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+-------------+---+---+-----------------------------+------+----------+-----+
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+-------------+---+---+-----------------------------+------+----------+-----+
| **STEP 1**  |   | F |                             | S    | OR       | U   |
|             |   | a |                             | tate | IS/Plant | nit |
| Identify    |   | c |                             |      | Code     | ID# |
| the unit by |   | i |                             |      |          |     |
| facility    |   | l |                             |      |          |     |
| (source)    |   | i |                             |      |          |     |
| name,       |   | t |                             |      |          |     |
| State,      |   | y |                             |      |          |     |
| ORIS/plant  |   | ( |                             |      |          |     |
| code and    |   | S |                             |      |          |     |
| unit ID#.   |   | o |                             |      |          |     |
|             |   | u |                             |      |          |     |
|             |   | r |                             |      |          |     |
|             |   | c |                             |      |          |     |
|             |   | e |                             |      |          |     |
|             |   | ) |                             |      |          |     |
|             |   | N |                             |      |          |     |
|             |   | a |                             |      |          |     |
|             |   | m |                             |      |          |     |
|             |   | e |                             |      |          |     |
+-------------+---+---+-----------------------------+------+----------+-----+
| **STEP 2**  |   |   | Acid Rain                   |      |          |     |
|             |   |   |                             |      |          |     |
| Indicate    |   |   | CAIR NO~X~ Annual           |      |          |     |
| the         |   |   |                             |      |          |     |
| program(s)  |   |   | CAIR SO~2~                  |      |          |     |
| that the    |   |   |                             |      |          |     |
| unit is     |   |   | CAIR NO~X~ Ozone Season     |      |          |     |
| subject to: |   |   |                             |      |          |     |
|             |   |   | CAMR (Hg Budget Trading)    |      |          |     |
+-------------+---+---+-----------------------------+------+----------+-----+
| **STEP 3**  |   |   |                             |      |          |     |
|             |   |   |                             |      |          |     |
| Identify    |   |   |                             |      |          |     |
| the date on |   |   |                             |      |          |     |
| which the   |   |   |                             |      |          |     |
| unit was    |   |   |                             |      |          |     |
| (or will    |   |   |                             |      |          |     |
| be)         |   |   |                             |      |          |     |
| permanently |   |   |                             |      |          |     |
| retired.    |   |   |                             |      |          |     |
+-------------+---+---+-----------------------------+------+----------+-----+
|             |   |   |                             |      |          |     |
+-------------+---+---+-----------------------------+------+----------+-----+
|             |   |   |                             |      |          |     |
+-------------+---+---+-----------------------------+------+----------+-----+
| **STEP 4**  |   |   |                             |      |          |     |
|             |   |   |                             |      |          |     |
| If the unit |   |   |                             |      |          |     |
| is subject  |   |   |                             |      |          |     |
| to the Acid |   |   |                             |      |          |     |
| Rain        |   |   |                             |      |          |     |
| Program,    |   |   |                             |      |          |     |
| identify    |   |   |                             |      |          |     |
| the first   |   |   |                             |      |          |     |
| full        |   |   |                             |      |          |     |
| calendar    |   |   |                             |      |          |     |
| year in     |   |   |                             |      |          |     |
| which the   |   |   |                             |      |          |     |
| unit meets  |   |   |                             |      |          |     |
| (or will    |   |   |                             |      |          |     |
| meet) the   |   |   |                             |      |          |     |
| r           |   |   |                             |      |          |     |
| equirements |   |   |                             |      |          |     |
| of 40 CFR   |   |   |                             |      |          |     |
| 72.8(d).    |   |   |                             |      |          |     |
+-------------+---+---+-----------------------------+------+----------+-----+
|             |   |   | January 1,                  |      |          |     |
|             |   |   | \_\_\_\_\_\_\               |      |          |     |
|             |   |   | _\_\_\_\_\_\_\_\_\_\_\_\_\_ |      |          |     |
+-------------+---+---+-----------------------------+------+----------+-----+
|             |   |   |                             |      |          |     |
+-------------+---+---+-----------------------------+------+----------+-----+
| **STEP 5**  | * |   |                             |      |          |     |
|             | * |   |                             |      |          |     |
| Read the    | A |   |                             |      |          |     |
| appropriate | c |   |                             |      |          |     |
| special     | i |   |                             |      |          |     |
| provisions. | d |   |                             |      |          |     |
|             | R |   |                             |      |          |     |
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|             | r |   |                             |      |          |     |
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|             | . |   |                             |      |          |     |
+-------------+---+---+-----------------------------+------+----------+-----+

+------------+----------------------------------+---------------------+
|            | Plant Name (from STEP 1)         | Retired Unit        |
|            |                                  | Exemption           |
|            |                                  |                     |
|            |                                  | Page 2              |
+------------+----------------------------------+---------------------+
|            | **CAIR NO~X~ Annual Trading      |                     |
|            | Program Special Provisions**     |                     |
|            |                                  |                     |
|            | \(1\) A unit exempt under 40 CFR |                     |
|            | 96.105(a) shall not emit any     |                     |
|            | nitrogen oxides, starting on the |                     |
|            | date that the exemption takes    |                     |
|            | effect.                          |                     |
|            |                                  |                     |
|            | \(2\) The permitting authority   |                     |
|            | will allocate CAIR NO~X~         |                     |
|            | allowances under 40 CFR 96       |                     |
|            | subpart EE to a unit exempt      |                     |
|            | under 40 CFR 96.105(a).          |                     |
|            |                                  |                     |
|            | \(3\) For a period of 5 years    |                     |
|            | from the date the records are    |                     |
|            | created, the owners and          |                     |
|            | operators of a unit exempt under |                     |
|            | 40 CFR 96.105(a) shall retain,   |                     |
|            | at the source that includes the  |                     |
|            | unit, records demonstrating that |                     |
|            | the unit is permanently retired. |                     |
|            | The 5‑year period for keeping    |                     |
|            | records may be extended for      |                     |
|            | cause, at any time before the    |                     |
|            | end of the period, in writing by |                     |
|            | the permitting authority or the  |                     |
|            | Administrator. The owners and    |                     |
|            | operators bear the burden of     |                     |
|            | proof that the unit is           |                     |
|            | permanently retired.             |                     |
|            |                                  |                     |
|            | \(4\) The owners and operators   |                     |
|            | and, to the extent applicable,   |                     |
|            | the CAIR designated              |                     |
|            | representative of a unit exempt  |                     |
|            | under 40 CFR 96.105(a) shall     |                     |
|            | comply with the requirements of  |                     |
|            | the CAIR NO~X~ Annual Trading    |                     |
|            | Program concerning all periods   |                     |
|            | for which the exemption is not   |                     |
|            | in effect, even if such          |                     |
|            | requirements arise, or must be   |                     |
|            | complied with, after the         |                     |
|            | exemption takes effect.          |                     |
|            |                                  |                     |
|            | \(5\) A unit exempt under 40 CFR |                     |
|            | 96.105(a) and located at a       |                     |
|            | source that is required, or but  |                     |
|            | for this exemption would be      |                     |
|            | required, to have a title V      |                     |
|            | operating permit shall not       |                     |
|            | resume operation unless the CAIR |                     |
|            | designated representative of the |                     |
|            | source submits a complete CAIR   |                     |
|            | permit application under 40 CFR  |                     |
|            | 96.122 for the unit not less     |                     |
|            | than 18 months (or such lesser   |                     |
|            | time provided by the permitting  |                     |
|            | authority) before the later of   |                     |
|            | January 1, 2009 or the date on   |                     |
|            | which the unit resumes           |                     |
|            | operation.                       |                     |
|            |                                  |                     |
|            | \(6\) On the earlier of the      |                     |
|            | following dates, a unit exempt   |                     |
|            | under 40 CFR 96.105(a) shall     |                     |
|            | lose its exemption:              |                     |
|            |                                  |                     |
|            | \(i\) The date on which the CAIR |                     |
|            | designated representative        |                     |
|            | submits a CAIR permit            |                     |
|            | application for the unit under   |                     |
|            | 40 CFR 96.105(b)(5);             |                     |
|            |                                  |                     |
|            | \(ii\) The date on which the     |                     |
|            | CAIR designated representative   |                     |
|            | is required under 40 CFR         |                     |
|            | 96.105(b)(5) to submit a CAIR    |                     |
|            | permit application for the unit; |                     |
|            | or                               |                     |
|            |                                  |                     |
|            | \(iii\) The date on which the    |                     |
|            | unit resumes operation, if the   |                     |
|            | CAIR designated representative   |                     |
|            | is not required to submit a CAIR |                     |
|            | permit application for the unit. |                     |
|            |                                  |                     |
|            | \(7\) For the purpose of         |                     |
|            | applying monitoring, reporting,  |                     |
|            | and recordkeeping requirements   |                     |
|            | under 40 CFR 96 subpart HH, a    |                     |
|            | unit that loses its exemption    |                     |
