1177 Annual LPG Reporting Forms

Please see the links to the various SCAQMD Rule 1177 (PDF) sample forms for monthly and annual recordkeeping and reporting as required by subdivision (g) of the rule.  Note also that the owner/operator may be required to maintain and make available, upon request, these and other pertinent records outlined in subdivision (f) of the rule.

If you have any questions or comments, please email Ken Ellis at kellis@aqmd.gov.

• Form R1177-GI - General Information (XLS, 109kb) 

• Form R1177-EDD - Exempt from Disclosure Designation (XLS, 114kb) 

• Form R1177-1 - LPG Purchase and Sales (XLS, 100kb)

• Form 1177-1S - LPG Supplier Customer Report (XLS, 100kb) 

• Form R1177-2 - Connector End of Year Inventory (XLS, 101kb) 

• Form R1177-3 - Container and FLLG End of Year Inventory (XLS, 101kb) 

Rule 1177 Forms (all forms as a single file workbook) (XLS, 186kb)