Air Permits_Content Page_Air Permit and Compliance Forms

Air Permit and Compliance Forms

This page includes air permit application forms for source-specific, general and registration permits, as well as forms for compliance activities for sources that have an air pollution control operation permit.

The DNR must receive an administratively complete permit application to proceed with reviewing the application and issuing a permit. Refer to the instructions and resources available on the How to Apply webpage to learn how to submit a complete application. The page has details specific to the different types of applications and instructions on where to submit the application, including how to submit and sign the forms electronically.

If unsure which permit to apply for, review information on the Air Permit Options webpage. Small businesses can also review the Air Permit Types for Small Businesses webpage.

NEW REGULATED POLLUTANT: 1-Bromopropane (1-BP) was added to the hazardous air pollutants listed under section 112(b) of the Clean Air Act, effective February 4, 2022. In addition to the air contaminants listed in Table 3 of s. NR 407.05, Wis. Adm. Code, sources must also provide emission calculations for 1-BP in any air permit application. NOTE: A source’s major source status and applicable requirements may have changed as a result of the addition of 1-BP. For more information, see 1bp-q-and-a-document-final.pdf (epa.gov).

Permit and Compliance Forms and Application Checklists

Application Checklists

Permit And Exemption Application Checklists

These checklists contain all of the information that must be submitted when applying for an air pollution control permit or exemption, including links to application forms, helpful tips and submittal instructions. Use the download link to save a fillable PDF version to your computer.

Publication NumberDescriptionDownload PDFTutorials and Examples
Source-specific operation permits/exemption:
Source-specific construction permits/exemptions:
Registration Permit Application Checklist:
AM-578Operation Permit Renewal Application ChecklistDownload
AM-597Operation Permit Exemption Application ChecklistDownload 
AM-598Operation Permit Revision Application ChecklistDownload 
AM-592Construction Permit Revision Application ChecklistDownload 
AM-593Construction Permit Exemption Application ChecklistDownload 
AM-594PSD Major (NR 405) Construction Permit Application ChecklistDownload 
AM-595Minor Source (NR 406) Construction Permit Application ChecklistDownload 
AM-555Registration permit application checklistDownload 

Source-Specific Forms

Source-Specific Permit Application Forms

Use these forms to apply for a source-specific air pollution control permit. Each form includes instructions at the back. Wisconsin Air Pollution Control Permit Application - Form-by-Form Instructions (AM-565) includes expanded explanations and examples.

Notice: To ensure proper functionality, always download Air Management Program PDF forms to the computer before opening and entering information. To download, click the link in the “Download PDF” column or right-click on the document link, choose "Save link as," and save the file to a location on the computer. Open the downloaded file using Adobe Reader. For more information, visit the PDF help page.
Form NumberForm NameDownload WordDownload PDFTutorials and Examples
4530-100Facility Details and Permit ActionsDownloadDownload 
4530-101Facility Plot Plan Download 
4530-102Source and Site Descriptions Download 
4530-102ASource Description - Supplemental Download 
4530-102BSource Description - Supplemental Download 
4530-103Stack IdentificationDownloadDownload 
4530-104Boiler or Furnace OperationDownloadDownload 
4530-104AStationary Reciprocating Internal Combustion Engine (RICE) Download 
4530-105Storage TanksDownloadDownload 
4530-106IncinerationDownloadDownload 
4530-107Printing OperationsDownloadDownload 
4530-108Painting and CoatingDownloadDownload 
4530-109Miscellaneous ProcessesDownloadDownload 
4530-110Control Equipment MiscellaneousDownloadDownload 
4530-111CondensersDownloadDownload 
4530-112AdsorbersDownloadDownload 
4530-113Catalytic or Thermal OxidationDownloadDownload 
4530-114Cyclone/Settling Chambers Download 
4530-115Electrostatic PrecipitatorDownloadDownload 
4530-116Wet Collection SystemsDownloadDownload 
4530-117Baghouse/Fabric FiltersDownloadDownload 
4530-118Compliance Certification - Monitoring and Reporting MethodsDownloadDownload 
4530-119Continuous Emission MonitoringDownload  
4530-120Period Emission Monitoring Using Portable MonitorsDownload  
4530-121Monitor Control System Parameters or Process Operating ParametersDownload  
4530-122Monitoring Maintenance ProceduresDownload  
4530-123Stack TestingDownload  
4530-124Fuel Sampling and AnalysisDownload  
4530-125RecordkeepingDownload  
AM-585OP RENEWAL – Emission Summary Form Index (Forms 4530-126 through 4530-129)DownloadDownloadTutorial [VIDEO]
4530-126Emission Unit HAP Summary Download 
4530-127Facility HAP Summary Download 
4530-128Criteria Pollutant Emission Unit Summary Download 
4530-129Facility Criteria Pollutant Emissions Summary Download
AM-586OP RENEWAL – Applicable Requirements Form Index (Forms 4530-130 and 4530-132)DownloadDownloadTutorial [VIDEO]
4530-130Current Emission Requirements and Status of Unit Download 
4530-132Current Emissions Requirements and Status of Facility Download 
AM-587OP RENEWAL – Compliance Plan and Schedule Form Index (Forms 4530-131 and 4530-133)DownloadDownloadTutorial [VIDEO]
4530-131Emission Unit Compliance Plan and Schedule Download 
4530-133Facility Requirements Compliance Plan and Schedule Download 
4530-135Supplemental InformationDownload  
4530-186Generation and Banking of Emissions Reduction Credits (ERCs)DownloadDownload 
4530-187Transfer of Emissions Reduction Credits (ERCs)DownloadDownload 
4530-188Identification Of Emissions Offsets For A Nonattainment Area New Source Review (NNSR) Permit Download 

General and Registration Permit Forms

General and Registration Permit Application Forms

These forms pertain to general and registration permits and permit exemptions.

Notice: To ensure proper functionality, always download Air Management Program PDF forms to the computer before opening and entering information. To download, click the link in the “Download PDF” column or right-click on the document link, choose "Save link as," and save the file to a location on the computer. Open the downloaded file using Adobe Reader. For more information, visit the PDF help page.
Form NumberForm NameDownload PDFDownload WordResources
4530-141Nonmetallic mineral processing plant (Crushers) General Operation Permits (GOP) Download 
4530-156Type A Registration Construction and Operation Permit ApplicationDownload Guide
4530-156ARegistration Construction and Operating Permit Modeling Assessment AttachmentDownload  
4530-163Hot Mix Asphalt Plant General Construction and Operation Permit (GCP/GOP)DownloadDownload 
4530-169General and Registration Permit PetitionDownload  
4530-172Type C Registration Construction and Operation Permit for Printers ApplicationDocument Guide
4530-183Type B Registration Construction and Operation Permit ApplicationDownloadDownloadGuide
4530-185Type G Registration Construction and Operation Permit ApplicationDownloadDownloadGuide

Compliance Forms

Compliance Forms

These forms are related to compliance activities. All facilities which have been issued an air operation permit are required to submit an annual (or more frequent) compliance certification and compliance monitoring report to the DNR.

Note: The DNR has an online reporting system for facilities with these compliance requirements. Use this reporting system to submit these documents electronically to the DNR. Do not bookmark the Air Permit and Compliance System. Always access the system via Switchboard.

Notice: To ensure proper functionality, always download Air Management Program PDF forms to the computer before opening and entering information. To download, click the link in the “Download PDF” column or right-click on the document link, choose "Save link as," and save the file to a location on the computer. Open the downloaded file using Adobe Reader. For more information, visit the PDF help page.
Form NumberForm NameDownload PDFInstructions and Examples
4500-025Portable Source Relocation NotificationDownload 
4500-125Excess Emission Report for opacityDownload 
4500-126Excess Emission Report for gasesDownload 
4500-134Fuel Sampling and Analysis ReportDownload 
4530-155112(j) MACT Combined Parts 1 and 2Download

PDF

Example [PDF]

4530-156ARegistration Construction and Operating Permit Modeling Assessment Attachment (include with form 4530-178 when needed)Download 
4530-184Air Operation Permit Compliance Certification & Deviation Summary ReportDownload 
4530-175Hot Mix Asphalt Plant GOP Combined Annual Monitoring Report and Certification of ComplianceDownload 
4530-177Nonmetallic Mineral Processing Plant (Crushers) GOP Combined Annual Monitoring Report and Certification of ComplianceDownload 
4530-178

Air Pollution Registration Operation Permit (ROP)

  • Section A - Annual Compliance Certification
  • Section B – Deviation Summary Report
DownloadPDF
4530-179

Registration Operation Permit (ROP)

  • Section C - Monitoring Summary/Checklist
DownloadPDF
4530-182Air Permit Next Business Day DeviationDownload

Example 1 [PDF]

Example 2 [PDF]

 Handling and Storage of Coal Certification FormDownloadsee s. NR 445.10, Wis. Adm. Code [exit DNR]