[ 52719 ] EE-01 EE/RE Set Aside NOx Allowance Application  [ PDF ] [ DOC ]
Program: Air Quality - Compliance and Enforcement
The purpose of this form is to obtain detailed information about the energy efficiency or renewable energy projects to calculate NOx allowance reservations.
[ 52720 ] EE-02 Ozone Control Period Notification of Results  [ PDF ] [ DOC ]
Program: Air Quality - Compliance and Enforcement
The purpose of this form is to obtain detailed information about actual electricity and other energy savings or electricity generation that occurred during the ozone season.
[ 52721 ] EE-03 EE/RE Set Aside Nox Allowance Reapplication  [ PDF ] [ DOC ]
Program: Air Quality - Compliance and Enforcement
The purpose of this form is to allow project sponsors to reapply for NOx allowances after an Initial NOx Allowance Application has been approved.
[ 53902 ] Voluntary Idling Pledge  [ PDF ]
Program: Air Quality - Programs
This form is used notify the Southwest Regional Office that you are establishing a voluntary idling program.
[ 50639 ] Air Permit Application Cover Sheet  [ DOC ]
Program: Air Quality - Permits
Cover sheet to obtain the core information needed to process the air permit application
[ 51607 ] Air Permit Application Form Checklist  [ DOC ]
Program: Air Quality - Permits
Checklist to help the applicant and IDEM, OAQ to ensure that the air permit application packet is administratively complete.
[ 50640 ] GSD-01 General Source Data - Basic Source Level Information  [ DOC ]
Program: Air Quality - Permits
Form to provide essential information about the entire source of air pollutant emissions.
[ 51605 ] GSD-02 General Source Data - Plant Layout Diagram  [ DOC ]
Program: Air Quality - Permits
Form to provide a diagram of the entire plant site.
[ 51606 ] GSD-04 General Source Data - Stack / Vent Information  [ DOC ]
Program: Air Quality - Permits
Form to provide basic information about each stack or vent that has the potential to emit air pollutants.
[ 51610 ] GSD-05 General Source Data - Emissions Unit Information  [ DOC ]
Program: Air Quality - Permits
Form to provide basic information about each emissions unit that has the potential to emit air pollutants.
[ 51612 ] GSD-06 General Source Data - Particulate Emissions  [ DOC ]
Program: Air Quality - Permits
This form is to provide basic information about each source of particulate emissions.
[ 51602 ] GSD-07 General Source Data - Criteria Pollutant Emissions Summary  [ DOC ]
Program: Air Quality - Permits
This form is to provide the actual and potential emissions of each criteria pollutant emitted from the source.
[ 51604 ] GSD-08 General Source Data - Hazardous Air Pollutant Emissions Summary  [ DOC ]
Program: Air Quality - Permits
This form is to provide the actual and potential emissions of each hazardous air pollutant emitted from the source.
[ 51611 ] GSD-09 General Source Data - Summary of Additional Information  [ DOC ]
Program: Air Quality - Permits
This form is used to supply a format for providing additional information about a process or emissions unit.
[ 51596 ] GSD-10 General Source Data - Insignificant Activity  [ DOC ]
Program: Air Quality - Permits
This form is to identify all trivial and insignificant activities in operation at the source.
[ 51601 ] GSD-11 General Source Data - Alternative Operating Scenario Summary  [ DOC ]
Program: Air Quality - Permits
This form is to identify and summarize any AOS that you are submitting with your air permit application.
[ 51600 ] GSD-12 General Source Data - Affidavit of Non-applicability  [ DOC ]
Program: Air Quality - Permits
This document is to certify that the requirement to notify adjacent landowners and occupants is not applicable to the source of air pollutant emissions.
[ 51603 ] GSD-13 General Source Data - Affidavit of Applicability  [ DOC ]
Program: Air Quality - Permits
This document is to certify that the requirement to notify adjacent landowners and occupants is applicable to the source of air pollutant emissions.
[ 51609 ] GSD-14 General Source Data - Owners and Occupants Notified  [ DOC ]
Program: Air Quality - Permits
The purpose of this document is to identify adjacent landowners and occupants that are to be notified that an air permit application has been submitted
[ 51608 ] GSD-15 General Source Data - Government Officials Notified  [ DOC ]
Program: Air Quality - Permits
This document is to identify local government officials that are to be notified that an air permit applicant has been submitted.
[ 51755 ] Air Permit Application - Renewal Checklist  [ DOC ]
Program: Air Quality - Permits
This checklist is to provide a worksheet for quickly assessing whether the air permit renewal application includes all necessary information.
[ 51860 ] AEF-01 Alternative Emissions Factor Request  [ DOC ]
Program: Air Quality - Permits
The purpose of this application is to request an alternate emission factor for permitting determinations, estimating source emissions for billing, or for development of emission inventories for use in air quality planning.
[ 52534 ] PI-01 Miscellaneous Processes  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the process.
[ 52535 ] PI-02A Combustion Unit Summary  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to summarize all of the combustion process units.
[ 52536 ] PI-02B Combustion: Boilers, Process Heaters, & Furnaces  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to specify details that pertain only to boilers, process heaters and furnaces.
[ 52537 ] PI-02C Combustion: Turbines & Internal Combustion Engines  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to specify details that pertain only to turbines and internal combustion engines.
[ 52538 ] PI-02D Combustion: Incinerators & Combustors  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to specify details only to incinerators and combustors.
[ 52539 ] PI-02E Combustion: Kilns  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to specify details that pertain only to kilns.
[ 52540 ] PI-02F Combustion: Fuel Use  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify each fuel that will be used in the combustion unit.
[ 52541 ] PI-02G Combustion: Emission Factors  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to specify the emission factors used to calculate potential to emit from the combustion unit.
[ 52542 ] PI-02H Combustion: Federal Rule Applicability  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify any federal rules that apply to the emission unit.
