Annual Report for Stationary Engines - 2017
Stationary engines rated at greater than 50 horsepower are required to report emission information to the North Coast Unified Air Quality Management District each year. To simplify this process, the District is providing you with this reporting tool. For the 2017 reporting year, please complete the required fields below and submit your responses prior to the reporting deadline listed in your notice. If you have more than one engine, you must complete this form for each permitted unit (complete the form for each unit with a unique permit ID number).
Please provide the name and contact information of the person completing this form.
If you received an email notice or a written request from the District, enter your invitation code. Or, enter the facility identification number (FAC ID#). This is located on the bottom left on the front page of your permit. Enter the three numbers, followed by "-", and then two numbers. For example "123-12".
Please identify the permit by completing the fields below.
Enter the name of the business listed on the permit.
Enter the permit ID number. It is located at the top of the front page of your permit. Enter six numbers followed by "-2". For example "000123-2".
BUSINESS CONTACT INFORMATION
Has the Contact Person or the mailing address changed?
If you answered "Yes", please provide the updated information in the fields below.
Enter the first and last name of the new Contact Person.
Mailing Street Address
Mailing Zip Code
EMISSION INVENTORY DATA
Your permit requires engine usage information be reported to the District each year. Please submit the information requested below.
Maintenance & Testing - Hours Operated
Report the number of hours the engine was operated for maintenance & testing. To report 50 engine hours, type "50".
Emergency Use - Hours Operated
Report the number of hours the engine was operated for emergency purposes. To report 500 engine hours, type "500".
Gallons of Diesel Used
Enter the quantity of diesel used during the calendar year.
By checking the box below, I certify that the information I am submitting via this form is true and correct to the best of my knowledge.
Please Contact Me
Questions? Require additional information? Contact Staff by calling (707) 443-3093 or email Support@ncuaqmd.org.
Send me a copy of my responses
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