Application – Operating Permit – Form 4.0 – Applicable Requirements
This information is provided by the Nebraska Department of Environment and Energy to assist the public and regulated community.
Form #: 08-204 Applications and Forms Revised: 9/30/22


Sections 4.1 – 4.3 Applicable Requirements Instructions

Section 4.1 Title 129 Applicable Requirements

Complete Section 4.1 to identify all applicable Title 129 regulations.

Section 4.2. New Source Performance Standard Applicable Requirements

Complete Section 4.2 to identify all applicable New Source Performance Standards.

Section 4.3 National Emission Standards for Hazardous Air Pollutants Applicable Requirements

Section 4.4 Compliance Assurance Monitoring Applicability

Class I sources subject to Compliance Assurance Monitoring (CAM) must complete Section 4.4. For more information about CAM, view the instructions and our factsheet on the NDEE Website. CAM factsheet

Note: Effective Oct. 1, 2009, any individual submitting any application or form that would derive public benefit from the state must also fill out a United States Citizenship Attestation form. This applies to individuals submitting the forms on their own behalf. If applicable, please fill out the United States Citizenship Attestation form below and submit it with the relevant applications and forms.

United States Citizenship Attestation Form

This Complete Form is only available as an Adobe Acrobat (PDF) file.
File size is 97 KB