[ 52543 ] PI-03 Storage and Handling of Bulk Material  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the storage and handling of bulk materials.
[ 52544 ] PI-04 Asphalt Plants  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the hot or cold asphalt production process.
[ 52545 ] PI-05 Brick / Clay Products  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the brick and clay products manufacturing process.
[ 52546 ] PI-06 Electroplating Operations  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the electroplating process.
[ 52547 ] PI-07 Welding Operations  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the welding and cutting of metal.
[ 52548 ] PI-08 Concrete Batchers  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about concrete batch processes.
[ 52549 ] PI-09 Degreasing  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the degreasing process.
[ 52550 ] PI-10 Dry Cleaners  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about dry cleaning operations.
[ 52551 ] PI-11 Foundry, Smelting, and Die Cast Operations  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about foundry, smelting, and die cast operations.
[ 52552 ] PI-12 Grain Elevators  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the grain elevator process.
[ 52553 ] PI-13 Lime Manufacturing  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the lime manufacturing process.
[ 52554 ] PI-14 Volatile Organic Liquid Compound Storage  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about all tanks larger than 250 gallons that are used to store volatile organic liquid compounds.
[ 52555 ] PI-14 ALT Alternate Version of Volatile Organic Liquid Compound Storage  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about all tanks larger than 250 gallons that are used to store volatile organic liquid compounds.
[ 52556 ] PI-15 Portland Cement Manufacturing  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the Portland cement manufacturing processes.
[ 52557 ] PI-16 Reinforced Plastics & Composites  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the reinforced plastics and composites processes.
[ 52558 ] PI-17 Blasting Operations  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the blasting process.
[ 52559 ] PI-18 Mineral Processing  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about mineral processes such as sand and gravel processes, stone quarries, stone processing plants, and slag and kish handling plants.
[ 52560 ] PI-19 Surface Coating & Printing Operations  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the surface coating and printing processes.
[ 52561 ] PI-20 Woodworking / Plastic Machining  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the woodworking or plastic machining process.
[ 52570 ] PI-21 On-site Soil Remediation  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the site remeditation process.
[ 51904 ] CE-01 Control Equipment Summary  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to summarize all of the equipment used to control emissions.
[ 51953 ] CE-02 Particulate Control Equipment Baghouse or Fabric Filter  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the parameters that describe the baghouse or fabric filter.
[ 52620 ] CE-03 Particulate Control - Cyclone  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all the parameters that describe the cyclone.
[ 52621 ] CE-04 Particulate Control - Electrostatic Precipitator  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all the parameters that describe the electrostatic precipitator.
[ 52622 ] CE-05 Particulate Control - Wet Collector / Scrubber / Absorber  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all the parameters that describe the wet collector, scrubber, or absorption unit.
[ 52623 ] CE-06 Organics - Flare / Oxidizer / Incinerator  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all the parameters that describe the oxidizer or incinerator.
[ 52624 ] CE-07 Organics - Absorbers  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all the parameters that describe the adsorber.
[ 52625 ] CE-08 Organics - Condenser  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all the parameters that describe the condenser.
[ 52626 ] CE-09 Nitrogen Oxides Reduction Technology  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the parameters that describe the nitrogen oxide (Nox) reduction technology.
[ 52436 ] CE-10 Miscellaneous Control Equipment  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the parameters that describe the control device.
[ 51861 ] CD-01 Emissions Unit Compliance Status  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify the requirements that apply to each emissions unit at the permitted source and to determine the compliance status of these emissions units.
[ 51862 ] CD-02 Compliance Plan Requirements Per Applicable Requirement  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify existing compliance monitoring activities (monitoring, testing, record keeping and/or reporting) required in an applicable requirement or to provide compliance monitoring activities for appliable requirements where there is no or inadequate compliance monitoring requirements.
[ 51863 ] CD-03 Compliance Plan Requirements Per Emissions Unit  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify existing compliance monitoring activities (monitoring, testing, record keeping and/or reporting) required in an applicable requirement or to provide compliance monitoring activities for appliable requirements where there is no or inadequate compliance monitoring requirements.
[ 51864 ] CD-04 Compliance Schedule and Certification  [ DOC ]
Program: Air Quality - Permits
The purpose of this forms to provide a schedule for compliance certification submittals, a certification of the source's compliance status with all applicable requirements, and a compliance schedule that details the measures a source will use to address non-compliance
[ 52451 ] PAL-01: Actuals Plantwide Applicability Limit  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to request a plantwide applicability limit (PAL) based on actual emissions.
[ 52452 ] PAL-02: Revised Plantwide Applicability Limit  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to request a revision to an established plantwide applicability limit (PAL)
[ 52453 ] PAL-03: Plantwide Applicability Limit Renewal  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to renew an established plantwide applicability limit (PAL)
[ 52454 ] PAL-04: Request for Termination of Plantwide Applicability Limit  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to request termination or revocation of an established plantwide applicability limit (PAL)
[ 53438 ] OA-01 Summary of Application and Existing Agreements  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to specify the individual operating agreements included with this application and to identify all existing operating agreements.
[ 53439 ] OA-02 Industrial / Commercial Surface Coating Operations -OR- Graphic Arts Operations (326 IAC 2-9-2.5)  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the source specific operating agreement requirements for 326 IAC 2-9-2.5.
[ 53440 ] OA-03 Surface Coating or Graphic Arts Operations (326 IAC 2-9-3)  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the source specific operating agreement requirements for 326 IAC 2-9-3.
[ 53441 ] OA-04 Woodworking Operations (326 IAC 2-9-4)  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the source specific operating agreement requirements for 326 IAC 2-9-4.
[ 53442 ] OA-05 Abrasive Cleaning Operations (326 IAC 2-9-5)  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the source specific operating agreement requirements for 326 IAC 2-9-5.