|            | under 40 CFR 96.105(a) shall be  |                     |
|            | treated as a unit that commences |                     |
|            | commercial operation on the      |                     |
|            | first date on which the unit     |                     |
|            | resumes operation.               |                     |
+------------+----------------------------------+---------------------+
|            | **CAIR SO~2~ Trading Program     |                     |
|            | Special Provisions**             |                     |
|            |                                  |                     |
|            | \(1\) A unit exempt under 40 CFR |                     |
|            | 96.205(a) shall not emit any     |                     |
|            | sulfur dioxide, starting on the  |                     |
|            | date that the exemption takes    |                     |
|            | effect.                          |                     |
|            |                                  |                     |
|            | \(2\) For a period of 5 years    |                     |
|            | from the date the records are    |                     |
|            | created, the owners and          |                     |
|            | operators of a unit exempt under |                     |
|            | 40 CFR 96.205(a) shall retain,   |                     |
|            | at the source that includes the  |                     |
|            | unit, records demonstrating that |                     |
|            | the unit is permanently retired. |                     |
|            | The 5‑year period for keeping    |                     |
|            | records may be extended for      |                     |
|            | cause, at any time before the    |                     |
|            | end of the period, in writing by |                     |
|            | the permitting authority or the  |                     |
|            | Administrator. The owners and    |                     |
|            | operators bear the burden of     |                     |
|            | proof that the unit is           |                     |
|            | permanently retired.             |                     |
|            |                                  |                     |
|            | \(3\) The owners and operators   |                     |
|            | and, to the extent applicable,   |                     |
|            | the CAIR designated              |                     |
|            | representative of a unit exempt  |                     |
|            | under 40 CFR 96.205(a) shall     |                     |
|            | comply with the requirements of  |                     |
|            | the CAIR SO~2~ Trading Program   |                     |
|            | concerning all periods for which |                     |
|            | the exemption is not in effect,  |                     |
|            | even if such requirements arise, |                     |
|            | or must be complied with, after  |                     |
|            | the exemption takes effect.      |                     |
|            |                                  |                     |
|            | \(4\) A unit exempt under 40 CFR |                     |
|            | 96.205(a) and located at a       |                     |
|            | source that is required, or but  |                     |
|            | for this exemption would be      |                     |
|            | required, to have a title V      |                     |
|            | operating permit shall not       |                     |
|            | resume operation unless the CAIR |                     |
|            | designated representative of the |                     |
|            | source submits a complete CAIR   |                     |
|            | permit application under 40 CFR  |                     |
|            | 96.222 for the unit not less     |                     |
|            | than 18 months (or such lesser   |                     |
|            | time provided by the permitting  |                     |
|            | authority) before the later of   |                     |
|            | January 1, 2010 or the date on   |                     |
|            | which the unit resumes           |                     |
|            | operation.                       |                     |
|            |                                  |                     |
|            | \(5\) On the earlier of the      |                     |
|            | following dates, a unit exempt   |                     |
|            | under 40 CFR 96.205(a) shall     |                     |
|            | lose its exemption:              |                     |
|            |                                  |                     |
|            | \(i\) The date on which the CAIR |                     |
|            | designated representative        |                     |
|            | submits a CAIR permit            |                     |
|            | application for the unit under   |                     |
|            | 40 CFR 96.205(b)(4);             |                     |
|            |                                  |                     |
|            | \(ii\) The date on which the     |                     |
|            | CAIR designated representative   |                     |
|            | is required under 40 CFR         |                     |
|            | 96.205(b)(4) to submit a CAIR    |                     |
|            | permit application for the unit; |                     |
|            | or                               |                     |
|            |                                  |                     |
|            | \(iii\) The date on which the    |                     |
|            | unit resumes operation, if the   |                     |
|            | CAIR designated representative   |                     |
|            | is not required to submit a CAIR |                     |
|            | permit application for the unit. |                     |
|            |                                  |                     |
|            | \(6\) For the purpose of         |                     |
|            | applying monitoring, reporting,  |                     |
|            | and recordkeeping requirements   |                     |
|            | under 40 CFR 96 subpart HHH, a   |                     |
|            | unit that loses its exemption    |                     |
|            | under 40 CFR 96.205(a) shall be  |                     |
|            | treated as a unit that commences |                     |
|            | commercial operation on the      |                     |
|            | first date on which the unit     |                     |
|            | resumes operation.               |                     |
+------------+----------------------------------+---------------------+

