**Initial Notification**

**National Emission Standards for Hazardous Air Pollutants:**

**Area Source Standards for Nine Metal Fabrication and Finishing Source
Categories**

**40 CFR 63 subpart XXXXXX**

**Section 1. Facility Information**

Yes, I am subject to 40 CFR Part 63 subpart XXXXXX, National Emission
Standards for Hazardous

Air Pollutants: Area Source Standards for Nine Metal Fabrication and
Finishing Source Categories

Source category and NAICS
code(s)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Compliance Date: Existing source: July 25, 2011 New source:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(Date of startup)

No, I am NOT subject to 40 CFR Part 63 subpart XXXXXX. Reason not
applicable:

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> *If you checked the "No" box above, please complete only Section 1 of
> this form and then proceed directly to Section 3 of this form (skip
> Section 2).*

Company name
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Facility name (if different):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Facility (physical location)
address:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Owner name/title:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Owner/company
address:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Owner telephone number
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Owner email address (if available):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Is the Operator the same person as the Owner? Yes No

If the Operator information is different from the Owner, please provide
the following:

^a^ This is an example of the type of information that must be submitted
to fulfill the Initial Notification requirement

of 40 CFR 63, subpart XXXXXX. You may submit the information in another
form or format, or you may use this form.

Operator name/title:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Operator telephone number:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Operator email address (if available):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Section 2. Identification of Affected Operations**

**The following are the operations at this facility subject^b^ to
subpart XXXXXX**

**(check all that apply):**

+---+-----------------------------------------------+-----------------+
| * |                                               |                 |
| * |                                               |                 |
| D |                                               |                 |
| r |                                               |                 |
| y |                                               |                 |
| A |                                               |                 |
| b |                                               |                 |
| r |                                               |                 |
| a |                                               |                 |
| s |                                               |                 |
| i |                                               |                 |
| v |                                               |                 |
| e |                                               |                 |
| B |                                               |                 |
| l |                                               |                 |
| a |                                               |                 |
| s |                                               |                 |
| t |                                               |                 |
| i |                                               |                 |
| n |                                               |                 |
| g |                                               |                 |
| * |                                               |                 |
| * |                                               |                 |
+---+-----------------------------------------------+-----------------+
|   | \(1\) Totally enclosed and unvented blast     |                 |
|   | chambers                                      |                 |
+---+-----------------------------------------------+-----------------+
|   | \(2\) Vented enclosures with a filtration     |                 |
|   | control device                                |                 |
+---+-----------------------------------------------+-----------------+
|   | \(3\) Objects over 8 feet in any dimension    |                 |
|   | without a filtration control device           |                 |
|   |                                               |                 |
|   | (includes outdoor blasting of objects over 8  |                 |
|   | ft in any dimension)                          |                 |
+---+-----------------------------------------------+-----------------+
| * |                                               |                 |
| * |                                               |                 |
| D |                                               |                 |
| r |                                               |                 |
| y |                                               |                 |
| M |                                               |                 |
| a |                                               |                 |
| c |                                               |                 |
| h |                                               |                 |
| i |                                               |                 |
| n |                                               |                 |
| i |                                               |                 |
| n |                                               |                 |
| g |                                               |                 |
| * |                                               |                 |
| * |                                               |                 |
+---+-----------------------------------------------+-----------------+
| * |                                               |                 |
| * |                                               |                 |
| D |                                               |                 |
| r |                                               |                 |
| y |                                               |                 |
| G |                                               |                 |
| r |                                               |                 |
| i |                                               |                 |
| n |                                               |                 |
| d |                                               |                 |
| i |                                               |                 |
| n |                                               |                 |
| g |                                               |                 |
| o |                                               |                 |
| r |                                               |                 |
| D |                                               |                 |
| r |                                               |                 |
| y |                                               |                 |
| P |                                               |                 |
| o |                                               |                 |
| l |                                               |                 |
| i |                                               |                 |
| s |                                               |                 |
| h |                                               |                 |
| i |                                               |                 |
| n |                                               |                 |
| g |                                               |                 |
| w |                                               |                 |
| i |                                               |                 |
| t |                                               |                 |
| h |                                               |                 |
| S |                                               |                 |
| t |                                               |                 |
| a |                                               |                 |
| t |                                               |                 |
| i |                                               |                 |
| o |                                               |                 |
| n |                                               |                 |
| a |                                               |                 |
| r |                                               |                 |
| y |                                               |                 |
| M |                                               |                 |
| a |                                               |                 |
| c |                                               |                 |
| h |                                               |                 |
| i |                                               |                 |
| n |                                               |                 |
| e |                                               |                 |
| s |                                               |                 |
| * |                                               |                 |
| * |                                               |                 |
+---+-----------------------------------------------+-----------------+
| * |                                               |                 |
| * |                                               |                 |
| S |                                               |                 |
| p |                                               |                 |
| r |                                               |                 |
| a |                                               |                 |
| y |                                               |                 |
| P |                                               |                 |
| a |                                               |                 |
| i |                                               |                 |
| n |                                               |                 |
| t |                                               |                 |
| i |                                               |                 |
| n |                                               |                 |
| g |                                               |                 |
| * |                                               |                 |
| * |                                               |                 |
+---+-----------------------------------------------+-----------------+
|   | \(1\) In a spray booth                        |                 |
+---+-----------------------------------------------+-----------------+
|   | \(2\) Without a spray booth                   |                 |
|   |                                               |                 |
|   | (for Fabricated Structural Metal facilities   |                 |
|   | or any objects over 15 feet)                  |                 |
+---+-----------------------------------------------+-----------------+
| * |                                               |                 |
| * |                                               |                 |
| W |                                               |                 |
| e |                                               |                 |
| l |                                               |                 |
| d |                                               |                 |
| i |                                               |                 |
| n |                                               |                 |
| g |                                               |                 |
| * |                                               |                 |
| * |                                               |                 |
+---+-----------------------------------------------+-----------------+
|   | \(1\) Use less than 2,000 pounds of           |                 |
|   | MFHAP-containing^b^                           |                 |
|   |                                               |                 |
|   | welding rod or wire annually                  |                 |
+---+-----------------------------------------------+-----------------+
|   | \(2\) Use 2,000 pounds or more of             |                 |
|   | MFHAP-containing^b^                           |                 |
|   |                                               |                 |
|   | welding rod or welding wire annually          |                 |
+---+-----------------------------------------------+-----------------+

