Eastern Kern APCD

Applications & Forms

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General Permitting ______________________________

1.   Authority to Construct & Permit to Operate (ATC/PTO)_PER-01

2.   Solar Plant ATC/PTO_PER-02

3.   General Application ATC/PTO Package with instructions and CEQA

4.   Solar ATC/PTO Package with instructions and CEQA

5.   Assignment of Agent_PER-03

6.   Intent To Use Notification_PER-04

7.   Priority Processing Request_PER-05

8.   Gasoline Storage & Dispensing Facility Application_PER-06

9.   Piston Engine Application Package_PER-07

10. Agricultural Diesel Engine Registration Form_PER-08

11. Agricultural Diesel Engine Change Form_PER09

12. Rock Drill Application Package_PER-10

13. Charbroiler Application Package _PER-11

14. Environmental Information & Initial Study Evaluation (CEQA)_PER-12

15. CEQA Indemnity Agreement _PER-13

16. Notice of Exemption CEQA

17. Confidential Classification Source of Data_PER-14

18. List and Criteria _PER-15

19. Agricultural CMP Plan _PER-16

Agricultural CMP List


Burn Permitting ______________________________

20. Application for Permit to Burn Ag Waste on a No Burn Day_BRN-01

21. Application for Film/Video/Photo Production Burn Permit_BRN-02

22. Bonfire Application_BRN-03

Bonfire Guidelines

23. Agricultural Burn Permit Application_BRN-04

Ag Burn Sample Permit


Title V _____________________________________

24. Title V Standard District Application_TVL-01

25. Title V Compliance Monitoring Report and Certification_TLV-02

26. NSR Compliance Certificate_TLV-03

27. Title V Deviation Reporting Form_TLV-04

28. 40 CFR Part 64 Compliance Assurance Monitoring

29. Compliance Assurance Monitoring (CAM)_TVL-05


Equipment Breakdown _________________________

30. Equipment Breakdown Initial Notice_REP-01

31. Equipment Breakdown Written Report_REP-02


Compliance Assistance _________________________

32. Compliance Test Review_COM-01

33. Source Test Consultant Audit_COM-02

34. EVR Self Inspection Checklist_REP-03

35. EVR Maintenance and Alarm Log_REP-04

36. EVR Compliance Plan_REP-05

37. Gasoline Dispensing Facilities Test Procedure Protocol Notice_REP-06

38. PERP Verbal Notification _REP-07

39. PERP Home District Inspection Request Form_REP-08

40. PERP Written Notification_REP-09

41. Fugitive Dust Control Plan_REP-11

42. Air Monitoring Plan_REP-12

43. Paint Stripping Form (40 CFR Part 63 Subpart HHHHHH)_REP-13

44. Daily Coating Log (Paint)_REP-15

45. Logging Paint Operations Bulletin_REP-16

46. NSPS NESHAPS Report_REP-17

Paint Usage Formulas (Call 661-862-5250)


Asbestos Removal ____________________________

47. Asbestos Fees_ASB-01

48. Asbestos Notification Form_ASB-02

Asbestos NESHAP Common Questions


Request to View Files, Records, and Rules ___________

49. Rules and Regulation Order Form_FIL-01

50. Request to Copy/View Files_FIL-02

51. File Checkout Form_FIL-03

52. ATC File Form_FIL-04

53. Confidential File Form_FIL-05

54. Per Your Request_FIL-06


Variance Information _________________________

55. Procedure for Variance_VAR-01

56. Petition for Variance_VAR-02

57. Variance Quick Reference Chart_VAR-03


District Grant Programs ________________________

58. Carl Moyer Program (CMP) Application_CMP-01

59. CMP Emergency Equipment Application_CMP-02

60. CMP Application Instructions_CMP-03

61. CMP Retrofit Waiver_CMP-04

62. CMP Annual Report Form_CMP-05

63. CMP Annual Report Instructions_CMP-06

64. Invoice for Payment Form_CMP-07

65. CMP Invoice for Payment Instructions

66. DMV Voucher Claim for Payment

67. DMV Grant Report Form

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