The following forms are used to prepare Title V permit applications, and subsequently, to submit other required information, certify compliance, and pay fees. The forms are provided in two formats: Adobe Acrobat (PDF) and Microsoft Word (DOC). The Air Program respectfully requests that all Title V permitting and compliance forms be submitted electronically via email.
- Attach all Microsoft Word and PDF forms as a PDF file.
- Attach all Microsoft Excel forms as a live electronic Excel file.
- Signed Certifications of Truth, Accuracy, and Completeness (CTAC) may also be scanned and emailed as an attachment
Email all forms to: airquality@southernute-nsn.gov
| PERMIT APPLICATION FORMS | |
| General Information and Summary (GIS) | |
| Emission Unit Description for Internal Combustion Sources (EUD-1) | |
| Emission Unit Description for External Combustion Sources (EUD-2) | |
| Emission Unit Description for Dehydration Units (EUD-3) | |
| Emission Unit Description for Process Sources (EUD-4) | |
| Emission Unit Description for VOC Emitting Sources (EUD-5) | |
| Insignificant Emissions (IE) | |
| Emission Calculations (EMISS) | |
| Potential to Emit Summary (PTE) | |
| Initial Compliance Plan & Compliance Certification (I-COMP) | |
| Certification of Truth, Accuracy, and Completeness (CTAC) | |
| COMPLIANCE FORMS | |
| Certification of Truth, Accuracy, and Completeness (CTAC) | |
| Annual Fee Calculation Worksheet (FEE) | Contact airquality@southernute-nsn.gov for this form. |
| Annual Compliance Certification (ACOMP) | Contact airquality@southernute-nsn.gov for this form. |
| Six Month Monitoring Report (SICMON) | Contact airquality@southernute-nsn.gov for this form. |