Small Business Assistance - Permit Primer

Section 4 - Compliance Requirement Forms

These forms are only required for operation permits. The link for all forms is found at the bottom of this page.

For those applying for a construction permit, you don't need these AT THIS TIME. When your construction permit is about to expire, you will need to amend your application to make it a complete operation permit application. At that time, these forms will be required.

Compliance Demonstration

4530-118

After completing form 4530-118 for an emissions unit, fill out the appropriate compliance demonstration forms as follows. NOTE: the link to these forms is found by clicking on the pdf above or on "link to Section 4 Forms" at the bottom of this page.

4530-119 Continuous Emission Monitoring
4530-120 Periodic Emission Monitoring using Portable Monitors
4530-121 Monitoring Control System Parameters or Operating Parameters
4530-122 Monitoring Maintenance Procedures
4530-123 Stack Testing
4530-124 Fuel Sampling and Analysis
4530-125 Recordkeeping

Compliance Status Forms (For operation permits ONLY* - Fill out forms -130 and -131 for each unit and forms -132 and -133 for the whole facility)
4530-130 Current Emissions Requirements and Status of Unit
4530-131 Emission Unit Compliance Plan - Commitments and Schedule
4530-132 Current Emissions Requirements and Status of Facility
4530-133 Facility Requirement Compliance Plan

Paint Booths

Printing Press With Incinerator

Compliance Status

The following forms are intended to inform the DNR about the compliance status of each of your emissions units and for any rules that are applicable facility-wide. On forms 4530-130 you list all the rules that apply, either to individual emissions units (-130) or facility-wide (-132). Then on the certification forms you either indicate that the emissions unit or whole facility is in compliance with all those rules, or if not then propose how and when the facility will come into compliance.

4530-130

You must fill out one form for each emissions unit at your facility. Do not fill out this form for insignificant emissions units.

4530-131

You must certify compliance for every significant emissions unit at your facility. If the emissions unit is in compliance you need to only fill out items 1- 4. If the unit is not presently in compliance you should check the box in item 6 and give a schedule of how and when you will attain compliance.

4530-132

You must fill out this form if you have any facility-wide emission limitations. Such requirements include existing permit requirements, such as restrictions on the total number of hours a plant may operate, total solvent usage, and so on. The hazardous air pollutant rule in NR 445, Wis. Adm. Code, is actually a facility wide limitation and is a rule that is considered "state-only". "State-only" refers to sections of the Wisconsin Administrative Code that have not yet been approved by the Federal Government. You may need to contact DNR Air Permit or SBCAAP staff for assistance on whether a rule is state-only or not.

4530-133

You must certify compliance with requirements that affect the entire facility (those you listed on 4530-132). If the facility is in compliance, you need to fill out only items 1- 3. If the facility is not presently in compliance you should check the box in item 4 and give a schedule of how and when you will attain compliance.

Alternative Operating Scenarios

While filling out your application, consider all the different operating scenarios you might want to operate under during the next five-year life of your permit. On some of the forms it is easy to address alternatives. For example, the printing form 4530-107 asks you to give information for all inks you currently use in your press and all inks you may want to use in the press for the next five years. Write "alternative" next to the inks that may be used in the future. Other forms don't lend themselves as easily to describing alternative operating scenarios. In this case, fill out a 4530-135 form for additional information to describe the alternative operating scenario (opens in new window)

Section 4 Forms (PDF, 122 KB)