BAY AREA AIR QUALITY MANAGEMENT DISTRICT
AUTOBODY FORM
This form replaces Data Form C & Data Form S.
Use one form for each operation requiring a Permit to Operate.
All fields are required unless otherwise noted. Please type or print.
Mail to:
BAAQMD
Engineering Division
375 Beale St., Suite 600
San Francisco, CA 94105
Tel: (415) 749-8665
Page 1 of 1 An electronic version of this form and instructions can be found at www.baaqmd.gov. v06/2018
1. Facility Information
Facility Name
BAAQMD Facility ID (Existing facility only)
Facility Address (Street address and city)
2. General Information
Device/Operation Name (The name how you want the device to be identified)
Device/Operation Description (Optional)
Is this device currently operating? Yes No
If yes, what was the initial date of operation?
(MM/DD/YYYY)
If no, what is the estimated startup date?
(MM/DD/YYYY)
Does this Auto Body coating operation ever use a dryer? Yes No
3. Material Used List the annual solvent usage (estimate for new facilities).
Amount (Gallons/Year)
*If no clean up solvents are used, leave bank.
4. Payment Submit payment with your forms.
Pay by credit card or check. Please make your checks payable to "BAAQMD". For credit card payments, fill out and submit a
Credit Card Payment Form” which is available on the BAAQMD website.
You will be invoiced separately for any adjustments. See BAAQMD Regulation 3, Schedule E for current fees.
5. Certification/Signature of person responsible for the information on this form.
This form contains confidential information. No Yes (If Yes, see instructions.)
I hereby certify that I am authorized to complete this form for the facility and that all information contained herein is true
and correct.
Name
Title
Signature
Date
Phone (xxx) xxx-xxxx
BAAQMD Office Use Only Skip this section
Device ID
Emissions Train, if any
BAY AREA AIR QUALITY MANAGEMENT DISTRICT
BAAQMD
Engineering Division
375 Beale St., Suite 600
San Francisco, CA 94105
Page 1 of 2 v06/2018
Instructions: Autobody Form
Introduction
Use the following instructions to help guide you through the Autobody form.
Who should use
this form?
This form should be submitted for all requested physical changes proposed for your
Autobody Facility. Some common physical changes include but are not limited to:
Adding a spray booth
Increasing solvent consumption
A Permit Application Cover form must accompany this form
What activities
at Autobody
facilities do not
require this
form?
The following activities at Autobody facilities do not require a permit application:
Shutdown of a spray booth (please use the Facility Information Update form)
Autobody facilities typically do not require CEQA or PSD analysis.
Facility
Information
BAAQMD Facility ID - If you are an existing facility, fill out this field so that BAAQMD
can associate your changes to your facility. The facility ID is available on your permit or
invoice issued by BAAQMD.
General
Information
Device/Operation Name This is the name you associate to this spray booth.
Initial/proposed date of operation For new construction, enter the date that you
propose will be the initial date of operation. For a modification/alteration of an existing
permitted Autobody source, enter the date that you propose the changes to occur. For
an existing Autobodies that are not currently permitted by BAAQMD, enter the date for
which the spray booth initially operated.
Device or Operation Description This is your description of the device or operation.
This field can be used to distinguish it with other similar devices (e.g. ID numbers,
location), make, model and other similar information.
Material Used
List the amount of solvent used at the Autobody facility. For new facilities, use an
estimate of anticipated solvent consumption.
BAY AREA AIR QUALITY MANAGEMENT DISTRICT
BAAQMD
Engineering Division
375 Beale St., Suite 600
San Francisco, CA 94105
Page 2 of 2 v06/2018
Payment
An Initial fee, Permit to Operate fee and Filing fee must be paid. Additional fees may
apply and are subject to change. Please refer to Regulation 3, Schedule E Fees for
more details. The table below lists the most common fees depending on solvent and
clean up solvent consumption:
Coating Applied (gallons)/Clean up Solvent Consumption (gallons)
2000/300
$1584
800/300
Initial Fee $922
Permit to Operate Fee $577
$789
Filing Fee $489 $489
TOTAL TOTAL
$1988* $2862*
* A Risk Screening Fee may apply for new and modified sources of toxic air contaminants for which a health
risk screening analysis is required under Regulation 2-5-401.
Fees can be paid by check or credit card (Visa & Mastercard).
Still need help? Call the Engineering Division at (415) 749-8665.