Air Compliance Assurance Forms
Access various compliance reporting forms which provide systematic communication between DEEP and the regulated community.Fillable PDF forms may not open properly in some browsers. If you are unable to open a fillable PDF form, follow these steps: download the file to your computer by right clicking on the PDF link and selecting "Save Target As..." or "Save Link As..." open the downloaded PDF form in Adobe Acrobat Reader complete the form using Adobe Acrobat Reader save the completed form (in Adobe Acrobat Reader - File > Save As > PDF) For additional guidance, visit Tips for Viewing and Using Fillable PDF.
Asbestos Demolition and Renovation
Additional Information
Title V Notification for Asbestos Demolition and Renovation for DEEP
Description
Title V sources must submit an Asbestos Demolition/Renovation Notification to DEEP, at least 10 days prior to any demolition or renovation activity, to the following address:- Asbestos Demo/Reno Notifications
- Compliance Analysis & Coordination Unit
- Bureau of Air Management
- Connecticut Department of Energy and Environmental Protection
- 79 Elm Street
- Hartford, CT 06106-5127
Attachments
- None
Non-Title V Notification for Asbestos Demolition and Renovation for EPA
Description
Sources that have not obtained or are not required to obtain a Title V operating permit from DEEP must submit a Notification of Demolition and Renovation to EPA, at least 10 days prior to any demolition or renovation activity, to the following address:- Asbestos Demo/Reno Notifications
- U.S. EPA Region 1
- 5 Post Office Square
- Mail Code: OES05-4
- Boston, MA 02109-3912
Attachments
- None
Combined Heat and Power (CHP)
Combined Heat and Power (CHP) Notification |
Description
Any person intending to operate a Combined Heat and Power (CHP) system pursuant to §22a-174-3d is required to submit a notification to DEEP no later than 30 days after beginning actual construction.Attachments
- None
Emissions and Opacity Monitoring
Continuous Emissions Monitoring (CEM) |
Description
Owners or operators of a stationary source required to install and operate a continuous emissions monitoring system (CEMS) are also required to submit to DEEP written reports no later than thirty (30) days following the end of each calendar quarter. For more information refer to the §22a-174-4.Attachments
- None
Continuous Opacity Monitoring (COM) |
Description
Owners or operators of a stationary source required to install and operate a continuous opacity monitoring system (COMS) are also required to submit to DEEP written reports no later than thirty (30) days following the end of each calendar quarter. For more information refer to the form instructions and §22a-174-4.Attachments
- None
Emissions Inventory (EMIT)
Electronic Signature Application and Subscriber Agreement |
Description
The Electronic Signature Application and Subscriber Agreement allows permitted sources to submit electronic documents to DEEP through EMIT (Emissions Inventory Reporting System), Connecticut's web based Emissions Reporting application. GPLPE and Title V sources are required to submit compliance related reports using EMIT. For more information refer to Emissions Inventory. Need help with EMIT? Call the EMIT Helpline at (860) 424-3882 or e-mail deep.bam.ts@ct.gov.Attachments
Emissions Reduction and Trading
Account Certificate of Representation |
Description
Sources operating under the CO2 Budget Trading Program (§22a-174-31) are required to have a CO2 authorized account representative. An account certificate of representation application must be submitted to DEEP before a CO2 Allowance Tracking System account is established for a source.Attachments
- None
Discrete Emission Reduction Credits
Description
Under the NOx Trading Agreements and Orders issued pursuant to §22a-174-22(j), by DEEP, a subject source is required to submit reports of discrete emission reduction credit (DERC) use, averaging, creation and sales for the previous calendar year or as required by permit or order, whichever is more stringent.For more information refer to Emission Reduction Credits.
Attachments
- None
Fuel Use and Hours of Operation
Fuel Use Tracking for External Combustion Units
Description
Owners or operators of an external combustion unit electing to operate under §22a-174-3b(c) may do so, in part, by restricting and maintaining records of the unit's fuel use. The Fuel Use Tracking form may be used to comply with the fuel use record creation and maintenance requirements of §22a-174-3b(c) for an external combustion unit.
Attachments
- None
Hours of Operation Tracking for Emergency Engines
Description
Owners or operators of an emergency engine electing to operate under §22a-174-3b(e) may do so, in part, by restricting and maintaining records of the unit's hours of operation. The Hours of Operation Tracking form may be used to comply with the hours of operation record creation and maintenance requirements of §22a-174-3b(e) for an emergency engine.
Attachments
- None
Notification of Operation and/or Cessation of Operation Under RCSA §22a-174-33a & 3b
Notification of Operation Under RCSA §22a-174-33a
Notification to Cease Operation Under RCSA §22a-174-33a
22a-174-33a Annual Compliance Certification Form
Description
Owners or operators of a stationary source may elect to limit potential emissions below major source thresholds by operating in accordance with the provisions of RCSA §22a-174-33a- Limit on Premises-Wide Actual Emissions Below 50% of Title V Source Thresholds. Any owner or operator committing to operate a premises pursuant to RCSA §22a-174-33a is required to submit notification to the commissioner, on forms provided by the commissioner. Any owner or operator electing to operate under RCSA §22a-174-33a shall comply with all conditions and applicable requirements of the section until such time the owner or operator submits a notification to the commissioner, on forms provided by the commissioner, that they are ceasing to operate a premises pursuant to the section.
