INSTRUCTIONS

1. Fully accomplish this form and complete all the supporting documents indicated hereunder.
Submit all documents in duplicate copies to our Air & Water Permitting Section of the Clearance
and Permitting Division for screening and assessment fees.
2. Proceed to the Accounting Section for the issuance of “Order of Payment”. Thereafter, pay to the
Cashier Section the corresponding amount indicated in the “Order of Payment”.
3. Submit your application together with the official receipt to the Records Section and ask for your
receiving copy.
Your application shall be acted upon with thirty (30) working days and you shall be informed of our
action accordingly.
Types of Application Documents Required
 New Item Nos. , , , , ,  & 
 Additional/Modification Item Nos. , , , ,  & 
 Change of Name/Ownership Item Nos. , , & 
 Renewal Item Nos.  & 11

Supporting Documents
 Engineer’s Report prepared by the Pollution Control Officer and approved by the
President/General Manager with at least containing the following:
 Company profile
 Amount of raw materials and finished products
 Material balance
 Process flow diagram indicating all sources of air emission or possible air emission
 Brief description of process.
 List of APSI and corresponding air pollution control facility (APCF) with complete
specifications
 Discussion of each APSI & APCF showing the process/mode of operation, design
criteria & efficiencies of the APCF, the quantities & types of pollutants in the final
emissions.
 Discussion of mitigating measures undertaken if APSI is not provided with APCF
 Pollution loading of the regulated air pollutants in tons/year.
 Drawing requirements in 50cm x 90 cm paper signed by the President/General Manager
and duly signed by PME/ChE or any appropriate engineer from the two.
 Vicinity Map;
 Plant & Machinery Layout showing the connection of the APSI to APCF;
 Plan & elevation drawings of each APSI & APCF.
 Sectional drawings of the APCF.
Copy of the Certificate of Accreditation of the Pollution Control Officer, or
appointment/designation as such by the Managing Head.

 Environmental Compliance Certificate (ECC) or Certificate of Non-Coverage (CNC) copy.

 Source Emission Test Requirement (if required).
 Copy of Recent “Permit to Operate” issued by the Office.
Copy of Discharge Permit, if applicable.
 Copy of Hazardous Waste Generator Registration ID, if applicable.
 Copy of SEC Registration Certificate & Articles of Incorporation.
 Copy of DTI Registration Certificate
     
11 Proof of compliance to permit conditions.