APCD Permit Application Forms

How to view or obtain permit application forms

The permit application forms below are available on-line in Microsoft Word 97-2003 format. Instructions are provided in PDF format. These and other application forms are also available from the District in paper form or in PDF format. (See contact information.)

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  3. Open it from the appropriate program (Microsoft Word, Adobe Reader, etc.).

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General Construction and Operating Permits

These are the permit application forms to apply for a permit to construct, reconstruct, install, modify or operate a process or air pollution control device. These new permit application forms supercede Form 201 and the AP-xx08 forms which APCD no longer accepts. Carefully read the instructions below before starting to fill out forms. If you are new to air permitting, see Permits for a description of APCD's permitting process including how to get started.

For quicker processing, please submit reports and applications for emissions-based permits to airpermits @ louisvilleky.gov. Any submissions e-mailed will need to also be submitted either as hardcopy, faxed, or on physical electronic media (CD, floppy, flash drive).

Form AP- Number and Description Revision Date
Instructions February 2015
100A: Administrative Information October 2020
100B: Emission Unit Definition March 2016
101X: Request for Temporary Exemption March 2016
200A: Generic Process March 2014
200B: Abrasive Blasting March 2014
200C: Grain Elevator March 2014
200D: Silo March 2014
200E: Combustion Source March 2014
200F: Crematory March 2014
200G: Printing Operation March 2014
200H: Coating Operation March 2014
200J: Engine or Generator September 2019
200K: Used Oil Heater March 2014
200L: Asphalt Plant March 2014
200M: Dry Cleaning March 2014
200N: VOC Storage Tank March 2014
200P: Parts Washer March 2014
200R: Cooling Tower March 2014
Control Devices
300A: Generic Control Equipment March 2014
300B: Baghouse March 2014
300C: Cyclone March 2014
300D: Settling Chamber March 2014
300E: Electrostatic Precipitator March 2014
300F: Chemical Scrubber March 2014
300G: Reducing Systems March 2014
300H: Condenser March 2014
300J: Vapor-Liquid Separator March 2014
300K: Adsorber March 2014
300L: Thermal Oxidizer March 2014
300M: Flare March 2014
300N: Venturi Scrubber March 2014
300O: Absorber October 2014
Major Source Operating Permits – Title V and FEDOOP
100C: Emission Data March 2014
100D: Stack Data March 2014
100E: Potential to Emit March 2014
100F: Plantwide Emission Summary March 2014
100G: Alternative Operating Scenarios March 2014
100H: Applicable Requirements March 2014
100J: Compliance Monitoring March 2014
100K: Compliance Status March 2014
100L: Compliance Schedule March 2014
100M: Risk Management Plan March 2014
100N: Episode Action Plans March 2014
100P: Insignificant Activities October 2015
150B: Production Rate March 2014
900B: Certified Progress Report March 2014
900C: Emission Reduction Credit March 2014

9400-O: Title V Annual Compliance Certification

January 2016
9440-O: FEDOOP Annual Compliance Certification February 2016
Registered Sources
500A: Source Registration or Exemption Request August 2020
500B: Annual Certification May 2018

Gasoline Dispensing (Stage I / Stage II) Permits

Form Number and Description Revision Date
Form APG-A: Application to change the owner or operator of a facility or update information for renewal March 2016
Form APG-C: Application for permit to modify or construct a facility March 2016
Form APG-D: Notice of Intent to Decommission Stage II Controls and Decommission Plan Form May 2016
Form APG-E: Complete Notice - Decommission Stage II Controls and Decommission Plan Form May 2016


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