Permit Application Forms
We strongly recommend that applicants contact the Forsyth
County Environmental Affairs Department before beginning work on a permit application.
We can often provide explanations and suggestions that prevent misunderstandings
and streamline the overall application process.
Standard Air Quality Permit Application and Instructions
CAA 112(j) Part 2 Case-By-Case MACT Application for Industrial,
Commercial and Institutional Boilers and Process Heaters
Sand, Gravel, and Crushed Stone Operations Permit Application
D3-3 Form: Emission Source (Reduction and Recycling Activities)
Transportation Facility Permit Application
Asbestos Application/Notification Form
Burning Permit Application for Structural Fire Training
Registration Forms
Perchloroethylene Dry Cleaning Operations
Paint Stripping & Miscellaneous Surface Coating Operations
(Subpart HHHHHH)
Land-Clearing Open Burning
Gasoline Dispensing Stations
Fire Training Notification Form
Other Forms
Emissions Inventory
Dispersion Modeling Protocol
Dispersion Modeling Request
Stack Test Protocol Submittal
Title V Compliance Certification
Special Award Application
Standard Air Quality Permit Application and Instructions
All air quality permit application submittals must include the appropriate
permit application fee, a completed D3-3 Form, and supporting calculations
and technical data. The application includes 45 forms and a matrix.
Back to Top
CAA 112(j) Part 2 Case-By-Case MACT Application for Industrial, Commercial and
Institutional Boilers and Process Heaters
Title V facilities that are also major sources of hazardous pollutants are required
to submit a Case-By-Case MACT permit application to comply with Section 112(j) of
the Clean Air Act for affected boilers and indirect-fired process heaters. Part
1 and Part 2 applications were requested by the Department in a letter to potentially
affected facilities issued on June 12, 2009. Facilities may choose to use the form
provided here and the emissions standards provided in the NC DAQ guidance (referenced
in the application) to satisfy the requirement to submit a Part 2 MACT application.
Part 2 applications must be submitted to the Department no later than September
30, 2009.
Back to Top
Sand, Gravel, and Crushed Stone Operations Permit Application
This application form is applicable only to sand, gravel and crushed stone operations
with a maximum rated crushing capacity for all primary crushers at the facility
of less than 5000 tons per hour (combined) and a facility-wide total output capacity
of all generator(s) at any one time of less than 736 HP (549 kW - electric).
Back to Top
D3-3 Form: Emission Source (Reduction and Recycling Activities)
A D3-3 Form must be submitted with each:
- payment of an annual permit fee,
- permit application for modification of an existing facility, and
- permit application for a new facility.
Back to Top
Transportation Facility Permit Application
Parking lots with more than 1500 spaces, parking decks with more 750 spaces, or
any combination of lots and decks with more than 1000 spaces need to apply for and
receive a transportation facility permit with the Department before beginning construction.
Back to Top
Asbestos Demolition/Renovation
In accordance with the federal NESHAP regulations for asbestos, notifications must
be provided and permits obtained from the FCEAD for all operations involving renovation
or demolition. Renovation includes the removal of greater than 160 square feet or
260 linear feet of friable asbestos materials or non-friable asbestos materials
that will become friable when disturbed.
Notification is required for demolition and a permit must be obtained from the FCEAD
whether asbestos is involved or not. An asbestos survey is required to obtain a
demolition permit.
Back to Top
Burning Permit Application for Structural Fire Training
A burning permit must be obtained from the FCEAD by any person or organization wishing
to intentionally burn a facility for the purpose of fire training.
Back to Top
Perchloroethylene Dry Cleaning Operations
Dry Cleaners using Perchloroethylene are required to register their facility with
FCEAD. These facilities are regularly inspected and federal law requires that FCEAD
be notified and that the facility owner certify their compliance with federal regulations.
Completion of the registration form provided will satisfy both local and federal
requirements.
