Permit register entry form

This form is only for Ecology and other Washington clean air agencies to electronically submit permit register entries.

* required field

Site information

Business applying for permit: *

Physical address: *

City: *

Zip code: *

Facility description: *

Permit activity

Permit type: *

Permit action: *

Date of agency decision: *

Today

Describe permit modification:

Pollutants that would be
increased with this action: *

Yes
No

Emissions reported

Year that emissions were reported
in emissions inventory (WEIRS): *

Ammonia tons per year (TPY):

Carbon monoxide TPY:

Chlorine TPY:

Hydrogen fluoride TPY:

Lead TPY:

Nitrogen oxides TPY:

Ozone TPY:

Particulate matter (PM_2.5) 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 and hearing

Public comment period:
(start date – end date)

example: January 2, 2022 – February 2, 2022

Public hearing:

Yes
No

Permitting agency

Clean air agency: *

Agency contact: *

Email: *

Enter your email to receive confirmation.

Re-enter your email: *

Date submitted: *

Today

Were you able to find what you were looking for today?*:	Yes No Not sure
What were you trying to find?*:
Please describe your experience. What was challenging? What was helpful? *:	Please include details that will help us address any issues you're reporting. NOTE: There is a 1,500 character limit (including spaces) on this form field.
Was the search tool helpful to you? *:	Yes No I didn't use Search.
How can we improve our website?:	Optional. If you have suggestions, we'd like to hear them! NOTE: There is a 1,500 character limit (including spaces) on this form field.
Your name:	Please include contact information if you'd like a reply.
Email:	If you’d like a reply, please provide an email address.
Phone number:	( ) - Second three digits Last four digits If you’d like us to call you, please provide a phone number.
Which best describes your role in visiting our site today?*:	Business / Consultant / Contractor Government - Local Government - State Government - Federal Government - Tribal Scientist / Researcher Non-profit Washington resident / Public Educator Student Job seeker Ecology employee
PleaseLeaveBlank:	Are you a robot? If not, please do not enter anything in this field.
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