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Relocation of Portable Concrete Batch Plant

  1. Only for relocation of portable concrete batch plants for which an Order of Approval has been previously issued by the Agency and the current annual registration fee has been paid

  2. AGENCY USE ONLY

  3. Date

  4. Registration No.

  5. Notification No.

  6. FACILITY INFORMATION

  7. Business Hours

  8. EQUIPMENT INFORMATION

    1. Silos

    2. Weigh Hopper Baghouse

    3. CERTIFICATION

    4. I, the undersigned, do hereby certify that the information contained in this notification is, to the best of my knowledge, accurate and complete.

    5. Electronic Signature Agreement

      By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    6. You must pay a $200 filing fee to complete this application. Please select an option for payment below.

    7. Leave This Blank:

    8. This field is not part of the form submission.