San Joaquin Valley Air Pollution Control District 

www.valleyair.org 

CONSERVATION MANAGEMENT PRACTICE PLAN (CMPP)

APPLICATION FOR 

 [ ] TRANSFER OF OWNERSHIP 

 [ ] NAME CHANGE ONLY No change in facility ownership has occurred. 

1. CMP PLAN(S) TO BE ISSUED TO: 

2. MAILING ADDRESS: 

 STREET/P.O. BOX: _________________________________________________________________________________________________________________________________________ 

 9-DIGIT 

 CITY: STATE: ZIP CODE: ________________________ 

3. LOCATION OF THE FACILITY THE CMP PLAN IS COVERING: 

 STREET: _____________________________________________________________________________________________________________________________________________________ 

 CITY: _______________________________________________________________________________________________________________________________________________________ 

4. CMP PLAN ID NO(S).: 

5. SIGNATURE OF APPLICANT (Acquiring Owner or Representative): TYPE OR PRINT TITLE OF APPLICANT: 

6. TYPE OR PRINT NAME OF APPLICANT: DATE: TELEPHONE NO: 

 

7. CMP PLAN(S) CURRENTLY ISSUED TO: 

8. MAILING ADDRESS: 

 STREET/P.O. BOX: _________________________________________________________________________________________________________________________________________ 

 9-DIGIT 

 CITY: STATE: ZIP CODE: 

FOR APCD USE ONLY: 

 DATE STAMP 

 FILING FEE 

 RECEIVED: $ / 

 DATE PAID: 

 PROJECT NO.: FACILITY ID.: ________________________ 
	


 	 

  	  
 

  

 
     	   



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TRANSFER OF OWNERSHIP 

LETTER OF RELEASE

 , as current holder 

 (PRINT BUSINESS NAME AS CURRENTLY LISTED ON CMP Plan)

of record of Conservation Management Practices Plan (as listed below) 

issued by the San Joaquin Valley Unified Air Pollution Control District 

(SJVUAPCD), hereby releases all rights of ownership of the listed CMP 

Plan 

to _______________________________ as of ______________________ 

 (PRINT NAME OF BUSINESS TRANSFERRING TO) (EFFECTIVE DATE OF TRANSFER) 

CMP PLAN ID NUMBER(s)

(PLEASE LIST) 

___________________________________________________________ 

___________________________________________________________ 

___________________________________________________________ 

___________________________________________________________ 

(USE ADDITIONAL SHEETS IF NECESSARY) 

SIGNED: DATE: 

 (PREVIOUS OR RELEASING OWNER’S SIGNATURE) 

NAME: TITLE: 

 (PRINT NAME) 

 

ACQUIRING COMPANY CONTACT (PLEASE PRINT) 

NAME: TELEPHONE: 

 ( ) 

ADDRESS: