Form Tceq 10400 – Fill Out and Use This PDF

Form Tceq 10400 is an Environmental Protection Agency, or EPA form. It documents team compliance with specific certification and record keeping requirements that state agencies must follow. Created to ensure protection of national air and water resources, Form Tceq 10400 certified necessary reports on these accurate readings, as well as proper management of oil levels and monitoring of licencing agreements in these areas of toxins. With its simple data entry segments, the form neatly tabulates all regular standards and ensures adherence to protocol. Over 42 states have adopted this rigorous regulation process. Furthermore, when the proper changes to legislation occur, Form Tceq 10400 adjusts accordingly to maintain its accuracy.

Form Tceq 10400 PDF Details

The TCEQ 10400 is an important document for any business that emits pollutants into the air. This form must be filled out and submitted to the TCEQ every year, and it contains detailed information about your company's emissions. Understanding what this form requires can help you stay in compliance with state regulations. In this blog post, we'll discuss what information is required on the TCEQ 10400 and explain how to complete it accurately. We'll also provide a sample template to help you get started. Happy reading!

Question	Answer
Form Name	Form Tceq 10400
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	TX, tceq, Preparer, E-Mail

Form Preview Example

TCEQ Core Data Form

TCEQ Use Only

For detailed instructions regarding completion of this form, please read the Core Data Form Instructions or call 512-239-5175.

SECTION I: General Information

1. Reason for Submission (If other is checked please describe in space provided)

New Permit, Registration or Authorization (Core Data Form should be submitted with the program application)

Renewal (Core Data Form should be submitted with the renewal form)

Other

2.	Attachments		Describe Any Attachments: (ex. Title V Application, Waste Transporter Application, etc.)
	Yes	No

3.	Customer Reference Number (if issued)			Follow this link to search	4. Regulated Entity Reference Number (if issued)
CN				for CN or RN numbers in	RN
CN				Central Registry**	RN

SECTION II: Customer Information

5. Effective Date for Customer Information Updates (mm/dd/yyyy)

6. Customer Role (Proposed or Actual) – as it relates to the Regulated Entity listed on this form. Please check only one of the following:

Owner

Occupational Licensee

Operator Responsible Party

Owner & Operator Voluntary Cleanup Applicant

Other:

7. General Customer Information

	New Customer		Update to Customer Information		Change in Regulated Entity Ownership
	Change in Legal Name (Verifiable with the Texas Secretary of State)				No Change**
**If “No Change” and Section I is complete, skip to Section III – Regulated Entity Information.

	8. Type of Customer:	Corporation		Individual	Sole Proprietorship- D.B.A
	City Government	County Government		Federal Government	State Government
	Other Government	General Partnership		Limited Partnership	Other:

	If new Customer, enter previous Customer
9. Customer Legal Name (If an individual, print last name first: ex: Doe, John)	If new Customer, enter previous Customer	End Date:
	below	End Date:

10.Mailing

Address:

City

State

ZIP

ZIP + 4

11.

Country Mailing Information (if outside USA)

12. E-Mail Address (if applicable)

13. Telephone Number

14. Extension or Code

15. Fax Number (if applicable)

(

)

(

)

16.

Federal Tax ID (9 digits)

17. TX State Franchise Tax ID (11 digits)

18. DUNS Number(if applicable)

19. TX SOS Filing Number (if applicable)

20. Number of Employees

21. Independently Owned and Operated?

0-20

21-100

101-250

251-500

501 and higher

Yes

SECTION III: Regulated Entity Information

22. General Regulated Entity Information (If ‘New Regulated Entity” is selected below this form should be accompanied by a permit application)

New Regulated Entity

Update to Regulated Entity Name

Update to Regulated Entity Information

No Change** (See below)

**If “NO CHANGE” is checked and Section I is complete, skip to Section IV, Preparer Information.

23. Regulated Entity Name (name of the site where the regulated action is taking place)

TCEQ-10400 (09/07)

Page 1 of 2

24.

Street Address

of the Regulated

Entity:

(No P.O. Boxes)

City

State

ZIP

ZIP + 4

25.

Mailing

Address:

City

State

ZIP

ZIP + 4

26.

E-Mail Address:

27. Telephone Number

28. Extension or Code

29. Fax Number (if applicable)

(

)

(

)

30.

Primary SIC Code (4 digits)

31. Secondary SIC Code (4 digits)

32. Primary NAICS Code

33. Secondary NAICS Code

(5 or 6 digits)

34.

What is the Primary Business of this entity? (Please do not repeat the SIC or NAICS description.)

Questions 34 – 37 address geographic location. Please refer to the instructions for applicability.

35.Description to Physical Location:

36.

Nearest City

County

State

Nearest ZIP Code

37.

Latitude (N)

In Decimal:

38. Longitude (W)

In Decimal:

Degrees

Minutes

Seconds

Degrees

Minutes

Seconds

39.TCEQ Programs and ID Numbers Check all Programs and write in the permits/registration numbers that will be affected by the updates submitted on this form or the updates may not be made. If your Program is not listed, check other and write it in. See the Core Data Form instructions for additional guidance.

Dam Safety

Districts

Edwards Aquifer

Industrial Hazardous Waste

Municipal Solid Waste

New Source Review – Air

OSSF

Petroleum Storage Tank

PWS

Sludge

Stormwater

Title V – Air

Tires

Used Oil

Utilities

Voluntary Cleanup

Waste Water

Wastewater Agriculture

Water Rights

Other:

SECTION IV: Preparer Information

40.

Name:

41. Title:

42.

Telephone Number

43. Ext./Code

44. Fax Number

45. E-Mail Address

(

)

(

)

SECTION V: Authorized Signature

46.By my signature below, I certify, to the best of my knowledge, that the information provided in this form is true and complete, and that I have signature authority to submit this form on behalf of the entity specified in Section II, Field 9 and/or as required for the updates to the ID numbers identified in field 39.

(See the Core Data Form instructions for more information on who should sign this form .)

Company:

Job Title:

Name(In Print) :

Phone:

(

)

Signature:

Date:

TCEQ-10400 (09/07)

Page 2 of 2

How to Edit Form Tceq 10400 Online for Free

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Form Tceq 10400 – Fill Out and Use This PDF

Form Tceq 10400 PDF Details

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