Ennis, TX · Ellis County
BMR Priority Pollutant Form
This form lets a facility’s authorized representative identify priority pollutants associated with its manufacturing or service activities and report concentrations.
What this form is
The BMR Priority Pollutant Form records whether listed chemicals are known or suspected to be present or absent in a facility’s manufacturing or service activity, or generated as a by-product. For each pollutant known or suspected to be present, the form asks for its concentration per day. It also requests the company and facility names, authorized representative’s name and signature, and date.
Who needs it
A facility’s authorized representative can use this form to report priority pollutants connected with the facility’s activities or generated as by-products.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This form is signed and dated without a notary; it lists no notarized attachment or sworn step.
How to submit this form
- 1
Download The Form
Download the BMR Priority Pollutant Form PDF.
- 2
Complete The Pollutant List
Mark the appropriate status for each pollutant and enter a daily concentration for each pollutant known or suspected to be present.
- 3
Add Facility Details
Enter the company name, facility name, authorized representative’s name, date, and signature.
- 4
Submit To The City
Submit the completed form to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What information does the BMR Priority Pollutant Form collect?
- It asks the facility to mark whether listed pollutants are known or suspected to be present or absent, and to enter daily concentrations for those known or suspected to be present. It also requests company and facility names, representative details, signature, and date.
- Who completes the BMR Priority Pollutant Form?
- The form includes fields for the company name, facility name, and authorized representative’s name, signature, and date.
- Do I need a notary for the BMR Priority Pollutant Form?
- No. The form has an authorized representative signature and date field, but no notary block or notarized attachment or sworn step.
- How do I submit the BMR Priority Pollutant Form?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This BMR Priority Pollutant Form doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.