B24-0578 - 32169 CAMINO CAPISTRANO12/03/24
Page 1 of 2
Rev. June 2019 AQPC #
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
Air Quality Permit Checklist
South Coast Air Quality Management District developed this Air Quality Permit Checklist (checklist) as a
screening evaluation tool in the process required by California Government Code Section 65850.2.
Please submit this checklist to the Small Business Assistance Office by email, mail, or in person for review.
If you have any questions or need assistance completing this checklist, contact the Small Business Assistance
Office. Provide a response to all sections of this checklist as South Coast AQMD may decline to approve this
checklist due to lack of information from the applicant.
NOTE: This checklist is not intended for the approval of demolition or renovation activities. If there are any
demolition or renovation activities that may disturb building materials, please contact the
Asbestos Hotline at 909-396-2336.
Section A – Operator and Business Information
1.Business Name:
2.Address:
___________________________________________ ______________________________ CA _________________
Street City Zip
3.Contact Name:Phone:
Title: Email:
Section B – Business and Equipment Description
Please provide a detailed description of the ongoing business operations performed and equipment used at this location,
including both new and existing equipment.
Provide the existing South Coast AQMD facility ID and/or permit numbers, if any.
Small Business Assistance Office
1-800-388-2121
smallbizassistance@aqmd.gov
www.aqmd.gov
CCH MANAGEMENT
32169 CAMINO CAPISTRANO SAN JUAN CAPISTRANO 92675
JERMAINE MAEWEATHER
JERMAINE@WEGREENINC.COMAGENT
6196778487
REPLACE - HVAC PACKAGE UNIT
THIS IS A STRIP MALL - COVERING 32169 CAMINO CAPISTRANO
CCH MANAGEMENT 0 MANAGES THIS PROPERTY FO RMULTIPLE TENANTS, WITHMULTIPLE UNITS AND SIZES.
#2024-0782
Page 2 of 2
Rev. June 2019 AQPC #
*An Authorized Representative is an employee of the business described in Section A, who is authorized to sign on behalf of the
owner.
Section C – Equipment List
Select from the list below equipment currently in operation or to be installed.
(Select all that apply and provide the specifications)
Section D - Business Self Certification
7.Owner or Authorized Representative*:Title:
Signature: Date: Phone:
I hereby certify by my signature above that, I am a duly authorized representative of the above-named business, and
that all information contained herein is true and correct. South Coast AQMD USE ONLY Equipment: Approved By:
Applicant has permit(s) or registration(s):
Applicant has filed for permit(s) or registration(s):
Applicant is exempt from permit requirements:
Based on the information provided, no equipment/process
requiring a permit or registration.
Soldering Oven
Spray Booth
Storage Tanks
Storage Silos
Fuel-burning equipment
OTHER equipment which may have the
potential to emit or control air
contaminants:
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
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Abrasive Blasting Cabinet/Room
Air Conditioning Systems (> 50 lbs of refrigerant)
Application of Paints/Adhesives/Resins
Baghouse/Dust Collector
Bakery Oven (gas-fired, excluding eating establishments)
Boiler/Water Heater
(max. heat input = or > 1 million BTU/hr)
Charbroiler
Coffee Roaster (excluding eating establishments)
Deep Fryer (excluding eating establishments)
Dry Cleaning
Electrostatic Precipitator
Etching/Plating/Casting/Melting/Forging/Grinding/Cutting
Fermentation
Gasoline Storage & Dispensing
Internal Combustion Engine
(rated > 50 bhp; e.g. back-up generator, fire pump)
Mixing/Bleding of Liquids and/or Powders
Molding/Extruding/Curing of Plastics
Pharmaceutical/Nutraceutical
Plasma/Laser Cutter
Printing/Coating/Drying
Refrigeration Systems (containing >50 lbs of refrigerant)
Contact the CA Air Resources Board to register the systems.
916-324-2517 or rmp@arb.ca.gov
JERMAINE MAEWEATHER AGENT
7/30/2024 6196778487
#2024-0782
None
x
Rhea Lam