AB617 Community Self-Recommendation Form

Note: Information provided by you on this worksheet (including contact or other personal information) is a public record and may be released in response to a California Public Records Act request

Contact Information

Input on Community Selection and Priorities

Community information

10. Is your community recommending itself for deployment of a community air monitoring campaign, for development of a community emissions reduction program, or both?

11.What are the air pollution concern(s) in your community? Select all that apply

Additional information

13. What is the best way for us to get your input? Select all that apply:

Would you like to sign up for updates on AB 617? Select yes to be included in the email list

File upload (optional)
Submit a letter or additional documents

South Coast Air Quality Management District

21865 Copley Dr, Diamond Bar, CA 91765



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