worksheet
Gasoline Dispensing Facility (GDF) Worksheet Internal Combustion Engine (ICE) Worksheet PERC
Dry Cleaners Worksheet		 Petroleum
Dry Cleaners
Worksheet		 Petroleum
Storage Tank
Worksheet
Printing
Worksheet		 Surface Coating Worksheet Woodworking Worksheet

 Stationary Source Administrative Applications and Forms

Visit the Source Permitting page for more information. The Permitting Program can be contacted at 775-784-7200 or AQMDPermitting@nnph.org. 

Application
for Change
of Ownership		 Change of Contact Information Declaration of Responsible Official Request to Close Permit to Operate Confidentiality
Request Form
Facility Start of Construction Notification Facility Startup Notification 12-Month Rolling Sums Calculation Guidance Change
With Notice
Application
(in development)		 MACT 6H
Compliance
Notification
AQMD Refund
Request Form

Non-Metallic Mineral Processing (Portable and Stationary) 
Application and Forms 

Visit the Source Permitting page for more information. The Permitting Program can be contacted at 775-784-7200 or AQMDPermitting@nnph.org. 

Application
for Mineral
Processing		 PTE/Emissions Inventory
Spreadsheet		 Example Mineral Processing Flow Diagram Mapping
Instructions		 Move Notification
for Portable Equipment

 Asbestos Program Applications and Forms

Visit the Asbestos Program page for more information. The Asbestos Program can be contacted at 775-784-7200 or AQMDAsbestos@nnph.org. 

Application for Acknowledgement
of Asbestos
Assessment (AAA)		 Asbestos NESHAP Notification of Renovation Notification of Demolition Notification Revision Summary Form
AHERA Certified Building Inspectors Local Licensed Asbestos Removal Contractors

Dust Control Program Applications and Forms

Visit the Dust Control Program page for more information. The Dust Control Program can be contacted at 775-784-7200 or AQMDDust@nnph.org. 

Dust Control Permit Application Dust Control Permit Modification Completion
of Project		 Dust Log
Template
Dust Control Permit Sign Requirements

Wood-Burning Device Program Applications and Forms

Visit the Wood-Burning Device Program page for more information. The Wood-Burning Device Program can be contacted at 775-784-7200 or AQMD-WBD@nnph.org. 

Certificate of
Compliance
Transfer		 Verification of Wood Burning Device Removal Wood Burning Device Inspection Form Wood Burning Device Exemption Form
List of Certified Wood Burning Device Inspectors Sole Source of Heat Declaration Dealer's Affidavit of Sales Form

Prescribed Burn Program

Visit the Smoke Management Program page for more information. The Smoke Management Program can be contacted at 775-784-7200 or KeepItClean@nnph.org. 

Prescribed Burn Application 24-Hour Notification of Prescribed Burn

Air Pollution Control Hearing Board

Visit the Air Pollution Control Hearing Board page for more information.

Request a Petition
to the Air 
Pollution Control
Hearing Board		 Request a Variance
to the Air
Pollution Control Hearing Board		 APCHB Member Application

Last modified on 12/19/2024