[ 53443 ] OA-06 Grain Elevators (326 IAC 2-9-6)  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the source specific operating agreement requirements for 326 IAC 2-9-6.
[ 53444 ] OA-07 Sand And Gravel Plants (326 IAC 2-9-7)  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the source specific operating agreement requirements for 326 IAC 2-9-7.
[ 53445 ] OA-08 Crushed Stone Processing Plants (326 IAC 2-9-8)  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the source specific operating agreement requirements for 326 IAC 2-9-8.
[ 53446 ] OA-09 Ready-Mix Concrete Batch Plants (326 IAC 2-9-9)  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the source specific operating agreement requirements for 326 IAC 2-9-9.
[ 53447 ] OA-10 Coal Mines And Coal Preparation Plants (326 IAC 2-9-10)  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the source specific operating agreement requirements for 326 IAC 2-9-10.
[ 53448 ] OA-11 Automobile Refinishing Operations (326 IAC 2-9-11)  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the source specific operating agreement requirements for 326 IAC 2-11.
[ 53449 ] OA-12 Degreasing Operations (326 IAC 2-9-12)  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the source specific operating agreement requirements for 326 IAC 2-12.
[ 53450 ] OA-13 External Combustion Sources (326 IAC 2-9-13)  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the source specific operating agreement requirements for 326 IAC 2-13.
[ 53451 ] OA-14 Internal Combustion Sources (326 IAC 2-9-14)  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to identify all of the source specific operating agreement requirements for 326 IAC 2-14.
[ 48625 ] Drycleaner Notification Form  [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form satisfies the notification requirements of 40 CFR 63.324 (a), (b) and (c) and 326 IAC 20-7.
[ 53430 ] Drycleaner Notification of Compliance Status  [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form satisfies the notification requirements of 40 CFR 63.324 (f).
[ 51956 ] Initial Notification Report Under Regulation 40 CFR Part 63, Subpart DDDDD  [ PDF ]
Program: Air Quality - Compliance and Enforcement
The form is an example notification to satisfy the requirements of 40 CFR 63, Subpart DDDDD and 40 CFR 63.9(b).
[ 53597 ] Outdoor Hydronic Heater Dealer Notice to Buyers  [ PDF ] [ DOC ]
Program: Air Quality - Compliance and Enforcement
Documents requirement for Sellers to provide a copy of 326 IAC 4-3 to Outdoor Hydronic Heater Buyers and may be used by Sellers to provide notice to IDEM within seven (7) days of delivering a unit to a Buyer as required by the rule.
[ 52571 ] Application Checksheet for Asbestos Contractor  [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form is to be used as a guide when applying for an asbestos contractor license.
[ 52575 ] Application for Asbestos Contractor License  [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form is to be submit when applying for an Indiana Asbestos Contractor License.
[ 48741 ] Application for Asbestos Training Course - Provider Approval  [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form is used to apply for an initial or renew an EPA approved Asbestos Training Course Provider certification.
[ 48740 ] Application for Duplicate Asbestos License  [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form is used to replace an individual asbestos license.
[ 43786 ] Application for Individual Asbestos License  [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form is used to apply for an initial or renew individual asbestos license.
[ 44593 ] Notification of Demolition and Renovation Operations  [ PDF ]
Program: Air Quality - Compliance and Enforcement
The form is used by property owners and contractors when demolishing or renovating a structure
[ 49635 ] Identification of Potentially Affected Persons  [ PDF ] [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form satisfies the notification requirements of 40 CFR 63.324 (a), (b) and (c)
[ 54801 ] Notification of Exempt Live Fire Training Under 326 IAC 4-1  [ PDF ] [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form is a notification of open burning by municipal fire departments for fire training noted as exempt under 326 IAC 4-1-3(c)(9).
[ 43688 ] Request for Use of an Air Curtain Open Pit Destructor  [ PDF ] [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form is an application for an open burning approval to use an air curtain open pit destructor to comply with 326 IAC 4-1.
[ 49634 ] Request for Fire Training Approval Under 326 IAC 4-1 - Acquired Structure  [ PDF ] [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form is an application for an open burning approval for fire training to comply with 326 IAC 4-1.
[ 50337 ] Request for Fire Training Approval Under 326 IAC 4-1 - Motor Vehicle  [ PDF ] [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form is an application for an open burning approval for fire training using motor vehicles to comply with 326 IAC 4-1.
[ 43692 ] Request for Tree or Clean Wood Waste Burn Approval Under 326 IAC 4-1  [ PDF ] [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form is an application for an open burning approval for tree waste or clean wood waste to comply with 326 IAC 4-1.
[ 55003 ] Compliance Test Protocol Form  [ PDF ]
Program: Air Quality - Compliance and Enforcement
The form is a notification to satisfy the requirements of 326 IAC 3-6-2(a) for stack testing.
[ 55059 ] RATA Notification Protocol Form  [ PDF ]
Program: Air Quality - Compliance and Enforcement
The form is a notification to satisfy the requirements of 326 IAC 3-6-2(a) for all Relative accuracy Test Audit testing.
[ 55058 ] VOCs & Toxics Compliance Test Protocol Form  [ PDF ]
Program: Air Quality - Compliance and Enforcement
The form is a notification to satisfy the requirements of 326 IAC 3-6-2(a) for all VOC, Toxics, and HAP stack testing.
[ 52052 ] AES-01 Air Emission Statement Certification  [ PDF ] [ DOC ]
Program: Air Quality - Programs
The purpose of the form is for certification of an air emission statement as well as any modifications submitted to comply with 326 IAC 2-6 (Emission Reporting).
[ 52057 ] AES-06 Voluntary Hazardous Air Pollutant Reporting  [ PDF ] [ DOC ]
Program: Air Quality - Programs
The purpose of the form is for voluntary reporting hazardous air pollutant emissions for an air emission statement.
