CWSRP Application

2024 PGAIR Wood Smoke Reduction Program Application

Please attach all required documents at the bottom of this form.
Name of applicant*

First NameLast Name
Application Tracking Number*
Please contact info@pgairquality.com with your physical address to obtain your tracking number.
Applicant Email*
example@example.com
Applicant Phone Number*
Address where installation is performed*

Street Address

Street Address Line 2

CityState / Province

Postal Code
Mailing address (if different than location of installation)

Street Address

Street Address Line 2

CityState / Province

Postal Code
The installation is within which local government/electoral area:*

Regional District of the Fraser Fort George (RDFFG)City of Prince George
If installation is within the RDFFG, please indicate which community: *
What type of OLD appliance was REMOVED?*

Non-EPA-Certified Wood StoveWood Fireplace insertOutdoor Wood Boiler (OWB)Wood Furnace
What is the Make/Brand and Model of the OLD appliance that was removed? (If available)
What type of NEW heating system was installed? (All wood/pellet appliances MUST be EPA-certified to qualify).*
Make/Brand and Model of the NEW Appliance*
Name of retailer where appliance was purchased *
Purchase date of appliance*
File Uploads (Required for application to be considered complete):
Photo of the existing installed appliance before removal.*

Cancelof
Photo(s) of the newly installed appliance - in the same place as the old appliance.*

Cancelof
Photo of EPA-Certified info plate/label (wood appliances only).*

Cancelof
Photo of the destroyed appliance or photo of the signed PGAIR recycling declaration form (see website for 2024 form).*

Cancelof
Invoice of NEW Appliance with same full name and installation address of the applicant*

Cancelof
Copy of WETT Inspection (for wood appliances only)

Cancelof
Copy of Solid Fuel Burning Permit (for new builds only and RDFFG residents only)

Cancelof
Applicant Signature*

Clear
Date*

MonthDayYear
Date
Community Wood Smoke Reduction Program (CWSRP) Participant Survey

Why are we doing a survey? To get feedback on the program from CWSRP participants and to improve our program. We hope to find out how can we encourage more exchanges of old wood stoves (for example, accessibility of program; are program requirements viewed as complex, what are the reasons that people participate?) The information from the survey will be summarized by the local program coordinator and submitted to the BC Ministry of Environment and BC Lung. The information will be used to help achieve: more removal of old uncertified wood stoves, better awareness of good burning practices and reduction in wood smoke pollution. This survey is a mandatory requirement for each CWSRP applicant. Please complete the survey. Your responses will be summarized and anonymized. No personal or identifying information will be retained. Thank you!
1. Why do you want to replace your old wood stove (You may choose multiple answers)?*

Concerned about wood smoke in my communityMy old woodstove no longer works wellConcerned about indoor air qualitySafety concernsRecommended by building inspection resultsMy old woodstove is not efficient enoughWant to heat my place with less effortFor cleanliness purposeOthers
2. What type of replacement appliance did you choose?*

certified wood burning appliancepellet burning appliancegas applianceelectric heat pumpelectric fireplace insertother heating appliance
3. How did you hear about this program?*

Brochure or posterIn-storeNewspaper adsRadio adsWebsite or social media such as FacebookHome inspectors or other qualified personnelOthers
4. How often (approximately) did you use your original wood appliance in winter? *
5. How much wood (approximately) do you use in winter?
6. What is the total cost of your new appliance including installation fees? *
7. What does it cost you to dispose of your old wood stove (removal, transportation, recycling)?*
8. How much rebate do you qualify for in total (from the provincial program, local governments, retailers, etc.)*

9. Why did you choose this type of replacement? (Please choose all that apply)*

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Appliance was affordable
Cleaner burning/more efficient
Fuel is affordable
It works during a power outage
Convenience
More effective heat (warmer during cold weather)
Includes air conditioning for hot weather (heat pump)

10. How would you rate the process of participating in the community wood smoke reduction program?*

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
It was easy to find all the required information
The information was clear and adequate
It was easy to fill out the application form
The local retailers were very helpful
It was easy to recycle/destroy your wood stove

How would you rate your overall experience in participating in the program? *

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5

1 is Worst, 5 is Best
Please provide comments or suggestions to improve the program
If you change to a new wood stove, it is mandatory to take the online wood burning course providing your community joins the provincial pilot education project. Did you take the BC Wood Smoke Education online course on our website at: https://www.fraserbasin.bc.ca/WoodSmokeCourse/story_html5.html*

YesNo
If yes, please provide the following comments on the course:
It took about # of hours to complete the course.
I liked the information on wood smoke and health.

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3

4

5

1 is Worst, 5 is Best
I liked the information on clean-burning practices.

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4

5

1 is Worst, 5 is Best
I liked the information on rules and regulations.

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4

5

1 is Worst, 5 is Best
Overall, the information was interesting and useful. I would recommend it to others.

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4

5

1 is Worst, 5 is Best
I did not like the course because:
Other comments you have about the course:
Survey Respondent Characteristics

(optional, if you do not want to provide information, please skip them, and submit the rest of answers)
To which gender, do you most identify?

FemaleMaleOtherPrefer not to answer
What is your family's income range?

Less than 40,000$40,000$ to 80,000$80,000$ to 120,000$120,000$ to 200,000$More than 200,000$Prefer not to answer
Should be Empty:

2024 PGAIR Wood Smoke Reduction Program Application

Community Wood Smoke Reduction Program (CWSRP) Participant Survey

Survey Respondent Characteristics