Permit Application Forms
Clean Air Branch permit application forms, and the instructions for completing them, are available from this site. These include applications for Agricultural Burning Permits and Air Pollution Control Permits. Permit requirements may be found in Hawaii Administrative Rules, Title 11, Chapter 60.1, Air Pollution Control (June 30, 2014). The documents have been converted into portable document format (pdf) to facilitate their posting on the web. Please review the instructions below on how to view documents in pdf format.
Agricultural Burning Permits
Anyone engaged in an agricultural operation is prohibited from causing or allowing agricultural burning without a permit from the Department of Health. The main requirements for agricultural burning, permits and fees appear in HAR Section 11-60.1-51 to -57, and Section 11-60.1-121.
Click to download the application form and instructions:
- Form CAB-AG-1: Application for Agricultural Burning Permit fillable (revised 06/21/2022)
- Form CAB-AG-1 Int: Instructions for Applying for an Agricultural Burning Permit (revised 05/01/2012)
Applicants should carefully read the instructions and the application form. If you need further assistance, please contact the Clean Air Branch.
REMEMBER:
- Submit your filing fee with your permit application.
- Make checks out to: Clean Air Special Fund – NON
- Write your phone number on the check.
- Submit an updated map with each application.
Air Pollution Control Permits (Covered Source Permits and Noncovered Source Permits)
Except as provided in HAR Section 11-60.1-62 or Section 11-60.1-82, an Air Pollution Control Permit is required prior to construction, reconstructing, modifying or operating a stationary air pollution source or air pollution control equipment. Choose from the two categories of Air Pollution Control Permits: Covered Source Permits and Noncovered Source Permits.
Applicants should carefully read the Instructions for Applying for an Air Pollution Control permit and the application forms. If you need further assistance, please contact the Clean Air Branch.
REMEMBER:
- Submit your filing fee with your permit application. Applicants should use the Fee Schedule in the instructions to determine the amount that must be submitted with your permit application.
- For a Covered Source Permit:
- Provide one original and one (1) copy of all application materials.
- Make checks out to Clean Air Special Fund – COV
- For a Noncovered Source Permit:
- Provide one original and one (1) copy of all application materials.
- Make checks out to: Clean Air Special Fund – NON
- Write your phone number on your check.
Covered Source Permit Application Forms
Covered sources include those sources that are major sources of air emissions and sources subject to a federal perfomance or control technology standard. For more details, please see the Definitions section of the instructions. The permit applicability requirements for covered sources are specified in HAR Section 11-60.1-82.
Click to download individual Covered Source Permit (CSP) forms separately or download all the forms required for a permit action at once.
Application for an Initial Covered Source Permit
| Form S-1 | Form S-2 | Form C-1 | Form C-2 | All Forms For an Initial CSP |
Application for a Covered Source Permit Renewal
| Form S-1 | Form S-3 | Form C-1 | Form C-2 | All Forms For a CSP Renewal |
Application for a Temporary Covered Source Permit
| Form S-1 | Form S-4 | Form C-1 | Form C-2 | All Forms For a Temporary CSP |
Application for a General Covered Source Permit
| Form S-1 | Form S-5 | Form C-1 | Form C-2 | All Forms For a General CSP |
Application for a Significant Modification to a Covered Source
| Form S-1 | Form S-6 | Form C-1 | Form C-2 | All Forms For a Significant Modification to a CSP |
Application for a Minor Modification to a Covered Source
| Form S-1 | Form S-7 | Form C-1 | All Forms For a Minor Modification to a CSP |
Application for an Ownership Transfer of a Covered Source Permit
| Form S-1 |
Noncovered Source Permit Application Forms
Noncovered sources include all other stationary sources of air pollution that are not covered sources. For more details, please see the Definitions section of the instructions. The permit applicability requirements for noncovered sources are specified in HAR Section 11-60.1-62.
Click to download individual Noncovered Source Permit (NSP) forms separately or download all the forms required for a permit action at once.
Application for an Initial Noncovered Source Permit
| Form S-1 | Form S-8 | Form C-1 | All Forms For an Initial NSP |
Application for an Noncovered Source Permit Renewal
| Form S-1 | Form S-9 | Form C-1 | All Forms For a NSP Renewal |
Application for an Temporary Noncovered Source Permit
| Form S-1 | Form S-10 | Form C-1 | All Forms For a Temporary NSP |
Application for a General Noncovered Source Permit
| Form S-1 | Form S-11 | Form C-1 | All Forms For a General NSP |
Application for a Modification to a Noncovered Source
| Form S-1 | Form S-12 | Form C-1 | All Forms For a Modification to a NSP |
Application for an Ownership Transfer of a Noncovered Source Permit
| Form S-1 |
If you are unable to download or print the application froms from this website, you may pick them up from the Clean Air Branch office. You may also call to request that forms be mailed or e-mailed to you.
Clean Air Branch
Environmental Management Division
Hawaii State Department of Health
2827 Waimano Home Road, Hale Ola Bldg., Rm. 130
Pearl City, HI 96782
Phone: (808) 586-4200
Fax: (808) 586-4359
E-mail: [email protected]