+------------+----------------------------------+---------------------+
|            | Plant Name (from STEP 1)         | Retired Unit        |
|            |                                  | Exemption           |
|            |                                  |                     |
|            |                                  | Page 3              |
+------------+----------------------------------+---------------------+
|            | **CAIR NO~X~ Ozone Season        |                     |
|            | Trading Program Special          |                     |
|            | Provisions**                     |                     |
|            |                                  |                     |
|            | \(1\) A unit exempt under 40 CFR |                     |
|            | 96.305(a) shall not emit any     |                     |
|            | nitrogen oxides, starting on the |                     |
|            | date that the exemption takes    |                     |
|            | effect.                          |                     |
|            |                                  |                     |
|            | \(2\) The permitting authority   |                     |
|            | will allocate CAIR NO~X~ Ozone   |                     |
|            | Season allowances under 40 CFR   |                     |
|            | 96 subpart EEEE to a unit exempt |                     |
|            | under 40 CFR 96.305(a).          |                     |
|            |                                  |                     |
|            | \(3\) For a period of 5 years    |                     |
|            | from the date the records are    |                     |
|            | created, the owners and          |                     |
|            | operators of a unit exempt under |                     |
|            | 40 CFR 96.305(a) shall retain,   |                     |
|            | at the source that includes the  |                     |
|            | unit, records demonstrating that |                     |
|            | the unit is permanently retired. |                     |
|            | The 5‑year period for keeping    |                     |
|            | records may be extended for      |                     |
|            | cause, at any time before the    |                     |
|            | end of the period, in writing by |                     |
|            | the permitting authority or the  |                     |
|            | Administrator. The owners and    |                     |
|            | operators bear the burden of     |                     |
|            | proof that the unit is           |                     |
|            | permanently retired.             |                     |
|            |                                  |                     |
|            | \(4\) The owners and operators   |                     |
|            | and, to the extent applicable,   |                     |
|            | the CAIR designated              |                     |
|            | representative of a unit exempt  |                     |
|            | under 40 CFR 96.305(a) shall     |                     |
|            | comply with the requirements of  |                     |
|            | the CAIR NO~X~ Ozone Season      |                     |
|            | Trading Program concerning all   |                     |
|            | periods for which the exemption  |                     |
|            | is not in effect, even if such   |                     |
|            | requirements arise, or must be   |                     |
|            | complied with, after the         |                     |
|            | exemption takes effect.          |                     |
|            |                                  |                     |
|            | \(5\) A unit exempt under 40 CFR |                     |
|            | 96.305(a) and located at a       |                     |
|            | source that is required, or but  |                     |
|            | for this exemption would be      |                     |
|            | required, to have a title V      |                     |
|            | operating permit shall not       |                     |
|            | resume operation unless the CAIR |                     |
|            | designated representative of the |                     |
|            | source submits a complete CAIR   |                     |
|            | permit application under 40 CFR  |                     |
|            | 96.322 for the unit not less     |                     |
|            | than 18 months (or such lesser   |                     |
|            | time provided by the permitting  |                     |
|            | authority) before the later of   |                     |
|            | January 1, 2009 or the date on   |                     |
|            | which the unit resumes           |                     |
|            | operation.                       |                     |
|            |                                  |                     |
|            | \(6\) On the earlier of the      |                     |
|            | following dates, a unit exempt   |                     |
|            | under 40 CFR 96.305(a) shall     |                     |
|            | lose its exemption:              |                     |
|            |                                  |                     |
|            | \(i\) The date on which the CAIR |                     |
|            | designated representative        |                     |
|            | submits a CAIR permit            |                     |
|            | application for the unit under   |                     |
|            | 40 CFR 96.305(b)(5);             |                     |
|            |                                  |                     |
|            | \(ii\) The date on which the     |                     |
|            | CAIR designated representative   |                     |
|            | is required under 40 CFR         |                     |
|            | 96.305(b)(5) to submit a CAIR    |                     |
|            | permit application for the unit; |                     |
|            | or                               |                     |
|            |                                  |                     |
|            | \(iii\) The date on which the    |                     |
|            | unit resumes operation, if the   |                     |
|            | CAIR designated representative   |                     |
|            | is not required to submit a CAIR |                     |
|            | permit application for the unit. |                     |
|            |                                  |                     |
|            | \(7\) For the purpose of         |                     |
|            | applying monitoring, reporting,  |                     |
|            | and recordkeeping requirements   |                     |
|            | under 40 CFR 96 subpart HHHH, a  |                     |
|            | unit that loses its exemption    |                     |
|            | under 40 CFR 96.305(a) shall be  |                     |
|            | treated as a unit that commences |                     |
|            | commercial operation on the      |                     |
