Follow the steps to complete the form successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Enter the owner information for the gasoline dispensing facility in the designated fields. This includes the name of the business, billing address, city, state, zip code, and telephone number.
3. Provide the name and title of the applicant. Ensure that the applicant is an authorized agent or owner of the facility.
4. Input the location details of the gasoline dispensing facility, including the name of the facility, street address, city, state, zip code, and telephone number.
5. Select the appropriate certificate number, indicating whether you are applying for an installation permit, an initial certificate of operation, or a renewal certificate of operation (invoiced annually).
6. Fill in the facility information, including the tank ID or number and the tank details such as octane type (regular, mid-grade, or premium) and tank size (in gallons).
7. Indicate whether the tank is dual or coaxial by selecting 'D' or 'C'.
8. Provide the normal operating schedule, including hours per day, days per week, annual gallons of throughput, previous years' gallons of throughput, and the estimate for a new facility.
9. Complete the certification section by signing your name and dating the form to confirm the accuracy of the information provided.
10. After filling out all sections, review the form for accuracy. Users can then save changes, download, print, or share the completed form as needed.

Complete your documents online to ensure compliance with local air pollution regulations.