[ 55543 ] Request for Fire Training Approval Under 326 IAC 4-1 – Stationary Facility  [ PDF ] [ DOC ]
Program: Air Quality - Compliance
Form used for fire training approvals.
[ 50864 ] Request for Prescribed Vegetation Burn Approval Under 326 IAC 4-1  [ PDF ] [ DOC ]
Program: Air Quality - Compliance and Enforcement
This form is an application for a prescribed vegetation open burning approval to comply with 326 IAC 4-1.
[ 51599 ] GSD-03 General Source Data - Process Flow Diagram  [ PDF ] [ DOC ]
Program: Air Quality - Permits
Document to provide a checklist for identifying the information on each Process Flow diagram.
[ 51783 ] EC-01 Emission Credit Registry - Generation of Emission Credits  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to provide information regarding the generation of emission credits.
[ 51784 ] EC-02 Emission Credit Registry - Transfer of Emission Credits  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to provide information regarding the transfer of emission credits.
[ 51785 ] EC-03 Emission Credit Registry - Use of Emission Credits  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to provide information regarding the use of emission credits.
[ 51906 ] EC-04 Emission Credit Registry - Emission Credits Request  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to provide a standardization method for submitting requests to post a company's emission credits wish list on the IDEM website.
[ 53512 ] FED-01 - Summary of Federal Requirements - NSPS & NESHAP  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to provide a standardized way for sources to identify the NSPS or NESHAP requirements that are applicable to the regulated source.
[ 51905 ] FED-02 MACT Pre-Construction Review  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to provide a standardized way for sources to request MACT preconstruction approval per 40 CFR 63.5.
[ 53377 ] FED-03 Compliance Assurance Monitoring  [ DOC ]
Program: Air Quality - Permits
The purpose of this form is to obtain detailed information about the monitoring protocol that is proposed to satisfy the federal requirements for compliance assurance monitoring (CAM) under 40 CFR Part 64.
[ 52053 ] AES-02 General Facility Information  [ PDF ] [ DOC ]
Program: Air Quality - Programs
The purpose of the form is to provide general facility information for an air emission statement submitted to comply with 326 IAC 2-6 (Emission Reporting).
[ 52054 ] AES-03 Stack Information  [ PDF ] [ DOC ]
Program: Air Quality - Programs
The purpose of the form is to provide stack information for an air emission statement submitted to comply with 326 IAC 2-6 (Emission Reporting).
[ 52055 ] AES-04 Abatement Equipment  [ PDF ] [ DOC ]
Program: Air Quality - Programs
The purpose of the form is to provide abatement (control) equipment information for an air emission statement submitted to comply with 326 IAC 2-6 (Emission Reporting).
[ 52056 ] AES-05 Group/Process/Emissions Information  [ PDF ] [ DOC ]
Program: Air Quality - Programs
The purpose of the form is to provide information about groups, processes, and process emissions for an air emission statement submitted to comply with 326 IAC 2-6 (Emission Reporting).
[ ----- ] Air Toxics - U.S. EPA: Initial Notification  [ DOC ]
Program: Air Quality - Permits
THIS IS A SAMPLE NOTIFICATION FORM, WHICH CAN BE USED BY FACILITIES AT THEIR DISCRETION TO MEET COMPLIANCE WITH 40 CFR 63 Subpart A, 63.9(b)
[ 47551 ] Automated Direct Deposit Authorization Agreement   [ PDF ]
[ 53788 ] Vendor Information  [ PDF ]
[ 50014 ] IDEM Complaint Form  [ PDF ]
Program: Chief of Staff - Media and Communications
This form is used to submit information on environmental pollution to IDEM.
[ 53088 ] Solid Waste Land Disposal Facilities Renewal Application Checklist  [ PDF ] [ DOC ]
Program: Chief of Staff - SW Permits
Checklist provided to Solid Waste Disposal Facilities for assurance all documentation is included in renewal applications.
[ 57061 ] Report a Complaint Online  [ WEBFORM ]
To obtain complaints electronically.
[ 57060 ] IDEM Questions / Comments  [ WEBFORM ]
To obtain questions for the Indiana Department of Environmental Management (IDEM) Electronically.
[ 57327 ] Remediation/Progress Monitoring (R/PM) Cover Sheet and Report Format  [ PDF ]
Program: Chief of Staff - VRP
[ 51778 ] Indiana Economic Impact - Proposals and Contracts   [ PDF ] [ XLS ]
[ 46270 ] Water Test Kit Order  [ PDF ]
[ 18865 ] Statement for Deduction of Assessed Valuation  [ PDF ]
[ 20094 ] Registration of a Significant Water Withdrawal Facility  [ PDF ]
[ 51872 ] Adjacent Landowner/Occupant Affidavit  [ DOC ]
Program: Land Quality - SW Permits
The form is used by the applicant to confirm they have notified adjacent landowners they have submitted an application for a new solid waste facility or a major solid waste facility expansion.
[ 51910 ] Field Tile Monitoring At Land Application Sites (Personal Document)  [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form is used to document monitoring of field tile outlets at manure application sites.
[ 53765 ] Auto Salvage Recyclers Environmental Self-Audit Checklist  [ PDF ]
Program: Land Quality - IW Compliance
This form is used to provide information about an auto salvage recycler facility.
[ 55051 ] Complete CFO/CAFO Application Packet  [ PDF ] [ DOC ]
Program: Land Quality - Confined Feeding Operations
Application packet to submit CFO, CAFO, and NPDES Individual Permits
[ 55054 ] CFO Closure Certification  [ PDF ] [ DOC ]
Program: Land Quality - Confined Feeding Operations
Certification on the closure of the waste storage structure
[ 51255 ] CFO Construction Affidavit  [ PDF ] [ DOC ]
Program: Land Quality - Confined Feeding Operations
Affidavit on meeting the requirements for construction of the confined feeding operation.