|            | first date on which the unit     |                     |
|            | resumes operation.               |                     |
+------------+----------------------------------+---------------------+
|            | **CAMR Hg Budget Trading Program |                     |
|            | Special Provisions**             |                     |
|            |                                  |                     |
|            | \(1\) A unit exempt under 40 CFR |                     |
|            | 60.4105(a) shall not emit any    |                     |
|            | mercury, starting on the date    |                     |
|            | that the exemption takes effect. |                     |
|            |                                  |                     |
|            | \(2\) The permitting authority   |                     |
|            | will allocate Hg allowances      |                     |
|            | under 40 CFR 60.4140 through     |                     |
|            | 60.4142 to a unit exempt under   |                     |
|            | 40 CFR 60.4105(a).               |                     |
|            |                                  |                     |
|            | \(3\) For a period of 5 years    |                     |
|            | from the date the records are    |                     |
|            | created, the owners and          |                     |
|            | operators of a unit exempt under |                     |
|            | 40 CFR 60.4105(a) shall retain   |                     |
|            | at the source that includes the  |                     |
|            | unit, records demonstrating that |                     |
|            | the unit is permanently retired. |                     |
|            | The 5-year period for keeping    |                     |
|            | records may be extended for      |                     |
|            | cause, at any time before the    |                     |
|            | end of the period, in writing by |                     |
|            | the permitting authority or the  |                     |
|            | Administrator. The owners and    |                     |
|            | operators bear the burden of     |                     |
|            | proof that the unit is           |                     |
|            | permanently retired.             |                     |
|            |                                  |                     |
|            | \(4\) The owners and operators   |                     |
|            | and, to the extent applicable,   |                     |
|            | the Hg designated representative |                     |
|            | of a unit exempt under 40 CFR    |                     |
|            | 60.4105(a) shall comply with the |                     |
|            | requirements of the Hg Budget    |                     |
|            | Trading Program concerning all   |                     |
|            | periods for which the exemption  |                     |
|            | is not in effect, even if such   |                     |
|            | requirements arise, or must be   |                     |
|            | complied with, after the         |                     |
|            | exemption takes effect.          |                     |
|            |                                  |                     |
|            | \(5\) A unit exempt under 40 CFR |                     |
|            | 60.4105(a) and located at a      |                     |
|            | source that is required, or but  |                     |
|            | for this exemption would be      |                     |
|            | required, to have a title V      |                     |
|            | operating permit shall not       |                     |
|            | resume operation unless the Hg   |                     |
|            | designated representative of the |                     |
|            | source submits a complete Hg     |                     |
|            | Budget permit application under  |                     |
|            | 40 CFR 60.4122 for the unit not  |                     |
|            | less than 18 months (or such     |                     |
|            | lesser time provided by the      |                     |
|            | permitting authority) before the |                     |
|            | later of January 1, 2010 or the  |                     |
|            | date on which the unit resumes   |                     |
|            | operation.                       |                     |
|            |                                  |                     |
|            | \(6\) On the earlier of the      |                     |
|            | following dates, a unit exempt   |                     |
|            | under 40 CFR 60.4105(a) shall    |                     |
|            | lose its exemption:              |                     |
|            |                                  |                     |
|            | \(i\) The date on which the Hg   |                     |
|            | designated representative        |                     |
|            | submits a Hg Budget permit       |                     |
|            | application for the unit under   |                     |
|            | 40 CFR 60.4105(b)(5);            |                     |
|            |                                  |                     |
|            | \(ii\) The date on which the Hg  |                     |
|            | designated representative is     |                     |
|            | required under 40 CFR            |                     |
|            | 60.4105(b)(5) to submit a Hg     |                     |
|            | Budget permit application for    |                     |
|            | the unit; or                     |                     |
|            |                                  |                     |
|            | \(iii\) The date on which the    |                     |
|            | unit resumes operation, if the   |                     |
|            | Hg designated representative is  |                     |
|            | not required to submit a Hg      |                     |
|            | Budget permit application for    |                     |
|            | the unit.                        |                     |
|            |                                  |                     |
|            | \(7\) For the purpose of         |                     |
|            | applying monitoring, reporting,  |                     |
|            | and recordkeeping requirements   |                     |
|            | under 40 CFR 60.4170 through     |                     |
|            | 60.4176, a unit that loses its   |                     |
|            | exemption under 40 CFR           |                     |
|            | 60.4105(a) shall be treated as a |                     |
|            | unit that commences commercial   |                     |
|            | operation on the first date on   |                     |
|            | which the unit resumes           |                     |
|            | operation.                       |                     |
+------------+----------------------------------+---------------------+

