Boilers (Old Form Do Not Use)
Air Emissions Inventory for Calendar Year as listed in Emissions Inventory Year below, for Boilers.

Before starting to complete this form be sure to have your permit number and the total hours of operation available.  If you have more than one boiler you should make sure that the Unit ID matches the identification given in your permit.  You will complete this form once for each boiler at your facility.  If you have multiple permits, be sure that the permit number matches each boiler.

When you have filled in the required fields click "Submit" at the bottom of the form to send us your data.  If you have multiple permits or multiple units per permit you will complete this for each unit.  When you complete the form for the first one, and submit it, there is an option to "return to the form."  You can then enter the next unit for each permit, then go on to the next permit.

If your permit requires additional reporting documentation, this documentation can be attached when completing your emissions inventory report.

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Emissions Inventory Year *
List calendar year (yyyy) of data being reported
Permit # *
This must match the most recent permit issued by AQD.
Facility Name *
Your facility name as it appears on your permit
Facility Address *
The street address of your facility.
Facility - City, State, Zip Code *
The city, state, and zip code of your facility.
Facility Phone Number *
The phone number of your facility.
Boiler Unit ID *
If the permit has more than one unit, one form per unit will need to be completed
Annual Operating Hours *
The total hours of operation for the calendar year.
Contact First and Last Name *
This is the name of the person filling out this emissions inventory form. The responsible official will need to sign the hard copy document after this form has been submitted.
E-mail Address *
Please enter your email address for confirmation and future contact
Is there more than one process equipment listed in this permit for which additional emission inventory forms need to be submitted?
Is this form a corrected version of a previous submittal?
Submit
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