**Section 3. Certification**

I hereby certify that the information presented herein is correct to the
best of my knowledge.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(Signature) (Date)

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
(\_\_\_\_)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(Name/title) (Telephone No.)

**Section 4. Submittal**

**Submit the Initial Notification to one of the following offices, as
appropriate:**

a\. If your State has been delegated the authority for this regulation
under section 112(l) of the Clean Air Act[^1], submit the notification
to your State agency found at the following link:

<http://www.epa.gov/ttn/atw/area/table_state_contacts.doc>

If your state/local contact is not listed at the above link, use this
link:

<http://www.4cleanair.org/contactUsaLevel.asp>

b\. If your EPA Region has assumed the authority for this rule, submit
the notification to your Regional Office of the EPA, from list below:

EPA Region I (Connecticut, Maine, Massachusetts, New Hampshire, Rhode
Island, Vermont)

Director, Air, Pesticides and Toxics Division

One Congress Street, Suite 1100 (SEA), Boston, MA 02114, Attn: Air
Compliance Clerk

EPA Region II (New Jersey, New York, Puerto Rico, Virgin Islands),

Director, Division of Enforcement and Compliance Assistance

290 Broadway, New York, NY 10007-1866

EPA Region III (Delaware, District of Columbia, Maryland, Pennsylvania,
Virginia, West Virginia)

Director, Air Protection Division, 1650 Arch Street, Philadelphia, PA
19103

EPA Region IV (Alabama, Florida, Georgia, Kentucky, Mississippi, North
Carolina, South Carolina, Tennessee)

Director, Air, Pesticides and Toxics Management Division

Atlanta Federal Center, 61 Forsyth Street, Atlanta, GA 30303--3104

EPA Region V (Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin)

Director, Air and Radiation Division, 77 West Jackson Blvd., Chicago, IL
60604--3507

EPA Region VI (Arkansas, Louisiana, New Mexico, Oklahoma, Texas)

Director, Air, Pesticides and Toxics, 1445 Ross Avenue, Dallas, TX
75202--2733

EPA Region VII (Iowa, Kansas, Missouri, Nebraska)

Director, Air and Waste Management Division, U.S. Environmental
Protection Agency

901 N. 5th Street, Kansas City, KS 66101

EPA Region VIII (Colorado, Montana, North Dakota, South Dakota, Utah,
Wyoming)

Director, Air and Toxics Technical Enforcement Program, Office of
Enforcement, Compliance and Environmental Justice, 1595 Wynkoop Street,
Denver, CO 80202-1129

EPA Region IX (Arizona, California, Hawaii, Nevada, American Samoa,
Guam)

Director, Air and Toxics Division, 75 Hawthorne Street, San Francisco,
CA 94105

EPA Region X (Alaska, Idaho, Oregon, Washington)

Director, Office of Air, Waste and Toxics, 1200 6th Ave., Suite 900,
AWT-107, Seattle, WA 98101

[^1]: To determine whether your State has been delegated the authority
    for this regulation under section 112(l) of the Clean Air Act,
    contact your EPA Regional Office, listed above.