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.
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 Number | Description | Download PDF | Tutorials and Examples |
|---|---|---|---|
| Source-specific operation permits/exemption: | |||
| AM-578 | Operation Permit Renewal Application Checklist | Download | |
| AM-597 | Operation Permit Exemption Application Checklist | Download | |
| AM-598 | Operation Permit Revision Application Checklist | Download | |
| Source-specific construction permits/exemptions: | |||
| AM-592 | Construction Permit Revision Application Checklist | Download | |
| AM-593 | Construction Permit Exemption Application Checklist | Download | |
| AM-594 | PSD Major (NR 405) Construction Permit Application Checklist | Download | |
| AM-595 | Minor Source (NR 406) Construction Permit Application Checklist | Download | |
| Registration Permit Application Checklist: | |||
| AM-555 | Registration permit application checklist | Download | |
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.
| Form Number | Form Name | Download Word | Download PDF | Tutorials and Examples |
|---|---|---|---|---|
| 4530-100 | Facility Details and Permit Actions | Download | Download | |
| 4530-101 | Facility Plot Plan | Download | ||
| 4530-102 | Source and Site Descriptions | Download | ||
| 4530-102A | Source Description - Supplemental | Download | ||
| 4530-102B | Source Description - Supplemental | Download | ||
| 4530-103 | Stack Identification | Download | Download | |
| 4530-104 | Boiler or Furnace Operation | Download | Download | |
| 4530-104A | Stationary Reciprocating Internal Combustion Engine (RICE) | Download | ||
| 4530-105 | Storage Tanks | Download | Download | |
| 4530-106 | Incineration | Download | Download | |
| 4530-107 | Printing Operations | Download | Download | |
| 4530-108 | Painting and Coating | Download | Download | |
| 4530-109 | Miscellaneous Processes | Download | Download | |
| 4530-110 | Control Equipment Miscellaneous | Download | Download | |
| 4530-111 | Condensers | Download | Download | |
| 4530-112 | Adsorbers | Download | Download | |
| 4530-113 | Catalytic or Thermal Oxidation | Download | Download | |
| 4530-114 | Cyclone/Settling Chambers | Download | ||
| 4530-115 | Electrostatic Precipitator | Download | Download | |
| 4530-116 | Wet Collection Systems | Download | Download | |
| 4530-117 | Baghouse/Fabric Filters | Download | Download | |
| 4530-118 | Compliance Certification - Monitoring and Reporting Methods | Download | Download | |
| 4530-119 | Continuous Emission Monitoring | Download | ||
| 4530-120 | Period Emission Monitoring Using Portable Monitors | Download | ||
| 4530-121 | Monitor Control System Parameters or Process Operating Parameters | Download | ||
| 4530-122 | Monitoring Maintenance Procedures | Download | ||
| 4530-123 | Stack Testing | Download | ||
| 4530-124 | Fuel Sampling and Analysis | Download | ||
| 4530-125 | Recordkeeping | Download | ||
| AM-585 | OP RENEWAL – Emission Summary Form Index (Forms 4530-126 through 4530-129) | Download | Download | Tutorial [VIDEO] |
| 4530-126 | Emission Unit HAP Summary | Download | ||
| 4530-127 | Facility HAP Summary | Download | ||
| 4530-128 | Criteria Pollutant Emission Unit Summary | Download | ||
| 4530-129 | Facility Criteria Pollutant Emissions Summary | Download | ||
| AM-586 | OP RENEWAL – Applicable Requirements Form Index (Forms 4530-130 and 4530-132) | Download | Download | Tutorial [VIDEO] |
| 4530-130 | Current Emission Requirements and Status of Unit | Download | ||
| 4530-132 | Current Emissions Requirements and Status of Facility | Download | ||
| AM-587 | OP RENEWAL – Compliance Plan and Schedule Form Index (Forms 4530-131 and 4530-133) | Download | Download | Tutorial [VIDEO] |
| 4530-131 | Emission Unit Compliance Plan and Schedule | Download | ||
| 4530-133 | Facility Requirements Compliance Plan and Schedule | Download | ||
| 4530-135 | Supplemental Information | Download | ||
| 4530-186 | Generation and Banking of Emissions Reduction Credits (ERCs) | Download | Download | |
| 4530-187 | Transfer of Emissions Reduction Credits (ERCs) | Download | Download | |
| 4530-188 | Identification 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.
| Form Number | Form Name | Download PDF | Download Word | Resources |
|---|---|---|---|---|
| 4530-141 | Nonmetallic mineral processing plant (Crushers) General Operation Permits (GOP) | Download | ||
| 4530-156 | Type A Registration Construction and Operation Permit Application | Download | Guide | |
| 4530-156A | Registration Construction and Operating Permit Modeling Assessment Attachment | Download | ||
| 4530-163 | Hot Mix Asphalt Plant General Construction and Operation Permit (GCP/GOP) | Download | Download | |
| 4530-169 | General and Registration Permit Petition | Download | ||
| 4530-172 | Type C Registration Construction and Operation Permit for Printers Application | Document | Guide | |
| 4530-183 | Type B Registration Construction and Operation Permit Application | Download | Download | Guide |
| 4530-185 | Type G Registration Construction and Operation Permit Application | Download | Download | Guide |
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.
| Form Number | Form Name | Download PDF | Instructions and Examples |
|---|---|---|---|
| 4500-025 | Portable Source Relocation Notification | Download | |
| 4500-125 | Excess Emission Report for opacity | Download | |
| 4500-126 | Excess Emission Report for gases | Download | |
| 4500-134 | Fuel Sampling and Analysis Report | Download | |
| 4530-155 | 112(j) MACT Combined Parts 1 and 2 | Download | |
| 4530-156A | Registration Construction and Operating Permit Modeling Assessment Attachment (include with form 4530-178 when needed) | Download | |
| 4530-184 | Air Operation Permit Compliance Certification & Deviation Summary Report | Download | |
| 4530-175 | Hot Mix Asphalt Plant GOP Combined Annual Monitoring Report and Certification of Compliance | Download | |
| 4530-177 | Nonmetallic Mineral Processing Plant (Crushers) GOP Combined Annual Monitoring Report and Certification of Compliance | ||
| 4530-178 | Air Pollution Registration Operation Permit (ROP)
|
Download | |
| 4530-179 | Registration Operation Permit (ROP)
|
Download | |
| 4530-182 | Air Permit Next Business Day Deviation | Download | |
| Handling and Storage of Coal Certification Form | Download | see s. NR 445.10, Wis. Adm. Code [exit DNR] |