Back to Top
Paint Stripping & Miscellaneous Surface Coating Operations (Subpart HHHHHH)
Facilities that use methylene chloride to strip paint, auto body shops, and other
facilities that spray paint metal or plastic surfaces are subject to federal emission
standards. Federal law requires that FCEAD and USEPA be notified and that the facility
owner certify their compliance with federal regulations. FCEAD has developed Notification
of Compliance Status Forms (NOC) in Excel and PDF format for Paint Stripping (NOC-S), Misc.
Coatings (NOC-MSC), Motor Vehicle Surface Coating (NOC-ME), and a form for requesting
an exemption for Motor Vehicle Coating (MEX) for download. For more information
click here.
Back to Top
Land Clearing Open Burning
Property owners and\or contractors are required to register if they intend to open
burn under the guidelines of the land- clearing open burning regulations. In rare
instances, LCOB operators may request a setback waiver if all parties within the
setback distance have read and signed a waiver form. More information about this
is within the downloadable form below
Back to Top
Gasoline Dispensing Stations
Owners of Gasoline Dispensing Stations are required to register if they currently
use or will be dispensing 50,000 gallons of gasoline or more in a year.
Back to Top
Fire Training Notification Form
FCEAD requires prior notification from permitted facilities to conduct fire training
exercises for the dates and times stated.
Back to Top
Emissions Inventory
Industrial facilities that have an air quality permit are required to prepare and
submit an inventory of their air pollution emissions periodically. Title V sources
and non-Title V sources with NOx or VOC emissions greater than 25 tons per year
are required to conduct an emissions inventory annually. Non-Title V sources with
NOx and VOC emissions of less than 25 tons per year are required to conduct an emissions
inventory every five years, to coincide with permit renewal. Facilities should contact
FCEAD if they think they may be required to submit an inventory but have not been
notified. The pollutant code list is available both as a tab within the EI Code Tables and as a separate .pdf file.
Facilities required to submit an inventory should complete and submit the forms
provided here or contact the Department to receive a Microsoft Access database interface
for entering this data. To read more information, click here to see the letter sent to permitted facilities.
Back to Top
Dispersion Modeling Protocol
This checklist can be used when submitting an air toxics modeling analysis. Completing
this checklist can help expedite the review process by ensuring all the necessary
information has been submitted and addressed.
Back to Top
Dispersion Modeling Request
Applicants submitting an air toxics modeling determination are required to complete
a D2M form documenting the stack parameters used in the analysis. In addition, applicants
requesting assistance from the Department in completing a modeling analysis should
also complete this form to provide stack information to the modeling staff.
Back to Top
Stack Test Protocol Submittal
The Stack Test Protocol Submittal Form is used to initiate communication between
representatives of a permitted facility, testing consultants, and to identify and
resolve any specific testing concerns prior to testing. Submit all forms and additional
information to the Department at least 30 days prior to testing.
Back to Top
Title V Compliance Certification
All Title V facilities are required to submit compliance certifications annually.
Certifications must be signed by a responsible company official as defined in FCAQTC
Rule 3Q .0503(15) and 40 CFR Part 70. Permittees are required to identify each permit
term and condition and describe its compliance status. Annual compliance certifications
must be submitted to FCEAD and EPA Region 4 (Atlanta).
FCEAD is providing this form to assist you in this effort. Use of this form is not
required and FCEAD will accept compliance certifications prepared in other formats.
The Department can provide you with a digital copy of your current permit to assist
you with preparing the certification (This will allow you to copy and paste text
from your permit into the certification). Please contact your case manager if you
would like a digital copy of your permit. The form, including tables for addressing
individual terms and conditions, and instructions is available in MS Word format.
The tables only are also available in MS Excel format.
Back to Top
Special Award Application
Businesses and institutions may apply to the Environmental Affairs Advisory Board
for Special Air Quality and Special Environmental Awards.
Applications should by submitted by May 15.
Back to Top
|
