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Air Quality Forms — Permit Application, Notifications, Compliance and Miscellaneous

Industrial Emissions

Available below are air emission permit application forms, compliance reporting forms and other miscellaneous air quality forms from the Minnesota Pollution Control Agency (MPCA). 

Instructions for completing and submitting the forms is available below. Each form is available as either a downloadable MS Word File Microsoft Word (word processing) file, or as an PDF Document Adobe Acrobat pdf file.

Timelines, Instructions, and Tips for Completing and Submitting Application Forms

  • Applicants have the option to submit their application on a compact disk (CD), if desired. The application should be a “pdf” document, and must include any calculations (which must also be provided in a spreadsheet on the CD). If you choose to exercise this option, you must still submit a paper copy of any form that includes a signature and a check for any required fees along with the CD. If you choose to instead submit a paper copy of the application, please submit two copies of the application. Note that if you are including non-public (confidential) information in your application, you must also submit a version of the application with the confidential information redacted. If you are using the electronic submittal option, your public and confidential versions must be on separate CDs.
  • Submit all applications (whether using the CD or the paper copy option) to: MPCA, Fiscal Services, 520 Lafayette Road, St. Paul, MN 55155-4194.
  • The MPCA has a completeness review process for applications for permit amendments, for Part 70 reissuance applications, for permit applications using the Total Facility Permit application forms, for Registration Permits, and for applicability requests. The following completeness checklists are currently in use by MPCA staff: PDF Document TFP Application Review Completeness Checklist (aq-f0-acc01, 12/3/12), PDF Document Amendment Application Completeness Checklist (aq-f0-acc02, 12/3/12), PDF Document Part 70 Reissuance Application Completeness Checklist (aq-f0-acc03, 5/15/12), PDF Document Applicability Determination Review Completeness Checklist (aq-f0-acc04, 3/22/12), PDF Document Registration Permit Application Review Completeness Checklists (aq-f0-acc05) . Please do not submit the MPCA's completeness checklist with your application or applicability request. Following our completeness review, we will notify you of the status of your application.
  • The MPCA has a goal of taking final action on priority permits that are needed to authorize construction within 150 days of the receipt of a complete permit application. If the project is subject to PSD, requires air dispersion modeling for criteria air pollutants or air toxics, requires an Environmental Assessment Worksheet (EAW) and/or and Air Emissions Risk Analysis (AERA), or is otherwise complex or potentially controversial, the project may take longer. If your proposed project requires any type of air dispersion modeling, your permit application must contain the final modeling results in order for it to be deemed substantially complete. In order for this to happen, you will need to obtain MPCA approval of your modeling protocol prior to submitting your permit application. See the MPCA webpage on Air Dispersion Modeling for the forms and more information on pre-application approvals. If your proposed project requires an AERA, your permit application must include the necessary AERA forms and information – see Air Emissions Risk Analysis (AERA) — Forms and Deliverables. If your AERA project uses a refined analysis based on EPA’s Human Health Risk Assessment Protocol (e.g. IRAP), you will need to obtain approval on the preliminary AERA package including the protocol form (AERA-26) prior to submitting your permit application and the final AERA results. If you wish to discuss your project with the MPCA prior to application submittal, please contact Steven Pak at 651-757-2633. For questions with the AERA forms and process, please contact Shelley Burman at 651-757-2255.
  • If you are located within the city of Minneapolis, you will need to determine if your facility will be subject to permitting requirements under Minn. Stat. 116.07, subd. 4a. For more information, please refer to Cumulative Impacts Air Permitting in South Minneapolis.
  • If you would like assistance determining what designation number (EUxxx, CExxx, SVxxx, etc) to use when adding new equipment to an existing facility, refer to the procedures outlined in the July 19, 2007 Air Quality Technical Information Listserv.
  • The MPCA also offers an expedited permit process for simple projects. If you need a permit issued faster than the above timelines, contact Steve Pak at 651-757-2633 to discuss your specific situation.
  • Application instructions are included with each form. To receive assistance, please call the MPCA at 651-296-6300 or 800-657-3864.
  • If your permit or amendment involves particulate matter emission sources, refer to the PM2.5 information and guidance.