+------------+-----------------------+-----+----+-----+--------------+---+
|            | Plant Name (from STEP |     |    | R   |              |   |
|            | 1)                    |     |    | eti |              |   |
|            |                       |     |    | red |              |   |
|            |                       |     |    | U   |              |   |
|            |                       |     |    | nit |              |   |
|            |                       |     |    | Exe |              |   |
|            |                       |     |    | mpt |              |   |
|            |                       |     |    | ion |              |   |
|            |                       |     |    |     |              |   |
|            |                       |     |    | P   |              |   |
|            |                       |     |    | age |              |   |
|            |                       |     |    | 4   |              |   |
+------------+-----------------------+-----+----+-----+--------------+---+
| **STEP 6** | **Statement of        |     |    |     |              |   |
|            | Compliance**          |     |    |     |              |   |
| Read the   |                       |     |    |     |              |   |
| statement  | I certify that the    |     |    |     |              |   |
| of         | unit identified above |     |    |     |              |   |
| compliance | at STEP 1 was (or     |     |    |     |              |   |
| and the    | will be) permanently  |     |    |     |              |   |
| a          | retired on the date   |     |    |     |              |   |
| ppropriate | identified at STEP 3  |     |    |     |              |   |
| cer        | and will comply with  |     |    |     |              |   |
| tification | the appropriate       |     |    |     |              |   |
| statements | Special Provisions    |     |    |     |              |   |
| and sign   | listed at STEP 5.     |     |    |     |              |   |
| and date.  |                       |     |    |     |              |   |
+------------+-----------------------+-----+----+-----+--------------+---+
|            | **Certification (for  |     |    |     |              |   |
|            | Acid Rain, CAIR, or   |     |    |     |              |   |
|            | Hg designated         |     |    |     |              |   |
|            | representatives or    |     |    |     |              |   |
|            | alternate Acid Rain,  |     |    |     |              |   |
|            | CAIR, or Hg           |     |    |     |              |   |
|            | designated            |     |    |     |              |   |
|            | representatives       |     |    |     |              |   |
|            | [only]{.underline})** |     |    |     |              |   |
|            |                       |     |    |     |              |   |
|            | I am authorized to    |     |    |     |              |   |
|            | make this submission  |     |    |     |              |   |
|            | on behalf of the      |     |    |     |              |   |
|            | owners and operators  |     |    |     |              |   |
|            | of the source and     |     |    |     |              |   |
|            | unit for which the    |     |    |     |              |   |
|            | submission is made. I |     |    |     |              |   |
|            | certify under penalty |     |    |     |              |   |
|            | of law that I have    |     |    |     |              |   |
|            | personally examined,  |     |    |     |              |   |
|            | and am familiar with, |     |    |     |              |   |
|            | the statements and    |     |    |     |              |   |
|            | information submitted |     |    |     |              |   |
|            | in this document and  |     |    |     |              |   |
|            | all its attachments.  |     |    |     |              |   |
|            | Based on my inquiry   |     |    |     |              |   |
|            | of those individuals  |     |    |     |              |   |
|            | with primary          |     |    |     |              |   |
|            | responsibility for    |     |    |     |              |   |
|            | obtaining the         |     |    |     |              |   |
|            | information, I        |     |    |     |              |   |
|            | certify that the      |     |    |     |              |   |
|            | statements and        |     |    |     |              |   |
|            | information are to    |     |    |     |              |   |
|            | the best of my        |     |    |     |              |   |
|            | knowledge and belief  |     |    |     |              |   |
|            | true, accurate, and   |     |    |     |              |   |
|            | complete. I am aware  |     |    |     |              |   |
|            | that there are        |     |    |     |              |   |
|            | significant penalties |     |    |     |              |   |
|            | for submitting false  |     |    |     |              |   |
|            | statements and        |     |    |     |              |   |
