Form PERF Portable Equipment Relocation Form (Perf) - Idaho

Form PERF or the "Portable Equipment Relocation Form (perf)" is a form issued by the Idaho Department of Environmental Quality.

The form was last revised in November 7, 2017 and is available for digital filing. Download an up-to-date Form PERF in PDF-format down below or look it up on the Idaho Department of Environmental Quality Forms website.

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Form PERF
Portable Equipment Relocation Form (PERF) -
DEQ AIR QUALITY PROGRAM
1410 N. Hilton, Boise, ID 83706
11/07/2017
Form must be submitted ten (10) days before plant is relocated. (IDAPA 58.01.01.500.01)
Facility Information
1. Facility Name:
(This number can be found on the first page of your DEQ permit/PBR.)
2. Facility ID Number:
3. Mailing Address (street/city/state/zip):
5. Facility Contact Phone:
4. Facility Contact Name & Title:
6. Responsible Official Name & Title:
7. Responsible Official Signature:
Date:
In accordance with IDAPA 58.01.01.123 (Rules for the Control of Air Pollution in Idaho), by signing, I certify based on information
and belief formed after reasonable inquiry, the statements and information in this document(s) are true, accurate, and complete.
(The responsible official is defined in IDAPA 58.01.01.006.99.)
Equipment
Rock Crusher
Concrete Batch
Other
Hot Mix Asphalt
8. Plant Type:
If Other, Describe:
Permit
Operating Permit (OP)
9. Permit Type:
Permit To Construct (PTC)
Permit By Rule (PBR)
Exempt
None
10. Permit / PBR Number:
11. Date Issued:
Current Location
12. Current Idaho County:
13. Nearest City:
Latitude:
Longitude:
14. GPS Coordinates (Decimal Degrees):
15. Describe Current Location:
In Storage/Idle
Out Of State
Other
If Other, Describe:
16. How long has plant operated at current location?
New Location
17. New Idaho County:
18. Nearest City:
Latitude:
Longitude:
19. GPS Coordinates (Decimal Degrees):
20. Describe New Location:
In Storage/Idle
Out Of State
Other
If Other, Describe:
21. Estimated Start Date:
22. Estimated End Date:
Additional Information
SUBMIT:
via E-mail:
or via FAX:
or via Mail:
aqperf@deq.idaho.gov
208-373-0340
Air Quality - PERF Processing
Subject: PERF Submittal
To: Air Quality Program
Dept. of Environmental Quality
Print Form
Complete form, sign it, and
Regarding: PERF Submittal
1410 North Hilton
attach to E-mail
Boise, ID 83706-1255
Page 1 of 1
Form PERF
Portable Equipment Relocation Form (PERF) -
DEQ AIR QUALITY PROGRAM
1410 N. Hilton, Boise, ID 83706
11/07/2017
Form must be submitted ten (10) days before plant is relocated. (IDAPA 58.01.01.500.01)
Facility Information
1. Facility Name:
(This number can be found on the first page of your DEQ permit/PBR.)
2. Facility ID Number:
3. Mailing Address (street/city/state/zip):
5. Facility Contact Phone:
4. Facility Contact Name & Title:
6. Responsible Official Name & Title:
7. Responsible Official Signature:
Date:
In accordance with IDAPA 58.01.01.123 (Rules for the Control of Air Pollution in Idaho), by signing, I certify based on information
and belief formed after reasonable inquiry, the statements and information in this document(s) are true, accurate, and complete.
(The responsible official is defined in IDAPA 58.01.01.006.99.)
Equipment
Rock Crusher
Concrete Batch
Other
Hot Mix Asphalt
8. Plant Type:
If Other, Describe:
Permit
Operating Permit (OP)
9. Permit Type:
Permit To Construct (PTC)
Permit By Rule (PBR)
Exempt
None
10. Permit / PBR Number:
11. Date Issued:
Current Location
12. Current Idaho County:
13. Nearest City:
Latitude:
Longitude:
14. GPS Coordinates (Decimal Degrees):
15. Describe Current Location:
In Storage/Idle
Out Of State
Other
If Other, Describe:
16. How long has plant operated at current location?
New Location
17. New Idaho County:
18. Nearest City:
Latitude:
Longitude:
19. GPS Coordinates (Decimal Degrees):
20. Describe New Location:
In Storage/Idle
Out Of State
Other
If Other, Describe:
21. Estimated Start Date:
22. Estimated End Date:
Additional Information
SUBMIT:
via E-mail:
or via FAX:
or via Mail:
aqperf@deq.idaho.gov
208-373-0340
Air Quality - PERF Processing
Subject: PERF Submittal
To: Air Quality Program
Dept. of Environmental Quality
Print Form
Complete form, sign it, and
Regarding: PERF Submittal
1410 North Hilton
attach to E-mail
Boise, ID 83706-1255
Page 1 of 1

Download Form PERF Portable Equipment Relocation Form (Perf) - Idaho

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