Republic of the Philippines

DEPARTMENT OF ENVIRONMENT & NATURAL

RESOURCES
ENVIRONMENTAL MANAGEMENT BUREAU
Region 10, Macabalan, Cagayan de Oro City
APPLICATION FORM FOR PERMIT TO OPERATE APSE & APCF
NATURE :

) New

) Renewal

) Change of Ownership

1. Name of Applicant : _______________________________________________________________

2. Position/Designation of Applicant: ____________________________________________________
3. Name of Firm/Establishment: _______________________________________________________
4. Office Location: __________________________________________________________________
5. Telephone No (s): ________________________________________________________________
6. Plant Location: __________________________________________________________________
7. Mailing Address: _________________________________________________________________
8. Capitalization: Authorized: _____________________________ Paid Up: ____________________
9. Name of Accredited/Appointed Pollution Control Officer: _________________________________
10. Nature of Business: _______________________________________________________________
11. List of Air Pollution Source Equipment (APSE) Process (es) and corresponding Air Pollution Control
Facility (ies) (APCP) covered by the permit application. (Use additional sheet if necessary)
Description

Date Installed

(e.g. One (1) unit 500hp Boiler with scrubber, 10 ton cap. Reverberatory
One (1) unit 300kW Diesel Engine Generator Set w/ Muffler

APSE

APCF

a.
b.
c.
d.
12. Maintenance and Operating Cost of Air Pollution Control Facility(ies) (APCF) or APSE
a. Power: __________________________________
b. Labor : __________________________________
c. Replacement Parts: ________________________
13. For new permit applications, total cost of all APCFs or APSEs: (including construction cost covered
by the same)
CERTIFIED CORRECT: _________________________________
Signature of applicant
Permit Fee: _________________
Filing Fee:
Php 55.00
LRF:
Php 10.00

O.R. No. _____________ Date Issued: __________

O.R. No. _____________ Date Issued: __________
O.R. No. _____________ Date Issued: __________

SUBSCRIBED AND SWORN before me, a Notary Public, this _____day of _________, affiants
exhibiting to me their Community Tax receipts:
Tax Receipts:
Name
___________________
___________________

CTR No
___________
___________

Issued at
___________
___________

Issued on
___________
___________

Requirements for Permit to Operate for New and Modified Sources

An application for permit to operate shall be filed for each source emitting regulated air pollutants. Facilities having more than one source may
group the sources under a single permit application, provided the requirements below are met for each individual source. Applications shall be
made in a format prescribed by the Department through the bureau, field in triplicate copies, together with a copy of the official receipt of the
filling fees and including the following:

(a.)

An engineering report covering the plant description and operations, the estimated types, concentrations and quantities of all
emissions to the atmosphere, the control facilities, the emission rate and annual mass emission objectives, the design criteria, if
warranted, shall be based on the results of laboratory and pilot plant scale studies. The designed efficiencies of the air control
equipment and the quantities and types of pollutants in the final emissions shall be indicated. Where confidential records are involved,
the bureau may limit the full disclosure of the same after discussions with the applicant;

(b.)

The plan and specifications of the installation and its control facilities (preferably in standard size of 50 cm by 90 cm) duly certified by a
registered professional mechanical engineer, chemical engineer or any appropriate engineer or a combination of any two or all of them
as may be required by the Bureau depending upon the nature of the construction, operation or activity sought to be covered by the
permit. The plans shall clearly show in adequate detail the agreement, location and size of the pollution control equipment or facilities,
including their accessories, cross, sections. And construction details. The specification shall be in sufficient detail so that, when read in
conjunction with the plans, they clearly reveal the proposed means and methods for the control of pollution and their expected
performance efficiency.

(c.)

The project proponent shall conduct and air quality impact analysis using Bureau-Approved computer dispersion models and
techniques. The impact analysis shall estimate the resulting ambient air concentrations for all significant pollutants from the facility, and
shall include the existing ambient air concentrations as a baseline. The impact analysis will be used by the Bureau, together with other
relevant information, to determine if the construction or modification will result in a violation of applicable air quality standard.

(d.)
(e.)
(f.)
(g.)
(h.)

A vicinity map adequately identifying the street address, if any, of the location or premises of the installation.
Photocopy of the Environmental Compliance Certificate (ECC) from the Department or Certificate of Non-Coverage (CNC);
Tax Identification Number and/or SEC registration.
Certification attesting the specific date when the installation(s) was/were completed/operated.
Appointment/designation of a Pollution Control Officer by the managing head.

(i.)

Additional requirements pursuant to MC No: 2007-003 for New and Modified sources prior to issuance of regular permit.
For large a and environmentally significant b sources permit applicants shall be required emission test and dispersion modeling
to demonstrate compliance with the source-specific ambient air quality standards.
For medium-sized source c, only emission testing shall be required.

Requirements for Renewal of Permit to Operate for Existing Air Pollution Sources and Control Installations
f
(a.)
(b.)
(c.)
(d.)

Copies of Quarterly Self-Monitoring Reports for the immediately preceding year;

Copy of the Certificate of Accreditation of the Pollution Control officer duly issued by the Department, or appointment or designation
as such by the Managing Head;
Official Receipt of Payment.
Periodic or Routine Compliance Testing of Existing Sources depending on the classification of the installation as provided in
Memorandum Circular 2007-003.
A large or environmentally significant existing source should be tested twice per year for each year of its operation by the
permittee/facility operator to verify its compliance. Each test shall consist of three sampling runs.
A medium-sized existing source should be tested annually by the permittee/facility operator to verify its compliance. Each
test shall consist of three sampling runs.
A small existing source should be tested by the permittee/facility operator once during the first year of its operation to verify
its compliance. Thereafter, it should be tested once in every second year. Each test shall consist of three sampling runs.
All sources using Bunker fuel, blended fuels involving Bunker fuel, or fuels with a sulfur content of 1% or more, shall be
tested twice each year for each year of their operation. Each test shall consist of three sampling runs.
Other Existing Sources Not Requiring emission testing for permitting purposes: boilers rated at less than 50 HP; diesel
generators rated at less than 300 kW and other sources that have the potential to emit less than 10 tonnes per year of an air
pollutant regulated under the Act.

Requirements in the Permit to Operate will be based on operating conditions at the time of the test. For example, if the facility passes
the stack sampling test at 50% operating capacity, then the Permit to Operate will require the facility to operate at or below 50% operating
capacity.
a

large source is defined as a boiler rated at 251horsepower (HP) or greater, a diesel generator rated at 1,250 kilowatts (kW) or
greater (regardless of its frequency of operation); or any source that has the potential; to emit 100 tonnes or more per year of an air
pollutant regulated under the Clean Air Act.
b

medium-sized source is defined as a boiler rated at 100 to 250 HP; a diesel generator rated at 600 to 1,249 kW (regardless of its
frequency of operation); or any other source that has the potential to emit at least 30 tonnes per year, but less than 100 tonnes per
year, of an air pollution regulated under the Act.
small source is defined as a boiler rated at 99 HP or less; a diesel generator rated at 599 kW or less (regardless of its frequency of
operation); or any source that has the potential to emit at least 10 tonnes per year, but less than 30 tonnes per year, of an air
pollution regulated under Act.
c

Environmentally significant source is defined as any source of emissions of hazardous air pollutants included on the list of
Priority Chemicals in DAO 1998-58; and the principal emission sources at petroleum refineries, petrochemical works, smelters,
cement kilns, and steel, ferro-alloy and glass-making plants.