Air & Climate Forms

Plan Approval Overview & Applicability Tables (June 2011)

Read this document first to determine whether your proposal requires a Plan Approval, is exempt, or qualifies for an alternative compliance pathway, such as a Permit-by-Rule or Environmental Results Program (ERP) certification.
MS Word 196 KB | PDF 158 KB

Related Links

Best Available Control Technology (BACT) Guidance & Top Case BACT Guidelines
Web page

Modeling Guidance for Significant Stationary Sources of Air Pollution
Web page

Application Forms

LPA-FUEL - Limited Plan Application (LPA) for Fuel Utilization Facilities (June 2011)

Use Permit Code BWP AQ 01 when applying.
Form: MS Word 378 KB | PDF 210 KB
Instructions: MS Word 160 KB | PDF - included with form above.

LPA-PROCESS - Limited Plan Application for Process Emission Units (June 2011)

Use Permit Code BWP AQ 01 when applying.
Form: MS Word 351 KB | PDF 218 KB
Instructions: MS Word 160 KB | PDF - included with form above.

CPA-FUEL - Comprehensive Plan Application for Fuel Utilization Facilities (June 2011)

Use Permit Code BWP AQ 02 (Non-Major) or BWP AQ 03 (Major) when applying.
Form: MS Word 528 KB | PDF 218 KB
Instructions: MS Word 160 KB | PDF - included with form above.

CPA-PROCESS - Comprehensive Plan Application for Process Emission Units (June 2011)

Use Permit Code BWP AQ 02 (Non-Major) or BWP AQ 03 (Major) when applying.
Form: MS Word 463 KB | PDF 241 KB
Instructions: MS Word 160 KB | PDF - included with form above.

CPA-CREMATORY - Comprehensive Plan Application for Crematories (October 2011)

Use Permit Code BWP AQ 02 when applying.
Form: MS Word 504 KB | PDF 165 KB
Instructions: MS Word 160 KB | PDF - included with form above.

LPA/CPA Administrative Amendment to Previously Issued Plan Approval (August 2011)

Form: MS Word 75 KB | PDF 58 KB
Instructions: MS Word 171 KB | PDF - included with form above.

LPA/CPA Consolidation of Previously Issued Plan Approvals (August 2011)

Form: MS Word 180 KB | PDF 76 KB
Instructions: MS Word 307 KB | PDF - included with form above.

Supplemental Forms

BWP AQ BACT - Determination of Best Available Control Technology (June 2011)

Before issuing its written approval of your application for a Plan Approval, MassDEP must determine the best available (air pollution) control technology (BACT) for your facility or process.
MS Word 215 KB | PDF 119 KB

Related: Best Available Control Technology (BACT) Guidance
Web page

BWP AQ Coatings & Inks (June 2011)

Submit for a spray painting, surface coating or printing operation.
MS Word 294 KB | PDF 57 KB

BWP AQ Sound (June 2011)

Submit if construction or alteration of stationary equipment has the potential to cause noise, or in response to a MassDEP enforcement action citing noise as a condition of air pollution.
MS Word 229 KB | PDF 89 KB

Pollution Control Device Forms

BWP AQ Adsorption Equipment (June 2011)

MS Word 179 KB | PDF 44 KB

BWP AQ Afterburner/Oxidizer (June 2011)

MS Word 199 KB | PDF 97 KB

BWP AQ Baghouse/Filter (June 2011)

MS Word 230 KB | PDF 135 KB

BWP AQ Cyclone (June 2011)

MS Word 1.5 MB | PDF 142 KB

BWP AQ Electrostatic Precipitator (June 2011)

MS Word 232 KB | PDF 133 KB

BWP AQ Selective Catalytic Reduction (June 2011)

MS Word 228 KB | PDF 116 KB

BWP AQ Scrubber (June 2011)

MS Word 364 KB | PDF 156 KB

BWP AQ Sorbant/Reactant Injection Technology (June 2011)

MS Word 216 KB | PDF 86 KB

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BWP AQ 04 (ANF-001) - Asbestos Removal Notification (November 2010)

