Compliance Assistance Templates and Forms


About the Forms

The forms below are available on-line in PDF format (PDF version 1.4 to 1.6). Some are also available in Microsoft Excel 97-2003 (Excel for short) or Microsoft Word 97-2003 (Word) format. Microsoft Office 2007 and 2010 programs can open Office 97-2003 documents. These documents are also available from the District in paper form. (See contact information.)

If a document does not download correctly when you click on it, try this:

  1. Right-click on the link, choose "Save Target As..." or "Save Link As..." (or similar option, depending on your web browser),
  2. Save the document somewhere convenient, and
  3. Open it from the appropriate program (e.g., Adobe Reader).

Note that some documents may appear differently on different computers depending on the fonts installed and other settings.

Record-Keeping Forms

These are forms for keeping track of routine compliance activities for specific types of processes.

Description Microsoft Excel 2003
Abrasive blasting (sand blasting, shot blastic, etc.) Abrasive blasting records form (Excel)
Automotive or marine body shop Body shop records form (Excel)
Dust collector Dust collector records form (Excel)
Emergency generator Generator records form (Excel)
Reg. 7.59 - coating of metal parts Reg. 7.59 records form (Excel)
Visible emissions Visible emissions records form (Excel)

PTE Calculation Templates

These are templates for calculating potential emissions from specific types of processes.

Description Microsoft Word 2003
Abrasive blasting booth Blast Booth PTE (Word)
Abrasive blasting cabinet Blast Cabinet PTE (Word)
Automotive body shop Body Shop PTE (Word)
Blending, storage and drum loading Blending, Storage and Loading PTE (Word)
Boiler Combustion PTE (Word)
Cold solvent parts washer Parts Washer PTE (Word)
Dry cleaning Dry Cleaning PTE (Word)
Lithographic press Lithographic Press PTE (Word)
Mineral crusher Mineral Crusher PTE (Word)
Pyrolysis oven Pyrolysis Oven PTE (Word)
Spray booth Spray Booth PTE (Word)

Other Compliance Forms

Description Microsoft Word 2003 or Adobe
Simple excess emissions reporting form for a startup, shutdown or upset condition involving odor or dust at a small facility Form 311 (Word)
Detailed excess emissions reporting form for a startup, shutdown or upset condition involving a criteria pollutant, air toxic or any problem at a larger facility Form 312 (Word)
Title V Annual Compliance Certification Form 9400-O (Word)
FEDOOP Annual Compliance Certification Form 9440-O (Word)
Minor Source or Registered Source Annual Certification Form 500B (Word)
Compliance certification: NESHAP - 40 CFR Part 63 Subpart HHHHHH NESHAP- HHHHHH (Word)
Petition for exemption under 40 CFR Part 63 Subpart HHHHHH Petition for Exemption (PDF)
MACT 40 CFR Part 63 Subpart JJJJJJ initial notification MACT 6J (Word)

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