Title V Operating Permits

Title V Application Forms

The Title V application forms for the initial Title V permit and the renewal of a Title V permit are identical.  They consist of a main application form, an actual emissions form, a potential to emit form, an insignificant activities form, a compliance plan form, and a compliance certification form.

The Title V modification forms for administrative amendments, minor modifications, or significant modifications are also identical, and must be accompanied by a compliance certification for modifications form.  Permit changes that do not affect federally enforceable requirements may be requested by letter pursuant to Section 6.4.4 of Rule 2520.

The District recommends every Title V facility submit a facility-wide template UM-0-3 qualification form (TQF).  This form significantly streamlines the process of identifying administrative requirements for a facility, has been approved by the federal EPA, and is therefore not subject to further EPA review.

Title V Initial & Renewal Application Forms

Title / Description Items
Title V Application Checklist
01/01/0001
Title V Permit Application Form (TVFORM-MAIN)
01/01/0001
Title V Actual Emission Report (TVFORM-001)
01/01/0001
Title V Potential Emissions Report (TVFORM-002)
01/01/0001
Title V Insignificant Activities (TVFORM-003)
01/01/0001
Title V Compliance Plan (TVFORM-004)
01/01/0001
Title V Compliance Certification (TVFORM-005)
01/01/0001
MACT Hammer Part I Application
01/01/0001

Title V Modification Application Forms

Title / Description Items
Title V Modification Application (TVFORM-008)
01/01/0001
Title V Compliance Certification for Modifications (TVFORM-009)
01/01/0001
Responsible Official Change Form (TVFORM-010)
01/01/0001

Templates

Title / Description Items
Facility-wide Umbrella (UM-0-3)
01/01/0001