South Coast Air Quality Management District, Form 200-D (2019.07)
Mail To:
South Coast AQMD - Billing Services
P.O. Box 4943
Diamond Bar, CA 91765-0943
Tel: (909) 396-2900
www.aqmd.gov
South Coast Air Quality Management District
Form 200-D
Request to Reinstate Expired Application or Permit to Operate
1. FACILITY NAME 2. ID NUMBER
3. EQUIPMENT LOCATION ADDRESS 4. PHONE NUMBER
Street Address
City State Zip Code Area Code
5. REQUEST IS HEREBY MADE TO REINSTATE THE APPLICATION(S) OR PERMIT(S) TO OPERATE THE FOLLOWING EQUIPMENT:
6. GRAND TOTAL DUE
(Include payment with this form) $
7. SIGNATURE OF RESPONSIBLE OFFICIAL 8. PRINT NAME 9. DATE
CA
THE REINSTATEMENT SURCHARGE IS IN ADDITION TO THE EXPIRED FEE AND IS 50% OF THE FEE DUE AT THE TIME THE APPLICATION OR
PERMIT EXPIRED UP TO A MAXIMUM OF $256.71 PER EQUIPMENT FOR NON-TITLE V FACILITIES, OR $321.66 FOR TITLE V FACILITIES FOR
FISCAL YEAR 2019-20.
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Description Application # Permit #
Expired Fee
Reinstatement
Surcharge
Total
(a)
(b)
(a+b)
South Coast Air Quality Management District, Form 200-D (2019.07)
Page 2 of 2
P.O. Box 4943
Diamond Bar, CA 91765-0943
Tel: (909) 396-2900
www.aqmd.gov
South Coast Air Quality Management District
Form 200-D
Request to Reinstate Expired Application or Permit to Operate
REQUEST TO REINSTATE INSTRUCTIONS
1. Refer to the invoice to determine the amount of fees due for each application/permit.
2. Each request must be filled out completely and submitted to
South Coast AQMD, P.O. Box 4943, Diamond Bar, CA 91765-0943. ATTENTION: Billing Services.
*If more rows have to be completed, continue on a new form.
3. Each request must be signed by a responsible member of the organization.
4. Total fees due must accompany request.
For assistance in completing this Request to Reinstate, please call Billing Services at (909) 396-2900;
Within California, you may call toll free (866) 888-8838.
Excerpts from Rule 301 (Permit Fees)
An application or a Permit to Operate which has expired due to non-payment of fees may be reinstated by submitting a Request to
Reinstate the application or Permit to Operate accompanied by a 50% reinstatement surcharge as described in subdivision (g) of Rule
301 and payment in full of the amount of fees due at the time the application of Permit to Operate expired. Such request and payment
of such fees for an application or Permit to Operate which has expired must be made within one year of the date of expiration. If
the period of expiration has exceeded one year or the affected equipment has been altered, a new application will be required.
The reinstatement surcharge shall not exceed $256.71 per equipment for Non-Title V facilities and $321.66 for Title V facilities.
Operation of equipment without a permit subjects owner or operator to misdemeanor penalties for each day of operation. See Excerpts
from State Health and Safety Code: Division 26, Part 4, Article 3. Penalties
42400. Any person who violates any provision of this part, or any order, rule, or regulation of the state board or district adopted
pursuant to this part, is guilty of a misdemeanor. Every day during any portion of which such violation occurs constitutes a
separate offense.
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For permitted equipment not being renewed a “Request to Inactivate a Permit to Operate” Form 200-C must be completed.
Mail To:
South Coast AQMD - Billing Services
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