For more detailed information on completing permit forms, see the MPCA Air Quality Permit Guide

1. Total Facility Permit Application Forms

Individual forms for the Total Facility Permit Application are listed below and are available as either MS Word File MS Word (.doc or .dot) files, or as PDF Document Adobe Acrobat pdf files.

A. Miscellaneous:

    B. General Information Forms:

        C. Compliance Data Forms:

            D. Emission Calculations Forms:

            See the MPCA Web page, Emissions Calculations.

              E. Monitoring Equipment Forms:

              F. Modeling Information Forms:

              G. EMS Permit Qualifications

              2. Change/Modification Application Forms (includes New Source Review Forms)

              The "CH" series of forms below replaces all of the previous "MOD" series of forms. All the individual forms for the Change/Modification Application are listed below and are available as either MS Word File MS Word (.doc) files, or as PDF Document Adobe Acrobat pdf files.

              3. Registration Permit Application Forms

              All the individual forms for the Registration Permit are listed below and are available as either MS Word File MS Word (.doc or .dot) files, or as PDF Document Adobe Acrobat pdf files.

              • Registration Permit Handbook. This document is being updated to reflect changes in applicable rules. Please check back at a future date for the revised version of the handbook.

                4. General Permit Application Forms

                A. Non-Metallic Mineral Processing General Permit (12/08/08)

                B. Part 70 Manufacturing General Permit June 2006

                Due to changes to the Minnesota air permitting rules to incorporate the federal permit thresholds for greenhouse gases, the general permits are currently unavailable. No new applications are being accepted at this time. The MPCA will evaluate all existing general permits to determine if they appropriately limit greenhouse gas emissions. If you have any questions, contact Nathan Grand of the MPCA, at 651-757-2166.

                C. Part 70 Fiberglass General Permit (December 2009)

                Due to changes to the Minnesota air permitting rules to incorporate the federal permit thresholds for greenhouse gases, the general permits are currently unavailable. No new applications are being accepted at this time. The MPCA will evaluate all existing general permits to determine if they appropriately limit greenhouse gas emissions. If you have any questions, contact Nathan Grand of the MPCA, at 651-757-2166.

                5. NESHAP Notifications and Record Keeping Forms

                A. Drycleaners

                B. Halogenated Solvent Cleaners

                C. Chrome Electroplating

                D. Miscellaneous Major- and Area-Source NESHAP Notifications

                6. Compliance Record Keeping, Submittals and Reporting Forms

                  7. Miscellaneous Certifications, Requests and Notifications

                  8. Expedited Permit Request Forms

                  Use the following forms to request expedited review of a permit application or stack test results. The forms may be emailed directly to Expedited Air Permit.  For questions about the expedited review process, contact Jeff Hedman at 651-757-2416.

                  9. Mercury

                  10. Capped Permit Application Forms

                  These forms may be used by sources electing to apply for the capped permit.

                  11. Part 70 Reissuance Application Forms

                  The following forms are to be used only when applying for reissuance of an expiring Part 70 permit. To use these forms, you will also need facility-specific information from MPCA’s permitting database. To obtain this information, send an email to Pt70Info  with the subject line “Request for Reissuance Materials.” Include all of the following information:

                  • Existing facility permit number
                  • Date of expiration of the existing permit
                  • Name, phone number, and email of facility contact person (such as the designated permit contact person or Responsible Official - this is not the facility’s consultant)

                  The necessary information will be emailed to the facility contact person, in Portable Document Format (pdf), typically within 5 business days.

                  Section 12. Checklists for Federal New Source Performance Standards

                  13. Greenhouse Gas Emissions

                  • None at this time
                  Last modified on June 03, 2013 14:15
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