Statewide Portable Equipment Registration Program

Form 39 - Rental Engine orEquipment Unit - District Notification Form

(Auto-fill format. Use “Tab” or up/down arrows to enter information. Additional form information is provided on the reverse side.)

PERP Registration forms are available at

1. Rental Company Name:
2. PERP RegistrationNumber:
3. Date Rental Period Started:
4. Air District (See Instructions):
5. Rental Customer Mailing Address:
City: / State: / Zip:
6. Rental Customer Phone Number:
7. Estimated Location:
8.Name of Responsible Official (Printed): / 9. Phone Number: / 10. Date:

Please send thisform to the air district listed in Item 4. Mailing addresses and contact information for the air districts can be found on this website:

Form 39Instructions

General: Submit a separate form for each PERP Registration number. This form shall be submitted by the rental business for transactions that exceed 9 months in duration.

  1. RentalCompany Name– Legal name of business that owns the registered portable engine or equipment unit.
  2. PERP Registration Number– Enter the registration number from the registrationcertificate or sticker. Use only one PERP registration number per form.
  1. Date Rental Period Started – Enter the exact date (month, day, year) that the renter took possession of the rental equipment.
  2. Air District – Enter the local air district (APCD or AQMD) where the rental business is located. Even if the rental equipment is operating in a different air district, enter the district where the equipment was rented out from.

Here is a list of air districts:

Amador County APCD / Lake CountyAQMD / San Diego CountyAPCD
Antelope Valley AQMD / Lassen CountyAPCD / San Joaquin Valley APCD
Bay Area AQMD / Mariposa CountyAPCD / San Luis Obispo CountyAPCD
Butte CountyAQMD / Mendocino CountyAQMD / Santa Barbara CountyAPCD
Calaveras CountyAPCD / Modoc CountyAPCD / Shasta CountyAQMD
Colusa CountyAPCD / Mojave Desert AQMD / Siskiyou CountyAPCD
El Dorado CountyAQMD / Monterey Bay Unified APCD / South Coast AQMD
Feather River AQMD / North Coast Unified AQMD / Tehama CountyAPCD
Glenn CountyAPCD / Northern Sierra AQMD / Tuolumne CountyAPCD
Great Basin Unified APCD / Northern Sonoma CountyAPCD / Ventura CountyAPCD
Imperial CountyAPCD / Placer CountyAPCD / Yolo-Solano AQMD
Kern County APCD / Sacramento Metro AQMD
  1. Rental Customer Mailing Address– Enter the mailing address provided by the rental customer.
  1. Rental Customer Phone Number – Enter thephone numberprovided by the rental customer.
  1. Estimated Location – Enter the location (street address, city, or county) where the rental equipment is expected to be operated.

8-9.Enter the name and phone number of the Responsible Official from the rental business.

  1. Date – Enter the date this form was filled out.

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