Ent for any air pollution control permit application filed pursuant to ss. 285.61, 285.62 or 285.66, Wis. Stats. Completion of this form is mandatory. The Department will not consider or act upon your application unless you complete and submit this application form. You are required to submit two copies in accordance with s. NR 407.05(2), Wis. Adm. Code. Personal information collected will be used for administrative purposes and may be provided to requesters to the extent required by Wisconsin's.

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How to fill out the WI DNR 4530-100 online

Completing the WI DNR 4530-100 form is essential for any air pollution control permit application in Wisconsin. This guide provides detailed instructions to help users efficiently complete the form online.

Follow the steps to successfully fill out the form.

  1. Click the ‘Get Form’ button to obtain the form and access it in the editor.
  2. Begin with the 'Facility Information' section. Enter the facility name, the Standard Industrial Class Code (SIC), and Facility ID Number (FID). Provide the street address where pollution sources are located, along with the city, town, village, and county information.
  3. In the 'Primary Operating Activity' field, describe the main activity of the facility, such as 'lead-acid battery manufacturer' or 'sulfite paper mill.' Indicate whether the facility is in a 'nonattainment' area. If yes, specify the pollutant(s) associated with the nonattainment designation.
  4. Proceed to the 'Applicant Information' section. Fill in the applicant's full name (business or individual) and their mailing address details, including city, state, and ZIP code. If applicable, provide the name and address of the parent corporation or owner.
  5. Identify the 'Responsible Official Name,' which is the person legally accountable for the facility's operation. Include their title, phone number, and the contact details for the permit contact person.
  6. In the 'Permit Information' section, choose the type of permit being applied for: 'Construction Permit,' 'Operation Permit,' 'Operation Permit Renewal,' or 'Operation Permit Revision.' Depending on your selection, provide relevant dates and any necessary citations or descriptions as instructed.
  7. If applicable, indicate if you are requesting expedited review services and provide the associated fee details.
  8. Ensure you have attached any additional information and confirm that two copies of the completed form and additional documents are included.
  9. Once all fields have been filled and reviewed for accuracy, save your changes. You can choose to download, print, or share the completed form as needed.

Complete your WI DNR 4530-100 form online today for efficient submission.

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Air Permit and Compliance Forms | Wisconsin DNR

Email ONE ELECTRONIC COPY* to DNRAMAirPermit@Wisconsin.gov. AND ... Madison WI 53707-7921...

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WI DNR 4530-100 Form

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