[ 50210 ] CFO Construction Notification  [ PDF ] [ DOC ]
Program: Land Quality - Confined Feeding Operations
To report any facility changes to the CFO operations as approved to IDEM in writing.
[ 50209 ] CFO Facility Change Notification  [ PDF ] [ DOC ]
Program: Land Quality - Confined Feeding Operations
To notify IDEM of a confined feeding operation facility change
[ 49832 ] CFO Request for Approval Transfer  [ PDF ] [ DOC ]
Program: Land Quality - Confined Feeding Operations
Form to document the transfer of CFO Approval to a new owner/operator within 90 days of the date of transfer
[ 55162 ] CFO Request for Approval to Surface Apply Manure to Frozen or Snow-Covered Ground  [ PDF ] [ DOC ]
Program: Land Quality - Confined Feeding Operations
Form for CFOs (not large CAFOs) with less than 120 days of approved storage capacity to request authorization to surface apply manure to frozen or snow-covered ground.
[ 49827 ] CFO Request for Exiting the Program  [ PDF ] [ DOC ]
Program: Land Quality - Confined Feeding Operations
Form used to exit the CFO program.
[ 55053 ] Professional Engineer Certification Construction of Concrete Liquid Manure Storage Structures  [ PDF ] [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form used by CFO to document the construction of concrete liquid manure storage structures by a professional engineer.
[ 55052 ] Professional Engineer Certification Construction of Earthen Liquid Manure Storage Structures  [ PDF ] [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form used by CFO to document the construction of earthen liquid manure storage structures by a professional engineer.
[ 55716 ] Professional Engineer Certification for Construction of Geomembrane Lined Liquid Manure Storage Structures  [ PDF ] [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form used by CFO to document the construction of geomembrane lined liquid manure storage structures by a professional engineer.
[ 56029 ] CFO Marketing or Distribution of Manure Information Sheet  [ PDF ] [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form is used to document distribution information of manure ¿from a CFO.
[ 52510 ] CAFO Annual Report  [ PDF ]
Program: Land Quality - Confined Feeding Operations
This form is used by a CAFO to document farm information annually.
[ 51913 ] CAFO Closure of Manure, Litter, Process Wastewater Storage Structures  [ PDF ]
Program: Land Quality - Confined Feeding Operations
This form is used to document the closure of manure, litter, process wastewater storage structures according to CAFO rules.
[ 55056 ] CAFO Construction Completion Affidavit  [ PDF ]
Program: Land Quality - Confined Feeding Operations
This form is used by a CAFO to document completion of approved construction.
[ 51911 ] CAFO Construction Notification  [ PDF ]
Program: Land Quality - Confined Feeding Operations
This form is used by a CAFO to document the beginning of approved construction.
[ 55055 ] CAFO Removal from NPDES CAFO Permit Program  [ PDF ]
Program: Land Quality - Confined Feeding Operations
This form is used by a CAFO to exit the NPDES CAFO Permit Program.
[ 54138 ] Registration Form for Storage and Processing Facilities  [ PDF ]
Program: Land Quality - HW Permits
This is the facility registration for electronic waste storage and processing facilities located in Indiana.
[ 47214 ] Facility Permit Fee Transmittal  [ DOC ]
Program: Land Quality - HW Permits
This form must be used to transmit fees for all hazardous waste management facility permit applications and modifications (NEW permits, RENEWAL of permits, Class 2 & 3 MODIFICATION of permits) pursuant to IC 13-22-12, and is to accompany all payments.
[ 56082 ] Environmental Restrictive Covenant / Deed Notice Modification or Termination Request  [ PDF ] [ DOC ]
Program: Land Quality - Institutional Controls
This form is necessary for owners of ERC restricted properties to request a change in land use restrictions.
[ 50405 ] Notification for the Construction of a Storage Structure for Biosolids/Industrial Waste Product or Pollutant-bearing Water  [ DOC ]
Program: Land Quality - SW Permits
This form is to apply for approval to construct and operate a storage structure for the storage of biosolids, industrial waste products, or pollutant-bearing water at the land application site or generating facility. Structures meeting specific criteria may apply under the notification program. Life time permit, does not require renewal
[ 50406 ] Permit Application for the Construction of a Storage Structure for Biosolids/Industrial Waste Product or Pollutant-Bearing Water  [ DOC ]
Program: Land Quality - SW Permits
This form is used to apply for a permit to construct and operate a storage structure for the storage of biosolids, industrial waste products, or pollutant-bearing water at the land application site or generating facility. A permit is required if constructing an earthen lagoon and for structures/locations of structures that do not meet the specific criteria outlined in 327 IAC 6.1-8. Life time permit, does not require renewal
[ 50407 ] Notification for the Land Application of Agricultural Lime Substitute  [ DOC ]
Program: Land Quality - SW Permits
This is an application to operating under the notification program. Annual renewal
[ 50408 ] Permit Application for the Marketing and/or Distribution of Biosolids  [ DOC ]
Program: Land Quality - SW Permits
To apply for or renewal of a Marketing & Distribution permit under 327 IAC 6.1 for the beneficial use of Class A biosolids. Beneficial use includes using as a feedstock for composting, soil amendment, and/or has fertilizer value.