Filing options: | MS Word Form 433 KB | PDF Form 175 KB
Instructions: eDEP | MS Word 267 KB | PDF - included with form above

BWP AQ 05 - Application for Asbestos Blanket - Form and Guidance (February 2003)

Filing options: MS Word Form 143 KB | PDF Form 35 KB
Instructions: MS Word 25 KB | PDF - included with form above

BWP AQ 06 - Construction/Demolition Notification (June 2004)

Filing options: | MS Word Form 156 KB | PDF Form 120 KB
Instructions: eDEP | MS Word 163 KB | PDF - included with form above

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Note: Instructions for submitting completed forms through the CO2 Allowance Tracking System (COATS) of the Regional Greenhouse Gas Initiative are included in each document.

Landfill Methane Capture & Destruction - Consistency Application (June 2009)

Form: MS Word 285 KB | PDF 125 KB
Instructions: MS Word 130 KB | PDF 56 KB

Landfill Methane Capture & Destruction - Monitoring & Verification Report (June 2009)

Form: MS Word 300 KB | PDF 138 KB
Instructions: MS Word 101 KB | PDF 41 KB

Reduction in Emissions of Sulfur Hexafluoride (SF6) - Consistency Application (June 2009)

Form: MS Word 307 KB | PDF 129 KB
Instructions: MS Word 135 KB | PDF 73 KB

Reduction in Emissions of Sulfur Hexafluoride (SF6) - Monitoring & Verification Report (June 2009)

Form: MS Word 287 KB | PDF 135 KB
Instructions: MS Word 73 KB | PDF 38 KB

Sequestration of Carbon Due to Afforestation - Consistency Application (June 2009)

Form: MS Word 330 KB | PDF 134 KB
Instructions: MS Word 235 KB | PDF 79 KB 

Sequestration of Carbon Due to Afforestation - Monitoring & Verification Report (June 2009)

Form: MS Word 290 KB | PDF 123 KB
Instructions: MS Word 125 KB | PDF 54 KB

Avoided Methane Emissions from Agricultural Manure Management Operations - Consistency Application (June 2009)

Form: MS Word 287 KB | PDF 129 KB
Instructions: MS Word 544 KB | PDF 267 KB

Avoided Methane Emissions from Agricultural Manure Management Operations - Monitoring & Verification Report (June 2009)

Form: MS Word 367 KB | PDF 145 KB
Instructions: MS Word 116 KB | PDF 54 KB

Reduction or Avoidance of CO2 Emissions Due to End-Use Energy Efficiency in the Building Sector - Consistency Application (June 2009)

Form: MS Word 479 KB | PDF 137 KB
Instructions: MS Word 268 KB | PDF 184 KB

Reduction or Avoidance of CO2 Emissions Due to End-Use Energy Efficiency in the Building Sector - Monitoring & Verification Report (June 2009)

Form: MS Word 297 KB | PDF 124 KB
Instructions: MS Word 149 KB | PDF 85 KB

Offset Verifier Application for Accreditation (July 2009)

Form: MS Word 128 KB | PDF 53 KB

Accredited Offset Verifier Pre-Engagement Disclosure Submittal (July 2009)

Form: MS Word 64 KB | PDF 39 KB

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BWP AQ 08 - Emission Control Plans (March 2002)

Filing options: MS Word Form 697 KB | PDF Form 121 KB
Instructions: MS Word 298 KB | PDF - included with form above

BWP AQ 22 - Municipal Waste Combustor - Emission Control Plan (ECP) (March 2002)

Filing options: MS Word 652 KB | PDF Form 112 KB
Instructions: MS Word Form 265 KB | PDF - included with form above

BWP AQ 25 - Emission Standards for Power Plants - Emission Control Plan ECP (November 2001)

Filing options: MS Word Form 153 KB | PDF Form 78 KB
Instructions: MS Word 248 KB | PDF - included with form above

BWP AQ 29 - Clean Air Interstate Rule (CAIR) Permit (July 2007)

Filing options: MS Word Form 186 KB | PDF Form 172 KB
Instructions: MS Word 250 KB | PDF - included with form above

BWP AQ 30 - CO2 Budget Emission Control Plan

See the Emissions Trading section of this web page.

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Carbon Dioxide (CO2) Emission Banking, Trading & Averaging Program Home Page

Web page

BWP AQ 18 - Creation of Emission Reduction Credits (ERC) (March 2008)

Filing options: MS Word Form 215 KB | PDF Form 579 KB
Instructions: MS Word 189 KB | PDF - included with form above

BWP AQ 26 - Public Benefit Set Aside NOx Allowance (April 2011)

Filing options: MS Word Form 284 KB | PDF Form 223 KB
Instructions: MS Word 160 KB | PDF - included with form above

Application for Award of Early Reduction CO2 Allowances (Regional Greenhouse Gas Initiative, April 2009)

Filing Options: MS Word Form 207 KB | PDF Form 75 KB

Greenhouse Gas (GHG) Credit Account Application/Revision (October 2006)

Filing options: MS Word Form 151 KB | PDF Form 27 KB

Greenhouse Gas (GHG) Credit Transfer Application (June 2008)

Filing options: MS Word Form 74 KB | PDF Form 22 KB

BWP AQ 27 - Application of Certification of Greenhouse Gas (GHG) Credits (October 2006)

Filing options: MS Word Form 368 KB | PDF Form 185 KB
Instructions: MS Word 102 KB | PDF - included with form above

BWP AQ 28 - Application of Verification of Greenhouse Gas (GHG) Credits (October 2006)

Filing options: MS Word Form 371 KB | PDF Form 183 KB
Instructions: MS Word 102 KB | PDF - included with form above

Related: Certification of Transfer of Carbon Credits (July 2008)
MS Word 131 KB | PDF 30 KB

BWP AQ 30 - CO2 Budget Emission Control Plan (June 2008)

Filing options: MS Word Form 255 KB | PDF Form 149 KB
Instructions: MS Word 278 KB | PDF - included with form above

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Environmental Results Program

Compliance certification is required for new emergency and non-emergency engines and turbines.
Web page

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BWP AQ 09 - Permit Restrictions (Restricted Emissions Status or RES) (May 2002)

Filing options: MS Word Form 439 KB | PDF Form 270 KB
Instructions: MS Word 343 KB | PDF - included with form above

Emissions Notification Form: 50% or 25% Facility Emissions Cap (May 2008)

Filing options: MS Word Form 130 KB | PDF Form 142 KB
Instructions: MS Word 159 KB | PDF - included with form above

Workbook for Annual Emissions Reporting & On-Site Record Keeping (March 2010)

Owners/operators of facilities with restricted emissions status (including facilities with 25% or 50% emissions cap status) are required to keep on-site records documenting emissions. The interactive Microsoft Excel Workbook below can be used for that purpose, and can also be submitted to MassDEP to fulfill annual reporting requirements. Facilities with 25% or 50% emissions caps are not required to submit annual reports unless specifically directed to do so. The Excel Workbook is designed to be completed electronically, and will automatically populate all reporting dates and calculate 12-month rolling totals as monthly emissions values are entered.

Instructions
Web page

Workbook
MS Excel 373 KB

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Greenhouse Gas Emissions Reporting Program

Web page

Electronic GHG Emissions Reporting

Log in to this system to report your Massachusetts facility's GHG emissions per 310 CMR 7.71(5).



Related: Facilities Required to Report GHG Emissions
Web page

BWP AQ 31 - Optional Greenhouse Gas Emissions Reporting Form for Retail Sellers of Electricity (May 2011)

Filing options: MS Word Form 246 KB | PDF Form 148 KB
Instructions: MS Word 205 KB | PDF - included with form above

BWP AQ 32 - Mandatory Greenhouse Gas Emissions Reporting Form for Retail Sellers of Electricity (December 2010)

Filing options: MS Word Form 100 KB | PDF Form 62 KB
Spreadsheet for Calculating Total Megawatt Hours & GHG Emissions: MS Excel 35 KB
Instructions: MS Word 160 KB | PDF - included with form above

Background & Supporting Information
Web page

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Greenhouse Gas Emissions Reporting Program: GHG Emissions Verification

