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.
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
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?
If no, what is the estimated startup date?
Does this Auto Body coating operation ever use a dryer? Yes No
3. Material Used – List the annual solvent usage (estimate for new facilities).
*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.
BAAQMD Office Use Only – Skip this section
