Forms & Applications

You will need the free Acrobat Reader to view and print these forms and applications. Some forms may be filled in using Reader; others must be printed and filled in by hand.

SKIP TO: Stationary Sources | | Throughputs | Agriculture | Asbestos | Complaints | Breakdowns & Variances | Administrative

Stationary Source Applications and Forms

Permit Applications
Used for new or modified units with potential to create emissions
More Info
Authority to Construct (ATC) Application
Permit Notification Form
Permit Changes
Used for change of ownership and name changes
Pemit To Operate (PTO) Change Application
For mailing or billing address changes, contact the Administrative Division at (530) 757-3650.
Emission Reduction Credits ERC Application
ERC Transfer of Ownership
Title V Permits
More info
Title V Application Packet
Supplemental Permit Forms
Don’t see the form you need?
Contact the District
Form 155 – Automotive Coating Operations
Form 170 – Boilers
Form 235 – Dehy
Form 280 – Gasoline Dispensing Facility (GDF)
Form 310 – IC Engine
Annual Throughput Reports General Information on Throughput Reporting
Internal Combustion Engine
Gasoline Storage and Dispensing
Coating Operations
General (other permitted processes)
Gasoline Inspection Reports Daily
Additional Info GDF Source Testing Companies

Agricultural Permits and Forms

Agricultural Engines
More info
Form AG1 (Basic Registration)
Form AG2 (Stationary)
Form AG3 (Portable)
Form AG4 (Location)
Form AG5 (Modified Application)
Agricultural Burning
More info
Please see our Agricultural Burn Program page to download the permit application and instructions.
Confined Animal Facility
More info
CAF Permit Application (Form 07)
Miscellaneous Equipment (Form 700)
Dairy (Form 710)
Emission Mitigation Plan (EMP) – Dairy: VOC (Form 711)
Emission Mitigation Plan (EMP) – Dairy: PM (Form 712)
Post-Harvest Processing Form 400
Large Ag Source Permit
More info
Agricultural Operating Permit (AOP) | Instructions
Permit Modification Application | Instructions
AOP Screening Worksheet


Renovation/Demolition Notification
More info
Asbestos Notification Form


Air Quality Complaints
More info
Complaint Form

Breakdowns & Variances

More info
Initial Breakdown Report
Breakdown Follow-up Report
More info
Application for Variance

Administrative Forms and Applications

Misc. Administrative Forms Public Records Request Form
Subscription Request Form
Fee Table