Texas Commission on Environmental Quality
Air Permits Division
Air Permitting Authorization Void Request Form Instructions
This form is to be completed by the current authorization holder of the facilities or equipment that is
authorized by the air authorization(s), which may include new source review (NSR) authorizations and federal
operating permit (FOP) authorizations. Additional information for FOP Voids is required to be submitted with
this form in most cases. A description of this information can be found at
A Change of
Ownership Form 20405 may be required if the authorization(s) are not currently listed under the entity
requesting voidance. If you have any questions, please call the Air Permits Division (APD) at (512) 239-1250.
Please contact other TCEQ programs areas for their authorization void process (if applicable).
I.
Applicant Information
Provide the Current Owner, Company Contact, Title, Mailing address, phone and fax numbers, and
email address. Also, include the Regulated Entity Number (RN) and for NSR authorizations the
effective date of voidance.
II.
Air Authorizations To Void
List the Registration and Permit Number(s) requesting to void.
III.
Reason For Voidance
Check the appropriate box and provide reasoning, if applicable.
IV.
Authorization Signature
The appropriate company official (owner, plant manager, president, vice president, or environmental
director) must sign the form. It is not appropriate for the applicant’s consultant to sign this form.
For FOPs, 30 TAC § 122.165 (relating to “Certification by a Responsible Official”) requires that a
Responsible Official (RO), or appropriate designee, certify all documents submitted to the TCEQ in
support of an FOP, or that are required by 30 TAC Chapter 122 or by an FOP condition.
Mailing Information
Regular, Certified, Priority Mail
Air Permits Initial Review Team
(APIRT), TCEQ
Mail Code 161, P.O. Box 13087, Austin, Texas 78711-3087
or Hand Delivery, Overnight Mail
Mail Code 161, 12100 Park 35 Circle, Building C,
Third Floor, Room 300 W, Austin, Texas 78753 or
for NSR only by email to apirt@tceq.texas.gov.
Appropriate TCEQ regional office To find your regional office address go to:
or call (512) 239-1250
Appropriate local air pollution
To find your local air pollution control programs go to:
control program(s)
TCEQ – 20569 (APDG 6045v5, Revised 02/16) Air Permitting Authorization Void Request
This form is for use by facilities subject to air quality permit requirements and
may be revised periodically.
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