Air Contaminant Discharge Permit (ACDPs) Forms
For questions or information requests regarding permitting forms contact LRAPA staff at permitting@lrapa.org or 541-736-1056.
Basic ACDP Forms
| Initial Basic Air Contaminant Discharge Permit (ACDP) Application Forms |
Forms Link (PDF) |
|---|---|
| Basic Air Contaminant Discharge Permit Application (Form Basic-100) |
Form |
| Basic Boiler Permit Application (AQB-002) |
Form |
| Basic Concrete Application (AQB-006) |
Form |
| Basic Crematory Application (AQB-007) |
Form |
| Basic Rock Crushing Application (AQB-015) |
Form |
| Basic Surface Coating Application (AQB-018) |
Form |
| Basic or General Coffee Roaster Application (AQB-116) |
Form |
| Surface Coating (6H) Application for a General, Basic, or Registration (AQGP-127) |
Form |
| Basic Wood Product Manufacturing (Sawmills & Millwork) Application |
Form |
| Transfer Application for ACDP (Use for change in ownership) - AQ103 (Instructions and Application) |
Form |
| Annual Reporting Forms for Basic Air Contaminant Discharge Permits (ACDPs) |
Forms Link (PDF) |
|---|---|
| Surface Coating (6H) Annual Reporting Form for A11 Autobody Repair or Painting Shops (AQRB-001) |
Form |
| Boilers Annual Reporting Form (AQRB-002) |
Form |
| Concrete Manufacturing Annual Reporting Form (AQRB-006) |
Form |
| Crematory Annual Reporting Form (AQRB-007) |
Form |
| Wood Product Manufacturing (Sawmills & Millwork) Annual Reporting Form (AQRB-009) |
Form |
| Rock, Concrete, and Asphalt Crushing Annual Reporting Form (AQRB-015) |
Form |
| Surface Coating Annual Reporting Form for A7 and A8 (AQBP-R27) |
Form |
General ACDP Forms
| Initial General Air Contaminant Discharge Permit (ACDP) Application Forms |
Forms Link (PDF) |
|---|---|
| Gasoline Dispensing Facility General Application (AQGP-022) | Form |
| Administration Information for Assignment to General Permit (AQGP-100) |
Form |
| Application for Re-Assignment to General Air Contaminant Discharge Permit (AQGP-100R) | Form |
| Hard Chromium Electroplating General Application (AQGP-101) |
Form |
| Decorative Chromium Electroplating General Application (AQGP-102) |
Form |
| Dry Cleaner Application for General or Registration (AQGP-106) |
Form |
| Asphalt Plant General Application (AQGP-107) |
Form |
| Rock Crushers General Application (AQGP-108) |
Form |
| Concrete Manufacturing General Application (AQGP-109) |
Form |
| Wood Products Manufacturing (Sawmills & Millwork) Application (AQGP-110) |
Form |
| Boilers General Application (AQGP-111) |
Form |
| Crematory Incinerators General Application (AQGP-112) |
Form |
| Coffee Roaster General or Basic Application (AQGP-116) |
Form |
| Electric Power Generators General Application (AQGP-118) |
Form |
| Metal Fabrication and Finishing Operations General Application (AQGP-125) |
Form |
| Plating and Polishing General Application (AQGP-126) |
Form |
| Surface Coating (6H) Application for a General Permit, Basic, EcoBiz Certification or Registration (AQGP-127) |
Form |
| Annual Reporting Forms for General Air Contaminant Discharge Permits (ACDPs) |
Forms Link (PDF) |
|---|---|
| Hard Chrome Platers Annual Reporting Form (AQGP-R01) | Form |
| Fiberglass Fabrication Process Annual Reporting Form (AQGP-R03) | Form |
| Dry Cleaners Annual Reporting Form (AQGP-R06) |
Form |
| Asphaltic Concrete Plant Annual Reporting Form (AQGP-R07) |
Form |
| Rock Crusher Annual Reporting Form (AQGP-R08) |
Form |
| Concrete Production Annual Reporting Form (AQGP-R09) |
Form |
| Wood Product Annual Reporting Form (AQGP-R10) |
Form |
| Boiler Annual Reporting Form (AQGP-R11) |
Form |
| Crematory Annual Reporting Form (AQGP-R12) |
Form |
| Coffee Roaster Annual Reporting Form (AQGP-R16) |
Form |
| Gasoline Dispensing Facility (GDF) Annual Reporting Form (AQGP-R022) |
Form |
| Metal Fabrication Operations (AQGP-R025) |
Form |
| Plating and Polishing Operations (AQGP-R026) | Form |
| Surface Coating (6H) Annual Reporting Form (AQGP-R027) |
Form |