[ 50409 ] Permit Application for the Land Application of Domestic Wastewater  [ DOC ]
Program: Land Quality - SW Permits
This form is used to apply for or renewal of a land application permit to land apply Pollutant-bearing water and specifically treated domestic wastewater (human waste)
[ 50410 ] Permit Application for the Land Application of Biosolids  [ DOC ]
Program: Land Quality - SW Permits
This form is used to apply for or renewal of a Land Application Permit for the land application of biosolids
[ 53514 ] Permit Application for the Marketing and/or Distribution of Industrial Waste Products  [ DOC ]
Program: Land Quality - SW Permits
This form is used to apply for or renewal of a Marketing & Distribution permit under 327 IAC 6.1 for the beneficial use of industrial waste products. Beneficial use includes using as a feedstock for composting, soil amendment, and/or has fertilizer value
[ 53517 ] Permit Application for the Land Application of Industrial Waste Products  [ DOC ]
Program: Land Quality - SW Permits
This form is used to apply for or renewal of a Land Application Permit for the land application of industrial waste products
[ 53558 ] Notification for the Land Application of Small Quantities of Pollutant-bearing Water  [ DOC ]
Program: Land Quality - SW Permits
This is an application for or renewal to operate under the notification program
[ 53584 ] Permit Application for the Land Application of Industrial Process Wastewater  [ DOC ]
Program: Land Quality - SW Permits
This form is to apply for or renewal of a Land Application Permit for the land application industrial waste products
[ 55308 ] Alternative Fuel Processor Registration Application  [ PDF ]
Program: Land Quality - SW Permits
This is a registration form to use waste as an alternative fuel in a boiler, kiln, etc.
[ 55309 ] Biomass Digester/Gasification Facility Registration Application  [ PDF ]
Program: Land Quality - SW Permits or CFO Permits
This form is used to register a Biomass Digester/Gasification Facility as a stand alone or on an approved confined feeding operation.
[ 53317 ] Insignificant Permit Modification Checklist Solid Waste Land Disposal Facilities  [ PDF ]
Program: Land Quality - SW Permits
This form is used for determining if submitting everything needed for insignificant modification.
[ 55307 ] Mobile Home Salvaging Facility Registration Application  [ PDF ]
Program: Land Quality - SW Permits
This form is for the registration to dismantle mobile homes for reuse of the resulting appliances, lumber, etc.
[ 50391 ] Municipal Solid Waste Landfill Closure Plan (329 IAC 10-22)  [ DOC ]
Program: Land Quality - SW Permits
This form is used to submit the closure plan for a municipal solid waste landfill.
[ 50388 ] Municipal Solid Waste Landfill Post-Closure Plan (329 IAC 10-23)  [ DOC ]
Program: Land Quality - SW Permits
This form is used to submit the post-closure plan for a municipal solid waste landfill.
[ 47215 ] Solid Waste Facility Permit Application & Registration Fee Transmittal  [ PDF ] [ DOC ]
Program: Land Quality - SW Permits
This form is used to submit solid waste application fees.
[ 50393 ] Solid Waste Facility Transfer Application  [ PDF ]
Program: Land Quality - SW Permits
This form is used to apply for transfer of solid waste permits.
[ 50404 ] Solid Waste Land Disposal Facility Permit Application  [ PDF ] [ DOC ]
Program: Land Quality - SW Permits
This form is used to apply for a new landfill permit or a major or minor modification of a landfill permit.
[ 50386 ] Solid Waste Land Disposal Facility Permit Renewal Application  [ PDF ] [ DOC ]
Program: Land Quality - SW Permits
This form is used to apply for a renewal of a landfill permit.
[ 53315 ] Solid Waste Processing Facilities and Incinerators / New Facility and Major Modification Permit Application Checklist  [ PDF ] [ DOC ]
Program: Land Quality - SW Permits
This form is a checklist of what needs to be submitted with an application for a new solid waste processing facility or a major modification of facility.
[ 50392 ] Solid Waste Processing Facility Permit Application  [ PDF ] [ DOC ]
Program: Land Quality - SW Permits
This form is used to apply for a new solid waste processing facility ¿permit, or a major or minor modification of a solid waste processing facility permit.
[ 50387 ] Solid Waste Processing Facility Permit Renewal Application  [ PDF ] [ DOC ]
Program: Land Quality - SW Permits
This form is used to apply for a renewal of a solid waste processing facility permit.
[ 56424 ] ELTF Claims Application (Phase Approach)  [ XLS ]
Program: Land Quality - UST Operations
ELTF claim submission for costs incurred on or after 1/1/2016.
[ 47139 ] ELTF Claims Application  [ XLS ]
Program: Land Quality - UST Operations
ELTF claim submission for costs incurred before 1/1/2018.
[ 55459 ] ELTF Eligibility Application  [ PDF ]
Program: Land Quality - UST Operations
Request ELTF eligibility determination for LUST incident.
[ 51955 ] ELTF Scope of Work for Leaking UST Sites  [ XLS ]
Program: Land Quality - UST Operations
Request preapproval for site characterization and corrective action costs for LUST incident.
[ 56548 ] Initial Registration for Underground Storage Tank Systems  [ PDF ]
Program: Land Quality - UST Operations
Register new UST facility.
[ 45223 ] Notification for Underground Storage Tank Systems  [ PDF ]
Program: Land Quality - UST Operations
Make amendments to UST facility data record.
[ 56553 ] Thirty (30) Day Notification of Intent to Close  [ PDF ]
Program: Land Quality - UST Operations
Notify of intent to close a UST.
[ 56554 ] Underground Storage Tank Systems Closure Report  [ PDF ]
Program: Land Quality - UST Operations
Report a closure of a UST.
[ 47271 ] VRP Application and Instructions  [ PDF ] [ DOC ]
Program: Land Quality - VRP
This form is used to apply to the Voluntary Remediation Program
[ 54168 ] VRP Remediation Completion Report Completeness Checklist  [ PDF ] [ DOC ]
Program: Land Quality - VRP
Checklist for submitting VRP Closure Report
[ 53413 ] VRP Remediation Work Plan Completeness Checklist  [ PDF ]
Program: Land Quality - VRP
Checklist for submitting Remediation Work Plan to the Voluntary Remediation Program.
[ 47221 ] Application for Waste Tire Processing Operation Registration (or Renewal)  [ PDF ]
Program: Land Quality - SW Permits
This is a form to register for Waste Tire Processing.
