Permit Register entry form

Business applying for permit: *

Physical address: *

City: *

State: *

ZIP code: *

Facility description: *

Permit type: *

Permit action: *

Date of agency decision: *

Today

Describe permit modification:

Pollutants that would be
increased with this action:

Calendar year that actual annual
emissions were reported in the
emissions inventory (WEIRS): *

Ammonia tons per year (TPY):

Carbon monoxide TPY:

Hydrogen fluoride TPY:

Chlorine TPY:

Nitrogen oxides TPY:

Particulate matter (PM₁₀) TPY:

Particulates, total TPY:

Sulfur dioxide TPY:

Volatile organic compounds (VOCs) TPY:

Other pollutant(s) not listed above TPY:

Public comment period:

start date – end date
example: January 2, 2020 – February 2, 2020

Public hearing:

Yes
No

Clean air agency: *

Agency contact: *

Email: *

Enter your email to receive confirmation.

Re-enter your email. *

Date submitted: *

Today

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