| Greenhouse Gas Reporting Form (R1001-G) |
Form |
| Area Source National Emission Standards for Hazardous Air Pollutants (NESHAP) Forms and Information |
Forms Link (PDF) |
|---|---|
| Paint Stripping and Miscellaneous Surface Coating (6H) Initial Notification Form |
Form |
| Paint Stripping and Miscellaneous Surface Coating Operations (6H) Petition for Exemption |
Form |
| Paint Stripping and Surface Coating Informational Pamphlet |
Pamphlet |
| Surface Coating Notification of Compliance Status (6H) Form |
Form |
| Gasoline Dispensing Facility (GDF) Form A Notification | Form |
| Gasoline Dispensing Facility (GDF) Compliance Report | Form |
| Gasoline Dispensing Facility (GDF) Stage I Pre-Test Vapor Recovery Notification Form | Form |
ACDP Construction Forms
| Air Contaminant Discharge Permit (ACDP) Construction Forms |
Forms Link (PDF) |
|---|---|
| Notice of Intent to Construct Form (AQ104) |
Form |
| Notice of Intent to Construct Instructions (AQ104 Instructions) |
Instructions |
Various Standard/Simple/General/Basic ACDP Forms
| Various Air Contaminant Discharge Permit (ACDP) Forms |
Forms Link (PDF) |
|---|---|
| Application Guidelines |
Document |
| Administrative Information Form (AQ101) |
Form |
| Administrative Information Form Instructions (AQ101 Instructions) |
Instructions |
| Facility Description Instructions (AQ102) |
Form |
| Transfer Application and Instructions - Use for Change in Ownership, etc. (AQ103) |
Form |
| General and Basic ACDP Land Use Compatibility Statement (LUCS) |
Form |
| Title V, Standard, Simple ACDP Land Use Compatibility Statement (LUCS) |
Form |
| Local Government Contact Information for Land Use Compatibility Statement (LUCS) |
Document |
| Non-Technical Modification Form for ACDPs (AQ105) |
Form |
| Annual Reporting Form Cover Page for Simple and Standard ACDPs (AQ107) | Form |
| Greenhouse Gas Reporting Form (R1001-G) |
Form |
| Burning Tuning Reporting Form for: Asphaltic Concrete Plants (AQGP-T07) | Form |
| Relocation Notice for Portable Plants in Lane County | Form |
ACDP Device and Equipment Forms (Series 200)
| Series 200 Forms - (Instructions/Answer sheets/Device descriptions) |
Forms Link (PDF) |
|---|---|
| Form Series 200 Guidelines |
Document |
| Asphalt Plant (AQ202) |
Form |
| Rock Crusher (AQ203) |
Form |
| Ready-mix Concrete Plant (AQ204) |
Form |
| VOC Containing Product Storage (AQ205) |
Form |
| Material Dryers (non-wood products) (AQ206) |
Form |
| Coffee Roasters (AQ207) |
Form |
| Boilers (AQ208) |
Form |
| Crematory Incinerator (AQ209) |
Form |
| Internal Combustion Engines and Turbines (AQ210) |
Form |
| Surface Coating Information painting, coating, solvents (AQ211 I) |
Document |
| Surface Coating Answer Sheet (AQ211 a) |
Form |
| Power Supply Generators (AQ213) |
Form |
| Solvent Usage - other than surface coating (AQ214) |
Form |
| Commercial Bakeries (AQ216) |
Form |
| Wood products facility data (AQ220) |
Form |
| Veneer Dryer Process Device Description (AQ221) |
Form |
| Wood Particle Dryer Process Device Description (AQ222) |
Form |
| Wood Panel Press Process Device Description (AQ223) |
Form |
| Hogged Fuel Boiler Process Device Description (AQ224) |
Form |
| Wood Drying Kiln Process Device Description (AQ225) |
Form |
| Wood Product Process Cyclone Process Device Description (AQ226) |
Form |
| Miscellaneous Processes and Devices (AQ230) |
Form |
| Operation and Maintenance (AQ231) |
Form |
ACDP Pollution Prevention and Control Forms (Series 300)
| Series 300 Forms (Instruction/Answer sheets) |
Forms Link (PDF) |
|---|---|
| Form Series 300 Guidelines |
Document |
| Pollution Prevention (AQ301) |
Form |
| Electrostatic Precipitators (ESP) Control Device (AQ302) |
Form |
| Wet Scrubbers Control Devices (AQ303) |
Form |
| Baghouse Control Devices (AQ304) |
Form |
| Cyclone/Multiclone Control Devices (AQ305) |
Form |
| Fume Incinerator Control Devices (AQ306) |
Form |
| Miscellaneous Control Devices (AQ307) |
Form |