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Application Forms

General

NCUAQMD Public Records Request Form, rev 6-18.pdfFee Schedule for Duplication of District Records, 1-1-21.pdf

Grant Application Forms

Grant application forms are available from each individual grant program's webpage - go to our Grants & Incentives web page

Burn Permit & Smoke Management Application Forms

NCUAQMD Standard Burn Permit Application.pdfStandard Burn Permit Fee Waiver.pdfNCUAQMD Non-Standard Burn Permit Application.pdfNS Burn Permit Fee WAIVER Request Form - Rx Fire Grant, rev 9-19.pdfNCUAQMD No Burn Day Application.pdfNCUAQMD SMP Application Package (rev 1-21).pdf

Asbestos Notification Forms

ASBESTOS NOTIFICATION INSTRUCTIONS 9-15.pdfASBESTOS NOTIFICATION FORM 5-18-2022.pdf

Stationary Source Permit Application Forms

In order to apply for a District operating permit or make changes to existing equipment under permit, the District form 1300 (Application for Stationary Source Permit) as listed below must be submitted along with the current application fee of $75.00 [=1/2 the District X-Factor, where the current District X-Factor is $150 per Rule 400(B)(1). Additional forms may also be required depending on the type of equipment or proposed air pollution control device.

1300 Authority to Construct 9-2015.pdf1300 B Emissions, Fuel and Process Materials (2).pdf1301 Internal Combustion Engine.pdf1302 External Combustion.pdf1303 PM Control Equipment.pdf1304 VOC Control Equipment.pdf1305 Scrubber.pdf1306 Fuel Dispensing and Storage.pdf1307 Vapor Extraction.pdf1308 (Auto Coating).pdf1309 Aggregate Plant.pdf1310 Hot Mix Asphalt Plant.pdf1312 Gasoline Bulk Storage Facility.pdf1313 Title V.pdf1398 Emission Reduction Credits.pdf1399 ATC to PTO Conversion.pdf

Compliance Forms

Title V Compliance Certification Report.pdfTitle V Compliance Forms.pdf