|            | information or        |     |    |     |              |   |
|            | omitting required     |     |    |     |              |   |
|            | statements and        |     |    |     |              |   |
|            | information,          |     |    |     |              |   |
|            | including the         |     |    |     |              |   |
|            | possibility of fine   |     |    |     |              |   |
|            | or imprisonment.      |     |    |     |              |   |
+------------+-----------------------+-----+----+-----+--------------+---+
|            | Name                  |     | T  |     |              |   |
|            |                       |     | it |     |              |   |
|            |                       |     | le |     |              |   |
+------------+-----------------------+-----+----+-----+--------------+---+
|            | Owner Company Name    |     |    |     |              |   |
+------------+-----------------------+-----+----+-----+--------------+---+
|            | Phone                 | Em  |    |     |              |   |
|            |                       | ail |    |     |              |   |
+------------+-----------------------+-----+----+-----+--------------+---+
|            | Signature             |     |    |     | Date         |   |
+------------+-----------------------+-----+----+-----+--------------+---+
|            | **Certification (for  |     |    |     |              |   |
|            | certifying officials  |     |    |     |              |   |
|            | of units subject to   |     |    |     |              |   |
|            | the Acid Rain Program |     |    |     |              |   |
|            | [only]{.underline})** |     |    |     |              |   |
|            |                       |     |    |     |              |   |
|            | I certify under       |     |    |     |              |   |
|            | penalty of law that I |     |    |     |              |   |
|            | have personally       |     |    |     |              |   |
|            | examined, and am      |     |    |     |              |   |
|            | familiar with, the    |     |    |     |              |   |
|            | statements and        |     |    |     |              |   |
|            | information submitted |     |    |     |              |   |
|            | in this document and  |     |    |     |              |   |
|            | all its attachments.  |     |    |     |              |   |
|            | Based on my inquiry   |     |    |     |              |   |
|            | of those individuals  |     |    |     |              |   |
|            | with primary          |     |    |     |              |   |
|            | responsibility for    |     |    |     |              |   |
|            | obtaining the         |     |    |     |              |   |
|            | information, I        |     |    |     |              |   |
|            | certify that the      |     |    |     |              |   |
|            | statements and        |     |    |     |              |   |
|            | information are to    |     |    |     |              |   |
|            | the best of my        |     |    |     |              |   |
|            | knowledge and belief  |     |    |     |              |   |
|            | true, accurate, and   |     |    |     |              |   |
|            | complete. I am aware  |     |    |     |              |   |
|            | that there are        |     |    |     |              |   |
|            | significant penalties |     |    |     |              |   |
|            | for submitting false  |     |    |     |              |   |
|            | statements and        |     |    |     |              |   |
|            | information or        |     |    |     |              |   |
|            | omitting required     |     |    |     |              |   |
|            | statements and        |     |    |     |              |   |
|            | information,          |     |    |     |              |   |
|            | including the         |     |    |     |              |   |
|            | possibility of fine   |     |    |     |              |   |
|            | or imprisonment.      |     |    |     |              |   |
+------------+-----------------------+-----+----+-----+--------------+---+
|            | Name                  |     | T  |     |              |   |
|            |                       |     | it |     |              |   |
|            |                       |     | le |     |              |   |
+------------+-----------------------+-----+----+-----+--------------+---+
|            | Owner Company Name    |     |    |     |              |   |
+------------+-----------------------+-----+----+-----+--------------+---+
|            | Phone                 | Em  |    |     |              |   |
|            |                       | ail |    |     |              |   |
+------------+-----------------------+-----+----+-----+--------------+---+
|            | Signature             |     |    |     | Date         |   |
+------------+-----------------------+-----+----+-----+--------------+---+