Attachments
Notification of Operation Under RCSA §22a-174-33b
Notification to Cease Operation Under RCSA §22a-174-33b
22a-174-33b Annual Compliance Certification Form
22a-174-33b Annual Emission Summary Form
Description
Owners or operators of a stationary source may elect to limit potential emissions below major source thresholds by operating in accordance with the provisions of RCSA §22a-174-33b- Limit on Premises-Wide Actual Emissions Below 80% of Title V Source Thresholds. Any owner or operator committing to operate a premises pursuant to RCSA §22a-174-33b is required to submit notification to the commissioner, on forms provided by the commissioner. Any owner or operator electing to operate under RCSA §22a-174-33b shall comply with all conditions and applicable requirements of the section until such time the owner or operator submits a notification to the commissioner, on forms provided by the commissioner, that they are ceasing to operate a premises pursuant to the section.
Attachments
Nitrogen Oxides (NOx) Reduction and Control
Phase 2 Case-by-Case NOx RACT Application
Description
Owners or operators of fuel-burning equipment at major stationary sources of NOx may request a case-by-case RACT determination pursuant to §22a-174-22e by submitting to DEEP a complete Case-by-Case NOx RACT application with the requisite attachments.
Attachments
- Attachment A - Emission Unit Information
- Attachment B - Feasibility of Control Alternatives and Compliance Options
- Attachment C - Effectiveness of Feasible Control Alternatives
- Attachment D - Cost and Cost Effectiveness of Feasible Control Alternatives and Compliance Options
- Attachment E - Recommendation of Case-by-Case NOx RACT
- Attachment F - Certification of Notice
Phase 2 NOx Compliance Option Application
Description
Owners or operators of fuel-burning equipment at major stationary sources of NOx requesting the use of a compliance option pursuant to §22a-174-22e must submit a Compliance Option Application with the requisite attachments.
Attachments
Pre-Inspection Questionnaire (PIQ)
Pre-Inspection Questionnaire (PIQ)
Description
A questionnaire sent by DEEP staff to sources of air emissions prior to an on-site compliance evaluation. A completed PIQ is a resource used to assist staff both during and after an on-site compliance evaluation.
Attachments
Stack and CEMS Performance Testing
Intent to Test Form for Compliance Emissions Testing
Description
Owners or operators of sources required to conduct stack or performance testing, pursuant to state and delegated federal standards, must notify DEEP by submitting a completed ITT Form for Compliance Emissions Testing, and protocol (where required) within the timelines specified in the Test Guidelines.
A report of the test results with a completed Compliance Certification for Emissions Test Results Form, and all supporting documents, must also be submitted to DEEP within the deadline specified in the Test Guidelines.
All emissions testing must be conducted in accordance with procedures prescribed by or acceptable to DEEP as set forth in the revised Source Emissions Monitoring Test Guidelines. For more information refer to Stack and CEMS Performance Testing.
Attachments
Intent to Test Form for CEMS Relative Accuracy Test Audit
Description
Owners or operators of sources with Continuous Emissions Monitoring (CEM) systems, required to pass quarterly testing audits including relative accuracy test audits (RATA), must notify DEEP by submitting a completed ITT Form for CEMS RATA within the timelines specified in the Test Guidelines.
A report of the test results with a completed Compliance Certification for CEMS RATA Results Form, and all supporting documents, must also be submitted to DEEP within the deadline specified in the Test Guidelines.
All RATAs must be conducted in accordance with procedures prescribed by or acceptable to DEEP as set forth in the revised Source Emissions Monitoring Test Guidelines. For more information refer to Stack and CEMS Performance Testing.
Attachments
Intent to Test Form for Visible Emissions
Description
Owners or operators of sources required to conduct visible emissions testing, pursuant to state and delegated federal standards, must notify DEEP by submitting a completed ITT Form for Visible Emissions Testing within the timelines specified in the Test Guidelines.
All emissions testing must be conducted in accordance with procedures prescribed by or acceptable to DEEP as set forth in the revised Source Emissions Monitoring Test Guidelines. For more information refer to Stack and CEMS Performance Testing.
Attachments
- None
Stage I and Stage II
Certification Report for Decommissioned Stage II |
Description
A Certification Report for a Decommissioned Stage II Vapor Recovery System is required, pursuant to section 22a-174e of the CT General Statutes, for owners or operators of Gasoline Dispensing Facilities (GDF) to demonstrate that the Stage II vapor recovery system has been decommissioned as required.
For more information refer to Gasoline Dispensing Facilities.
Attachments
Intent to Decommission |
Description
An Intent to Decommission form is used by owners or operators of a Gasoline Dispensing Facility (GDF) to notify DEEP, at least 30 days prior to the start, of the decommissioning of a Stage II vapor recovery system. Once decommissioning is initiated it must be completed within 100 days.
For more information refer to Gasoline Dispensing Facilities.
Attachments
- None
Pressure Decay Test Notification |
Description
A Pressure Decay Test Notification is used to notify DEEP of the time and location of a pressure decay test, at least 7 business days before the start of the test.
For more information refer to Gasoline Dispensing Facilities.
Attachments
- None
Stage I Vapor Recovery Test Results Report
Description
Owners or operators of a Gasoline Dispensing Facility (GDF) are required to conduct pressure decay, vapor space tie-in, and P/V vent valve tests at least once per calendar year. A completed Stage I Vapor Recovery Test Results Report must be submitted to DEEP no later than 10 days after testing.
For more information refer to Gasoline Dispensing Facilities.
Attachments
- None
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Content Last Updated: January 3, 2022