[ 47222 ] Application for Waste Tire Storage Site Registration (or Renewal)  [ PDF ]
Program: Land Quality - SW Permits
This form is used to apply or renew as a Waste Tire Transporter
[ 47220 ] Application for Waste Tire Transporter Registration (or Renewal)  [ DOC ]
Program: Land Quality - SW Permits
This form is used to apply or renew as a Waste Tire Storage Site
[ 54817 ] Contingency Plan for Waste Tire Processing Operations and Storage Sites  [ PDF ]
Program: Land Quality - SW Permits
This form describes the actions the operator will take to minimize hazards for files, contaminated run-off from fires, and mosquito breeding
[ 47273 ] Waste Tire Manifest  [ PDF ]
Program: Land Quality - SW Permits
This form is used to track the source or generator of waste tires and where they are shipped to.
[ 55351 ] Waste Tire Facility Closure Notification  [ DOC ]
Program: Land Quality - SW Permits
This form is to notify IDEM of the closure of a Waste Tire Facility.
[ 50403 ] Application for a Wastewater (Septage) Management Land Application Site Permit  [ DOC ]
Program: Land Quality - SW Permits
This form is used to apply for a Wastewater (Septage) Land Application Permit
[ 50399 ] Application for Septage Management Business Permit  [ PDF ]
Program: Land Quality - SW Permits
This form is used to apply for a Septage Management Business Permit
[ 50397 ] Septage Land Application Quarterly Report  [ PDF ] [ XLS ]
Program: Land Quality - SW Permits
This form is used to track the gallons of septage land applied and verifies completion of lime treatment.
[ 53238 ] Claim for Payment for Mercury Switches from End-of-life Vehicles (ELVs)  [ PDF ] [ DOC ]
Program: Land Quality - SW Auto
Use this form to request payment for mercury switches removed from end-of-life vehicles under IC 13-20-17.7
[ 53924 ] Indiana Clean Yard Best Management Practices Checklist  [ DOC ]
Program: Land Quality - SW Auto
Checklist for auto salvage yards to enter into the Indiana Clean Yard program-Gold-Level
[ 53766 ] Indiana Clean Yard Certification Statement  [ PDF ]
Program: Land Quality - SW Auto
This form is used to submit a certification statement to enter Indiana Clean Yard Program
[ ----- ] CFO Emergency Notification for Manure Application to Frozen or Snow-Covered Ground  [ PDF ]
Program: Land Quality - Confined Feeding Operations
This form is used to apply for and receive approval to apply manure to frozen or snow-covered ground in an emergency situation
[ ----- ] CFO Emergency Spill Response Documentation  [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form is used to document the response to a manure spill from a CFO.
[ ----- ] CFO Emergency Spill Response Plan  [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form is used to document the prepared response to a manure spill from a CFO.
[ ----- ] CFO Manure Application Record  [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form is used to document manure application records for a CFO.
[ ----- ] CFO Manure Distribution Record  [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form is used to document distribution information of manure ¿from a CFO.
[ ----- ] CFO Manure Land Usage Agreement  [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form is used to document the agreement between a land owner and CFO operator to apply manure on specific acres.
[ ----- ] CFO Self-Inspection Records  [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form is used to document self-inspection records of a CFO by the CFO operator.
[ ----- ] CFO Storm Water Management Certification  [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form is used to document the CFO meets storm water management requirements from 327 IAC 19-11-2.
[ ----- ] CFO Storm Water Management Requirements for Concentrated Animal Feeding Operations  [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form is used to document the CAFO meets the storm water record keeping requirements in 40 CFR 122.42(e)(2).
[ ----- ] Compliance Guide (Construction & Operation)  [ PDF ]
Program: Land Quality - Confined Feeding Operations
This form is used to document the CFO is in compliance with the CFO Approval.
[ ----- ] Solid Manure Staging Record  [ PDF ]
Program: Land Quality - Confined Feeding Operations
This document is used to document solid manure staging information.
[ ----- ] 2015 Self Inspection Sheet  [ XLS ]
Program: Land Quality - Confined Feeding Operations
This form is used to document CFO self inspection results.
[ ----- ] CAFO Emergency Spill Response Documentation  [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form is used to document the response to a manure spill from a CAFO.
[ ----- ] CAFO Emergency Spill Response Plan  [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form is used to document the prepared response plan to a manure spill from a CAFO.
[ ----- ] CAFO Land Usage Agreement  [ PDF ]
Program: Land Quality - Confined Feeding Operations
This form is used to document the agreement between a land owner and CAFO operator to apply manure on specific acres.
[ ----- ] CAFO Manure Application Record   [ PDF ]
Program: Land Quality - Confined Feeding Operations
This form is used to document manure application records for a CAFO.
[ ----- ] CAFO Manure Distribution Record  [ PDF ]
Program: Land Quality - Confined Feeding Operations
This form is used to document distribution information of manure ¿from a CAFO.
[ ----- ] CAFO Marketing or Distribution of Manure Information Sheet  [ PDF ]
Program: Land Quality - Confined Feeding Operations
This form is used to document distribution information of manure ¿from a CAFO.
[ ----- ] CAFO Precipitation Events at Land Application Sites  [ PDF ]
Program: Land Quality - Confined Feeding Operations
This form is used to document precipitation events at manure land application sites.
[ 52953 ] Waste Classification Application Checklist  [ PDF ]
Program: Land Quality - Compliance
Used to track waste classifications
[ 55715 ] Institutional Controls Self Audit Checklist  [ PDF ]
Program: Land Quality - State Cleanup
Self Audit for those that are under the Institutional Controls program
[ 52954 ] Legitimate Use Approval Application Checklist  [ PDF ]
Program: Land Quality - Legitimate Use Approval
Form used as a checklist for legitimate use.