  ---------------------------------------------------- --------------------------------------------------------
  ![](media/image1.png){width="1.2013888888888888in"   **Instructions for Submission of the\
  height="0.4041666666666667in"}                       Retired Unit Exemption Notice**

  ---------------------------------------------------- --------------------------------------------------------

Please type or print. If you have any questions regarding the submission
of the Retired Unit Exemption notice, contact Robert Miller at
<miller.robertl@epa.gov> or 202.343.9077, or contact your local, State,
or EPA Regional Acid Rain, CAIR, or CAMR contact, as appropriate. You
may also call U.S. EPA\'s Acid Rain Hotline at (202) 343-9620.

Any reference in these instructions to the Designated Representative
means the Acid Rain Designated Representative, CAIR Designated
Representative, and/or Hg Designated Representative, as applicable. Any
reference to the Alternate Designated Representative means the Alternate
Acid Rain Designated Representative, the Alternate CAIR Designated
Representative, and/or the Alternate Hg Designated Representative, as
applicable. The Acid Rain Designated Representative, the CAIR Designated
Representative, and the Hg Designated Representative for a facility
(source) must be the same individual, and the Alternate Acid Rain
Designated Representative, the Alternate CAIR Designated Representative,
and the Alternate Hg Designated Representative for a facility (source)
must be the same individual.

**Submission Deadline:** For units subject [only]{.underline} to CAIR
and/or CAMR, submit the retired unit exemption notice no later than [30
days]{.underline} after the date the unit is permanently retired (i.e.,
within 30 days of the date entered at STEP 3). For units subject
[only]{.underline} to the Acid Rain Program, submit the form by December
31 of the first year the unit is to be exempt. If the unit is subject to
the Acid Rain Program [and]{.underline} to CAIR and/or CAMR, submit the
retired unit exemption notice no later than [30 days]{.underline} after
the date the unit is permanently retired (i.e., within 30 days of the
date entered at STEP 3).

**STEP 1** Enter the facility name and state where the unit is located,
the ORIS/Plant Code for the facility, and Unit ID for the unit,
consistent with the data listed on the most current Certificate of
Representation for the facility. A Plant Code is a 4 or 5 digit number
assigned by the Department of Energy=s (DOE) Energy Information
Administration (EIA) to facilities that generate electricity. For older
facilities, \"Plant Code\" is synonymous with \"ORISPL\" and
\"Facility\" codes. If the facility generates electricity but no Plant
Code has been assigned, or if there is uncertainty regarding what the
Plant Code is, contact EIA at (202) 586-4258 or (202) 586-2402. For
facilities that do not produce electricity, use the facility identifier
assigned by EPA (beginning with \"88\"). If the facility does not
produce electricity and has not been assigned a facility identifier,
contact Laurel DeSantis at <desantis.laurel@epa.gov> or (202) 343-9191.

**STEP 2** Identify the programs to which the unit is subject.

**STEP 3** Enter the date on which the unit was (or will be) permanently
retired.

**STEP 4** If the unit is subject to the Acid Rain Program, identify the
first full calendar year in which the unit meets (or will meet) the
requirements of 40 CFR 72.8(d).

**STEP 5** Read the appropriate special provisions.

**STEP 6** Read the appropriate certification statements, sign, and
date.

For units subject [only]{.underline} to the Acid Rain Program, if no
designated representative has been authorized, a certifying official for
each owner of the unit must read the certification at STEP 6 labeled
\"for certifying officials of Acid Rain affected units
[only]{.underline},@ enter his or her name, title, name of the owner
company for which he or she is the certifying official, phone number,
email address, and then sign and date. A certifying official is
[not]{.underline} required to submit a Certificate of Representation. If
there is more than one owner of a unit for which no designated
representative has been authorized, [each]{.underline} owner of the unit
must have a certifying official sign the appropriate certification at
STEP 6.

Submit the original Retired Unit Exemption notice to the title V
permitting authority for the facility, and a copy to U.S. EPA:

**For regular/certified mail:** **For overnight mail:**

U.S. Environmental Protection Agency U.S. Environmental Protection
Agency

Clean Air Markets Division (6204J) Clean Air Markets Division (6204J)

Attention: Retired Unit Exemption Attention: Retired Unit Exemption

1200 Pennsylvania Avenue, NW 1310 L Street, NW

Washington, DC 20460 Second Floor

Washington, DC 20005

\(202\) 343-9191

**Paperwork Burden Estimate**

The public reporting and recordkeeping burden for this collection of
information is estimated to average 3.5 hours per response annually.
Burden means the total time, effort, or financial resources expended by
persons to generate, maintain, retain, or disclose or provide
information to or for a Federal agency. This includes the time needed to
review instructions; develop, acquire, install, and utilize technology
and systems for the purposes of collecting, validating, and verifying
information, processing and maintaining information, and disclosing and
providing information; adjust the existing ways to comply with any
previously applicable instructions and requirements; train personnel to
be able to respond to a collection of information; search data sources;
complete and review the collection of information; and transmit or
otherwise disclose the information. An agency may not conduct or
sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number.

Send comments on the Agency\'s need for this information, the accuracy
of the provided burden estimates, and any suggested methods for
minimizing respondent burden, including through the use of automated
collection techniques to the Director, Collection Strategies Division,
U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave.,
NW., Washington, D.C. 20460. Include the OMB control number in any
correspondence. **Do not send the completed form to this address.**