What is the Non-Attainment-Area Dust Permit Closeout Form?

It collects project and permit details, the permit holder’s information, and responses about whether development has ceased and disturbed areas have been stabilized.

Who uses this dust permit closeout form?

The form is for a permit holder completing a closeout for a project. It asks the permit holder to identify their relationship to the property and provide project and contact information.

Do I need a notary for the Non-Attainment-Area Dust Permit Closeout Form?

No. The form has a signature and date field, but no notary block; the permit holder just signs and dates it.

How do I submit the dust permit closeout form?

The form lists the Pinal County Air Quality Control District mailing address as PO Box 987, Florence, AZ 85132, and provides fax number (520) 866-6967.

Pinal County, AZ · Pinal County

No notary required

Non-Attainment-Area Dust Permit Closeout Form

The Pinal County Air Quality Control District form records project details and stabilization information for a dust permit closeout.

At a glance

Issued by: City of Pinal County · Pinal County, Pinal County, Arizona
Notarization: Not required: file this form without a notary.
Official source: pinal.gov
Blank form: Download the PDF
Catalogued: Oct 5, 2026
Machine-readable: JSON record · about the forms index

What this form is

Use this form to provide project and permit details and report whether development activity has ceased and disturbed portions of the site have been stabilized. It asks for the permit holder’s relationship to the property, entity and contact information, parcel details, and stabilization test form status. The form includes signature and date fields and a section for district office use.

Who needs it

A permit holder completing a dust permit closeout for a project in a non-attainment area can use this form.

How to submit it

The form lists the Pinal County Air Quality Control District at PO Box 987, Florence, AZ 85132, and provides fax number (520) 866-6967.

About notarization

This form is signed without a notary; the permit holder just signs and dates it.

How to submit this form

1
Download the Form
Download the Non-Attainment-Area Dust Permit Closeout Form PDF.
2
Complete Project Details
Enter the project name, permit number, address, parcel information, permit holder details, and stabilization responses.
3
Gather Parcel Information
Attach an assessor’s parcel list if necessary, as indicated on the form.
4
Sign and Submit
Sign and date the form, then use the district mailing address or fax number listed on it.

Frequently asked questions

What is the Non-Attainment-Area Dust Permit Closeout Form?: It collects project and permit details, the permit holder’s information, and responses about whether development has ceased and disturbed areas have been stabilized.
Who uses this dust permit closeout form?: The form is for a permit holder completing a closeout for a project. It asks the permit holder to identify their relationship to the property and provide project and contact information.
Do I need a notary for the Non-Attainment-Area Dust Permit Closeout Form?: No. The form has a signature and date field, but no notary block; the permit holder just signs and dates it.
How do I submit the dust permit closeout form?: The form lists the Pinal County Air Quality Control District mailing address as PO Box 987, Florence, AZ 85132, and provides fax number (520) 866-6967.

Need something notarized?

This Non-Attainment-Area Dust Permit Closeout Form doesn’t need a notary, but if you have another Pinal County form that does, a commissioned online notary can help.