In response to the COVID-19 pandemic, the District is now accepting permit applications by e-mail. Completed and signed permit application forms can be scanned and e-mailed to [email protected]. If files are too large to submit via email, please contact us and District staff will arrange for an alternative solution.
In general, permit applications must contain form APCD-01 plus the appropriate equipment-specific form. Refer to the checklist at the end of each application form to see what supplemental information must be submitted with your permit application.
For more information about permitting specific types of requirements, see Engineering Programs or call (805) 979-8050 or email [email protected].
Advisories
- 10/28/2024: Form-25T for gasoline station HRAs was updated.
- 09/05/2024: Form-25 for gasoline station applications was updated.
- 07/22/2024: Form-15S for Health Risk Assessment Screenings was updated: apcd-15S.pdf.
- 07/09/2024: Form-15, the Health Risk Assessment application form, was updated to Form-15R: apcd-15R.pdf.
- 07/01/2024: See updated District Fees.
- 07/10/2023: The Cannabis Processing, Manufacturing, Distribution & Storage application form apcd-104.pdf was updated.
- 12/31/2020: The Air Toxics Certification form apcd-15c.pdf was newly published. This form must be submitted with all HRAs, ATEIPs, ATEIRs, and RRAPs.
- 10/17/2019: The Cannabis Product Manufacturing, Distribution & Storage application form apcd-104.pdf was updated.
- 08/14/2019: New Cannabis Product Manufacturing, Distribution & Storage application form is available: apcd-104.pdf
- 07/26/2019: The Guidance Document For Emission Verification Of Contaminated Soil/Groundwater Cleanup (CSC) Processes was updated: apcd-07.pdf.
- 10/11/2018: The following forms were updated: apcd-77.pdf, apcd-07a, apcd-07b.pdf, apcd-07C.pdf
- 05/29/2018: The Winery permit application form was updated: apcd-50.pdf
| Form No. | Form Name | Adobe PDF |
|---|---|---|
| Title 5 | Title 5 Operating Permit Forms (includes all application and reporting forms) | t5-forms.pdf |
| AG-1 | Agricultural Engine Registration Application Form | ag1.pdf |
| AG-2 | Instructions For Use of Agricultural Engine Registration Form AG-1 | ag2.pdf |
| AG-3 | Ag Engine Change Notification Form | ag3.pdf |
| APCD-01 | Permit Application – General | apcd-01.pdf |
| APCD-01a | Authorized Agent Form | apcd-01a.pdf |
| APCD-01C | Credit Card Form | apcd-01c.pdf |
| APCD-01T | Transfer of Owner/Operator | apcd-01T.pdf |
| APCD-02 | BACT Analysis Summary Form | apcd-02.pdf |
| APCD-02a/b | Rule 331 BACT Replacement Guidelines and Forms | 331bact.pdf |
| APCD-03 | School Summary Form | apcd-03.pdf |
| APCD-05A | Emission Reduction Credits – Creating New ERCs | apcd-05a.pdf |
| APCD-05E | Emission Reduction Credits – Creating New ERCs for Agricultural Facilities | apcd-05e.pdf |
| APCD-05ER | Emission Reduction Credits – Returning Credits | apcd-05er.pdf |
| APCD-05R | Emission Reduction Credits – Renewal | apcd-05r.pdf |
| APCD-05T | Emission Reduction Credits – Transfer | apcd-05t.pdf |
| APCD-05U | Emission Reduction Credits – Authorization of ERC Use | apcd-05u.pdf |
| APCD-05VT | Emission Reduction Credits – VAFB Return | apcd-05vt.pdf |
| APCD-06 | Application Requirements for Contaminated Soil Cleanup | apcd-06.pdf |
| APCD-07 | Guidance Document For Emission Verification Of Contaminated Soil/Groundwater Cleanup (CSC) Processes | apcd-07.pdf |
| APCD-07A | Request For Exemption From Permit Requirement For Contaminated Soil Excavation of 1,000 yd3 or Less | apcd-07a.pdf |
| APCD-07B | Request For Exemption From Permit Requirement For Pilot Tests For Soil Remediation Sites | apcd-07b.pdf |
| APCD-07C | Contaminated Soil Excavation Projects (over 1,000 yd3) | apcd-07c.pdf |
| APCD-08 | Fiberglassing Operation/Resin Usage | apcd-08.pdf |
| APCD-08A | Fiberglassing Facility Applications | apcd-08a.pdf |
| APCD-09 | Exhaust Hood Summary | apcd-09.pdf |
| APCD-10 | IC Engine Timing Certification Form | apcd-10.pdf |
| APCD-13 | Bake Oven Summary | apcd-13.pdf |
| APCD-14 | Rule 360 Compliance Report | apcd-14.pdf |
| APCD-14A | Rule 360 Summary of Requirements | apcd-14A.pdf |
| APCD-15c | Air Toxics Certification | apcd-15c.pdf |
| APCD-15i | Health Risk Assessment Application Instructions | apcd-15i.pdf |
| APCD-15R | Health Risk Assessment Application | apcd-15R.pdf |
| APCD-15S | Health Risk Assessment Screening Application | apcd-15S.pdf |
| APCD-17 | Solvent Recovery Plan Guideline Document and Application Form | apcd-17.pdf |
| APCD-18 | Solvent Usage/Wipe Cleaning | apcd-18.pdf |
| APCD-19 | Sand, Rock and Gravel Facilities | apcd-19.pdf |
| APCD-22 | Surface Coating | apcd-22.pdf |
| APCD-25 | Gas Station Application Form | apcd-25.pdf |
| APCD-25E | Gas Station EVR Supplemental Form | apcd-25e.pdf |
| APCD-25A | Gas Station AST Supplemental Form | apcd-25a.pdf |
| APCD-25P | Gas Station PTO Application Form | apcd-25p.pdf |
| APCD-25b | Bulk Fuel Storage Facility Summary | apcd-25b.pdf |
| APCD-25T | Gas Station HRA Application Form | apcd-25T.pdf |
| APCD-26 | Emergency Episode Plan for Stationary Source Curtailment | apcd-26.pdf |
| APCD-27 | Emergency Episode Plan for Traffic Abatement | apcd-27.pdf |
| APCD-29 | Parameters & Emission Summary | apcd-29.pdf |
| APCD-33 | External Combustion Equipment – Boilers | apcd-33.pdf |
| APCD-34A | Diesel-Fired Primary Agricultural Engine | apcd-34a.pdf |
| APCD-34E | Diesel-Fired Emergency/Standby Engine | apcd-34e.pdf |
| APCD-34P | Diesel-Fired Primary Engine | apcd-34p.pdf |
| APCD-34R | Diesel-Engine ATCM Inventory Form | apcd-34r.pdf |
| APCD-35 | In-Use 20 Hour or Less Diesel-Fired Emergency/Standby Engine | apcd-35.pdf |
| APCD-36 | New Residential Diesel-Fired Emergency/Standby Engine | apcd-36.pdf |
| APCD-37 | Existing Residential Diesel-Fired Emergency/Standby Engine | apcd-37.pdf |
| APCD-38 | Request for Written Determination of Permit Exemption | apcd-38.pdf |
| APCD-38B | Request for Written Determination of Permit Exemption – Breweries | apcd-38b.pdf |
| APCD-38D | Request for Written Determination of Permit Exemption – Distilled Spirits | apcd-38d.pdf |
| APCD-38M | Marine Vessel Exemption Request Form | apcd-38m.pdf |
| APCD-38P | 14 Day PERP Notification – State Territorial Waters and Outer Continental Shelf | apcd-38p.pdf |
| APCD-38W | Request for Written Determination of Permit Exemption – Wineries | apcd-38w.pdf |
| APCD-39 | Vapor Recovery Systems Defect Guide | apcd-39.pdf |
| APCD-43 | Dry Cleaning Equipment | apcd-43.pdf |
| APCD-44 | Degreaser Summary Form | apcd-44.pdf |
| APCD-45 | Odorant & Metering Station | apcd-45.pdf |
| APCD-46 | Concrete Batch Plant Form | apcd-46.pdf |
| APCD-47 | Fabric Filter Form | apcd-47.pdf |
| APCD-50 | Winery Fermentation and Storage/Aging Tanks Form | apcd-50.pdf |
| APCD-60 | Small Boilers and Process Heaters – Installed Prior to January 17, 2008 | apcd-60.pdf |
| APCD-61 | Small Boilers and Process Heaters – Installed After January 16, 2008 | apcd-61.pdf |
| APCD-70 | Spark-Ignited Reciprocating Internal Combustion Engine Form | apcd-70.pdf |
| APCD-77 | Contaminated Soil and/or Groundwater Clean-Up | apcd-77.pdf |
| APCD-95 | Chrome Plating or Chromic Acid Anodizing | apcd-95.pdf |
| APCD-102 | Autobody Shop and Mobile Equipment Coating Operating Supplemental Form | apcd-102.pdf |
| APCD-103 | Monthly Motor Vehicle Refinishing, Coating, Surface Prep and Cleanup Solvent Log | apcd-103.pdf |
| APCD-104 | Cannabis Product Manufacturing, Distribution & Storage Form | apcd-104.pdf |
| APCD 200-00 | Oil and Gas General Form | apcd-200-00.pdf |
| APCD 200-01 | Compressors | apcd-200-01.pdf |
| APCD 200-02 | ES DICE | apcd-200-02.pdf |
| APCD 200-03 | Prime Diesel | apcd-200-03.pdf |
| APCD 200-04 | Spark Ignited Engine | apcd-200-04.pdf |
| APCD 200-05 | External Combustion | apcd-200-05.pdf |
| APCD 200-06 | Fixed Roof Tanks | apcd-200-06.pdf |
| APCD 200-07 | Floating Roof Tanks | apcd-200-07.pdf |
| APCD 200-08 | Waste Water Tanks | apcd-200-08.pdf |
| APCD 200-09 | Wells | apcd-200-09.pdf |
| APCD 200-10 | Sump Pit and Well Cellar | apcd-200-10.pdf |
| APCD 200-11 | Separators | apcd-200-11.pdf |
| APCD 200-12 | Loading Rack | apcd-200-12.pdf |
| APCD 200-13 | Pigging Equipment | apcd-200-13.pdf |
| APCD 200-14 | Flares or Thermal Oxidizer | apcd-200-14.pdf |
| APCD 200-15 | H2S Scrubber | apcd-200-15.pdf |
| APCD 200-16 | Miscellaneous Equipment | apcd-200-16.pdf |
| APCD 200-17 | Pneumatic Controller | apcd-200-17.pdf |
| APCD 200-18 | Fuel Meters | apcd-200-18.pdf |
| APCD 200-19 | Engine Diesel Particulate Filter | apcd-200-19.pdf |
| APCD 200-20 | Fugitives | apcd-200-20.pdf |
| APCD 200-21 | Critical Component Design and Review Checklist | apcd-200-21.pdf |
