Permit Register Entry Form

This form is for Ecology and other permitting agencies to electronically submit permit register entries.


Provide the following information:

Agency:
Permit Type:
Codes:
Permit Applicant:
Physical Address:
Zip Code:
Mailing Address: if not the same as above
Zip Code:
Facility Description:
Actual ANNUAL emission reported in the emission inventory for calendar year:
Total Particulates: Tons Per Year (TPY):
CO TPY:
NOx TPY:
SO2 TPY:
PM10 TPY:
VOCs TPY:
Other Pollutant:
Public Comment Period:
Public Comment Period Contact: if not the same as above
Public Hearing:
Date, Time:
Location:
Describe Permit Modification:
Date of Determination:
Agency Contact:
* Email Address: * REQUIRED FIELD
Date Submitted:

Electronic Submittal Version of 020-8 (revised 1/17)

 


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