Fillable TRANSFER OF OWNERSHIP & PERMIT/REGISTRATION REQUIREMENTS Current Stationary (City of Albuquerque New Mexico)

Fill Online, Printable, Fillable, Blank TRANSFER OF OWNERSHIP & PERMIT/REGISTRATION REQUIREMENTS Current Stationary (City of Albuquerque New Mexico) Form

Use Fill to complete blank online CITY OF ALBUQUERQUE NEW MEXICO (NM) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

TRANSFER OF OWNERSHIP & PERMIT/REGISTRATION REQUIREMENTS Current Stationary (City of Albuquerque New Mexico)

On average this form takes 16 minutes to complete

The TRANSFER OF OWNERSHIP & PERMIT/REGISTRATION REQUIREMENTS Current Stationary (City of Albuquerque New Mexico) form is 2 pages long and contains:

  • 1 signature
  • 0 check-boxes
  • 61 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Albuquerque New Mexico

BROWSE CITY OF ALBUQUERQUE NEW MEXICO (NM) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Albuquerque Environmental Health Department, Air Quality Division
P. O.
Box 1293, Albuquerque, New Mexico 87103 (Suite 3047, One Civic Plaza, Albuquerque, NM, 87102)
(505) 768-1972 1-800-659-8331 (TTY) (505) 768-1977 (Fax)
TRANSFER OF OWNERSHIP & PERMIT/REGISTRATION REQUIREMENTS
Version: 09/09
Current Stationary Source Facility Name(s)
Authority to Construct or Registration Number(s)
Stationary Source Location
Effective Date of Transfer
Current Owner of the Permit(s) or Registration(s)
Current Responsible Official
New Owner of the Permit(s) or Registration(s)
New Responsible Official
Contact Number of New Responsible Official
NOTICE: All terms and conditions of the transferred permit(s) and registration(s) still apply. Upon signing below the new owner will be
subject to the terms of the permit(s) or registration(s). All applicable Albuquerque-Bernalillo County Air Quality Control Regulations, whether
listed in permit(s) and registration(s) or not, will apply. In addition, the new owner or certificate holder shall be liable for violations of the
Permit(s) or Registration(s) before the date of transfer. The new owner shall comply with all permit conditions, including pending applications
associated with the stationary source and financial responsibilities. The individual who signs below on behalf of the new owner verifies that
the transfer will not result in a change in operation of the stationary source. The new owner shall maintain the Facility in compliance with the
Air Quality Control Act and the laws and regulations in force pursuant to the Act.
For permitted sources, submit a fee for an Administrative Modification to an existing permit (20.11.2.18.G. NMAC).
Current Permit/Registration Owner (Pre-Transfer)
Company Name of Current Owner
Name, Title Date
Address City State Zip Code Telephone Number
I certify I am authorized to bind the current permit owner or registration holder and that the statements and information in and attached to this
document are true, accurate, and complete.
, ,
Signature Title Date
New Permit/Registration Owner
Company Name of New Owner
Name, Title Date
Address City State Zip Code Telephone Number
I certify I am authorized to bind the current permit owner or registration holder and that the statements and information in and attached to this
document are true, accurate, and complete. The new owner hereby accepts the conditions set out in the “NOTICE” paragraph above and the
assignment of the above described stationary source permit(s) and registration(s) from the current owner
.
, ,
Signature Title Date
FOR OFFICIAL USE ONLY
Transfer Signed and Approved By Date:
Version: 09/09
New Owner or Operator Identification Information (Complete one for Each Facility)
Facility Name
Physical Address
Mailing Address
UTM coordinates: east north
Company Name
Company Address
Phone:
Fax: Email:
Mailing Address (if different)
Operator (if different from owner)
Mailing Address
Phone:
Fax: Email:
Facility Contact
Phone: Fax: Email:
Authorized Representative
Mailing Address
Phone: Fax: Email:
Responsible Official
Mailing Address
Phone: Fax: Email:
Billing Contact
Mailing Address
Phone: Fax: Email:
I
P
certify that the statements and information in and attached to this document are true, accurate, and complete.
rinted Name:
Title:
esponsible Official Signature: _________________________________ Date: _____________
R
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

TRANSFER OF OWNERSHIP & PERMITREGISTRATION REQUIREMENTS Current Stationary (City of Albuquerque New Mexico)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 9 February 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document