Web page

Application for Verification Body Recognition (January 2011)

MS Word 148 KB | PDF 96 KB

Verification Body Conflict of Interest Assessment Form (June 2011)

MS Word 164 KB | PDF 34 KB

GHG Emissions Verification Statement (June 2011)

MS Word 68 KB | PDF 18 KB

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Massachusetts Operating Permit & Compliance Program

Web page

BWP AQ 10 - Operating Permit Minor Modification (March 2005)

Filing options: MS Word Form 395 KB | PDF Form 146 KB
Instructions: MS Word 302 KB | PDF - included with form above

BWP AQ 11 - Operating Permit Administrative Amendment (January 2003)

Filing options: MS Word Form 135 KB | PDF Form 100 KB
Instructions: MS Word 215 KB | PDF - included with form above

BWP AQ 12 - Operating Permit Renewal (January 2003)

Filing options: MS Word Form 227 KB | PDF Form 140 KB
Instructions: MS Word 302 KB | PDF - included with form above

BWP AQ 13 - Operating Permit Significant Modification (January 2003)

Filing options: MS Word Form 196 KB | PDF Form 167 KB
Instructions: MS Word 308 KB | PDF - included with form above

BWP AQ 14, 15, 16, 17 - Group A, B, C, Operating Permits (November 2005)

Filing options: MS Word Form 753 KB | PDF Form 523 KB
Instructions: MS Word 929 KB | PDF - included with form above

BWP AQ Operating Permit Supplemental Information/Documentation (August 2010)

Supplemental Application Information:
MS Word 219 KB | PDF 37 KB

Application Activity Cover Sheet:
MS Word 124 KB | PDF 63 KB

BWP AQ Operating Permit Reporting Kit

Instructions (January 2003)

MS Word 316 KB | PDF 135 KB

Operating Permit Deviation Report (January 2003)

MS Word 167 KB | PDF 64 KB

Cross Reference Form (January 2003)

MS Word 153 KB | PDF 52 KB

Compliance Report (January 2003)

MS Word 309 KB | PDF 62 KB

Semi-Annual Compliance Monitoring Summary & Certification (September 2011)

MS Word443 KB | PDF 45 KB

Annual Compliance Certification & Report (September 2011)

MS Word 355 KB | PDF 40 KB

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Note: Facility owner/operators can seek local property tax exemptions for air pollution equipment they install and MassDEP certifies to be reducing industrial emissions to acceptable levels.

BWP AQ TAX: Application & Affidavit for Property Tax Exemption Certification (February 2011)

Filing Options: MS Word Form 100 KB | PDF Form 63 KB
Guidance/Instructions: MS Word 60 KB | PDF 48 KB

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Guidance on Complying with 310 CMR 7.16: Massachusetts Rideshare Regulation (October 2011)

MS Word 106 KB | PDF 53 KB

Base Report (October 2011)

Filing options: MS Word 263 KB | PDF 168 KB

 

Update Report Short Form (November 2009)

NOTE: Please call 617-292-5663 to determine eligibility to use this form.
Filing options: MS Word 237 KB | PDF 155 KB

Update Report Long Form (October 2011)

NOTE: Please call 617-292-5663 to determine eligibility to use this form.
Filing options: MS Word 282 KB | PDF 171 KB

Guidance on Collecting Commute Data for Rideshare Reporting (October 2011)

An overview of the three methods that can be used to meet Massachusetts Rideshare Program requirements.
MS Word 160 KB | PDF 110 KB

Summary Commute Data Forms (October 2011)

Filing options: MS Word 204 KB | PDF 170 KB

Employee Commute Survey Form (October 2011)

Filing options: MS Word 70 KB | PDF 16 KB

Student Commute Survey Form (October 2011)

Filing options: MS Word 72 KB | PDF 16 KB

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Now Available:

eDEP online filing of Source Registrations now replaces both the existing AP forms for new sources and the side-by-side computer printouts used in previous years for annual and triennial emissions reporting.

See the Source Registration page for more information or to access your forms.

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Stage II Vapor Recovery Program Information

Web page

Certification & Notifcation Forms

Web page

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