Application – Construction 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 #:  08-104
Applications and Forms
Revised: 1/1/11

Section 4.1 New Source Performance Standards


Complete Section 4.1 to identify all applicable New Source Performance Standards

Section 4.2 National Emission Standards for Hazardous Air Pollutants
Utilize Section 4.2 to identify all applicable National Emission Standards for Hazardous Air Pollutants

Section 4.3 Prevention of Significant Deterioration
Section 4.3 should be completed by facilities subject to the federal Prevention of Significant Deterioration Program.

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