[ 53082 ] Satellite Manure Storage Structure (SMSS) Request for Permit Transfer  [ PDF ]
For permit transfer requests of satellite manure storage structures
[ 53084 ] Professional Engineer Certification for Construction of Geomembrane Lined Liquid Satellite Manure Storage Structures (SMSS)  [ PDF ]
Use this form to certify construction of a liquid manure storage structure.
[ 53085 ] Satellite Manure Storage Structure SMSS Construction of Earthen Liquid Manure  [ PDF ]
To certify construction of a liquid manure storage structure.
[ 53037 ] Satellite Manure Storage Structure (SMSS) Construction Notification  [ PDF ]
A notification for Satellite Manure Storage Structure (SMSS) construction
[ 53081 ] Satellite Manure Storage Structure (SMSS) Facility Change Notification  [ PDF ]
A notification for Satellite Manure Storage Structure (SMSS) facility change
[ 53079 ] Acknowledgement of Reliance Upon Ordinance to Control Access to Groundwater  [ PDF ]
Form for Acknowledgement of Reliance Ordinance to Control Access to Groundwater
[ 53083 ] Satellite Manure Storage Structure (SMSS) Completed Construction Affidavit  [ PDF ]
Construction affidavit for Satellite Manure Storage Structures
[ 53086 ] Satellite Manure Storage Structure (SMSS) Construction of Concrete Liquid Manure  [ PDF ]
To certify construction of a liquid manure storage structure.
[ 57059 ] IDEM Dry Cleaner and Laundry (DCaL) Dataset  [ WEBFORM ]
Dataset for DCal
[ 57103 ] IDEM E-Submission Enrollment  [ WEBFORM ]
E-Submission Enrollment for various Office of Land Quality programs.
[ 57234 ] Notice of Contamination in Right of Way  [ PDF ]
Program: Land Quality - Institutional Controls
Provides notice that contaminated soil an/or groundwater is present in Right of Way because a release of contamination to the environment from an IDEM reported incident.
[ 57241 ] Waste Tire Grant Program Application  [ PDF ] [ DOC ]
To apply for waste tire grant.
[ 57242 ] Waste Tire Grant Expenditure Report  [ PDF ] [ DOC ]
To report expenses on waste tire grant.
[ 53148 ] Application for Underground Storage Tank Certification  [ PDF ]
Program: Land Quality - UST Operations
[ 53150 ] Application for Renewal of Underground Storage Tank Certification  [ PDF ]
Program: Land Quality - UST Operations
[ 57108 ] Voluntary Remediation Program Annual Report  [ PDF ]
Program: Land Quality - VRP
Form for VRP sites to document annual progress
[ 57108 ] Voluntary Remediation Program Annual Report  [ PDF ]
Program: Land Quality - VRP
Form for VRP sites to document annual progress
[ 57335 ] Notification for Aboveground Storage Tank Systems  [ PDF ]
Program: Land Quality - Petroleum Remediation
[ 57385 ] Site Characterization Report Cover Sheet/Checklist  [ PDF ] [ DOC ]
Program: Land Quality - VRP
[ ----- ] Post-Closure Permit Application Checklist  [ DOC ]
Program: Land Quality - Hazardous Waste Permits
[ 56088 ] LUST No Further Action Request Cover Sheet and Report Format  [ PDF ] [ DOC ]
Program: Land Quality - Petroleum Remediation
This form is intended to assist with the organization of No Further Action (NFA) Requests.
[ 50400 ] Good Character Disclosure Statement  [ PDF ] [ DOC ]
Program: Land Quality - SW Permits
This form shall be used to submit the good character disclosure statement required by IC 13-19-4 for obtaining a solid waste facility permit or a hazardous waste treatment, storage, or disposal facility permit
[ 52123 ] Transfer Facilities Notification  [ PDF ] [ DOC ]
Program: Land Quality - Regulatory Reporting
This form is used to provide IDEM with a notification of hazardous waste transfer facilities
[ ----- ] RCRA Part B Permit Application Checklist Comments  [ DOC ]
Program: Land Quality - Hazardous Waste Permits
[ 50402 ] Application for a Wastewater (Septage) Management Storage/Treatment Facility Permit  [ DOC ]
Program: Land Quality - SW Permits
This form is used to apply for a Wastewater (Septage) Management Storage/Treatment Facility Permit
[ ----- ] RCRA Part B Permit Application Checklist  [ PDF ]
Program: Land Quality - Hazardous Waste Permits
[ 55439 ] LUST Initial Site Characterization (ISC) Report Cover Sheet & Report Format  [ PDF ] [ DOC ]
Program: Land Quality - Petroleum Remediation
This form is intended to assist with the organization of the Initial Site Characterization (ISC).
[ 54487 ] LUST Initial Incident Report  [ PDF ] [ DOC ]
Program: Land Quality - Petroleum Remediation
This form is used to report all suspected and confirmed releases within twenty-four (24) hours of discovery
[ ----- ] Letter of Credit Suggested Language  [ DOC ]
Program: Land Quality - Hazardous Waste Permits
[ 50414 ] Yard Waste Composting Facility Registration Application  [ PDF ] [ DOC ]
Program: Land Quality - SW Permits
This form is for facilities subject to IC 13-20-10 that wishes to compost vegetative matter, such as leaves, grass, brush, limbs, and branches
[ 56423 ] Satellite Manure Storage Structure (SMSS) Permit Application Packet  [ PDF ] [ DOC ]
Program: Land Quality - Confined Feeding Operations
This form is used to submit a Satellite Manure Storage Structures (SMSS) application under 327 IAC 20 and IC 13-18-10.5.
[ 55440 ] LUST Initial Site Characterization (ISC) Checklist  [ PDF ] [ DOC ]
Program: Land Quality - Petroleum Remediation
This form is used to create consistency and to ensure the submittal of all information required by 329 IAC 9-5-5.1 for an Initial Site Characterization (ISC).
[ 46244 ] Hazardous Waste Disposal Fee  [ PDF ] [ DOC ]