ENCLOSURE 1

FORM A - GENERAL INFORMATION

Parent Company Information

Parent Company

Street Address- Line 1

Street Address- Line 2

City

State

Zip code

Mailing Address (if different)- Line 1

Mailing Address (if different)- Line 2

City

State

Zip code

Number of Employees in Parent Company (circle 

one)

Dun and Bradstreet number

Facility Information

Please Number the Facilities  Facility ________ Facility ________ Facility _________

Facility ID

Facility Name

Address 1

Address 2

City

County

State

Zip code

Mailing Address (if different)- Line 1

Mailing Address (if different)- Line 2

City

State

Zip code

Number of employees at facility (circle one) 0-99 100-249 250-499 >500 0-99 100-249 250-499 >500 0-99 100-249 250-499 >500

What is your size classification for HAP 

emissions? (circle one)

Major Source Area Source (Synthetic) Not 

Sure 

Major Source Area Source (Synthetic) Not 

Sure 

Major Source Area Source (Synthetic) Not 

Sure 

Hours of operation for this facility (hr/yr)

Facility's primary NAICS or SIC code

Total Number of Periodic Kilns at this Facility

Total Number of Tunnel Kilns at this Facility

Contact Person for this ICR

Contact Phone Number ( ) _____________  __________________ ( ) _____________  __________________ ( ) _____________  __________________

Contact Email Address

INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

0-99 100-249 250-499 >500

Please reprint the form to include additional facilities

FORM A - Page 1 of 1
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM B - KILN INFORMATION

Facility ID Kiln ID(s) (a)

Reporting 

Year (if 

not 2007) Type of Kiln (b)

If periodic, 

number of 

identical kilns on 

this line Year Built

Stack 

Diameter 

(ft)

Does this kiln 

have an Air 

Pollution Control 

Device (APCD)? 

Yes or No

Major Product Types Fired in 

Kiln

Annual 

Operating 

Hours for 

Kiln

 Full Design 

Capacity (tph)

Permitted 

Capacity (tph) 

if applicable

Average/Actual 

Capacity 

Utilization (%) 

(d) 

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

FACILITY and KILN IDs GENERAL INFORMATION KILN SIZE (c)

(a) Use the ID from your permit or assign using TK-1, 2, etc. for tunnel and RK-1, 2, etc. for roller, and PK-1, 2, etc. for periodic. Use same ID throughout this form.

(b) Enter one of these: Tunnel Kiln, Roller Kiln, Shuttle Kiln, Other Periodic Kiln

(d) For sources that have a maximum permitted production capacity higher than the design capacity, enter the actual capacity utilization, which is defined as the actual production divided by the maximum permitted production rate. For 

sources with an enforceable permit production limit less than the design capacity, enter the average production capacity, which is defined as the actual production divided by the design capacity.

(c) Kiln size capacities should be in units of tons per hour (tph) of fired product.

FORM B - Page 1 of 2
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM B - KILN INFORMATION (Continued)

ADDITIONAL INFORMATION ON PERIODIC KILNS

Facility ID Kiln ID(s) (a) Primary Fuel Secondary Fuel

Percent Use 

of 

Secondary 

Fuel (% of 

operating 

time) Back-up Fuel

Reason(s) back-up 

would be used (e.g., 

NG curtailment)

Total time 

back-up fuel 

was used 

during year 

(hr)

Kiln 

batch 

capacity 

(tons)

Averag

e batch 

cycle 

time 

(hr)

Average 

number of 

batch 

cycles per 

year

Average time 

required to 

load unfired 

shapes into 

kiln (hr)

Average 

time 

required to 

unload fired 

shapes 

from kiln 

FACILITY and KILN IDs FUEL USAGE

FORM B - Page 2 of 2
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM C - GLAZE APPLICATION INFORMATION

GENERAL INFORMATION PLANTWISE GLAZE USE

Facility ID Glaze Line ID(s) (a)

Number of 

Spray 

Booths per 

Line

Reporting 

Year (if 

not 2007) Year Built

Annual 

Operating 

Hours for 

Glaze Line

Is this glaze line 

Controlled with an 

Air Pollution 

Control Device 

(APCD)? Yes or No

Average 

Percentage of 

HAP's Contained 

in Glazes (b)

Glaze Annual 

Consumption 

Annual 

Consumption 

Units

(H)*(I) 

.... 

Annual Total of 

HAPs In Glazes

HAPs In Glazes 

Units

% of HAP Containing 

Glazes that are spray 

applied (if known)

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

FACILITY and GLAZE LINE IDs

(b) Enter percentage of spray booth operating time that any glaze, which contains a metal HAP, is applied in the booth. A "HAP containing glaze" is any glaze that contains a material or ingredient listed as a 

metal HAP on the MSDS for that glaze/material.

(a) Use the ID from your permit or assign using GZ-1, 2, etc.

FORM C - Page 1 of 1
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM D - KILN APCD INFORMATION 

APCD Information

Facility ID Kiln ID(s) (a)

Stack Diameter 

(ft) Control ID (b) Type (c) Reason Control was Installed (d)

Number of 

kilns vented to 

this control 

device

Year control 

device was 

installed

(b) Assign based on ID used in Title V or using CD-1, 2, etc.

(d) Select One: Comply with MACT, become Synthetic Minor, SO2 Control, Particulate / Opacity Control, Other.

(c) Select One: Dry Limestone Adsorber (DLA), Dry Injection / Fabric Filter (DIFF), Dry Lime Scrubber (DLS), Wet Scrubber, Fabric Filter / Baghouse Only, Lime 

System (unsure if DIFF or DLS), Spray Dryer / Electrostatic Precipitator, Other.

(a) Use the ID from your permit or assign using TK-1, 2, etc. for tunnel and RK-1, 2, etc. for roller, and PK-1, 2, etc. for periodic. Use same ID throughout this form.

FORM D - Page 1 of 4
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM D - KILN APCD INFORMATION (Continued)

Facility ID Kiln ID(s) (a)

Total bag 

surface area 

(ft2)

Bag- material of 

construction

Avg. Life 

of bags 

(yrs)

Air-to-Cloth Ratio 

(see instructions) Cleaning method Reagent Type

Reagent feedrate 

(value) Units/ time

Total annual 

reagent usage 

(indicate units)

Is reagent 

recirculated or 

one-pass? (Enter 

one)

If recirculated, 

average ratio of 

recirculated to 

fresh reagent

FACILITY and KILN IDs BAGHOUSE/FABRIC FILTER (Stand-alone or as part of DIFF or DLS) DIFF or DLS

FORM D - Page 2 of 4
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM D - KILN APCD INFORMATION (Continued)

DLA

Facility ID Kiln ID(s) (a)

Number of 

cascades

Do you use 

reconditioning 

drum/peeler? Yes 

or No

What is the rate at which 

limestone is removed from the 

system as waste? Parameter monitored (Circle One) Monitoring frequency

Y / N

Pressure Drop / 

Alternative

Y / N

Pressure Drop / 

Alternative

Y / N

Pressure Drop / 

Alternative

Y / N

Pressure Drop / 

Alternative

Y / N

Pressure Drop / 

Alternative

Y / N

Pressure Drop / 

Alternative

Y / N

Pressure Drop / 

Alternative

Y / N

Pressure Drop / 

Alternative

Y / N

Pressure Drop / 

Alternative

Y / N

Pressure Drop / 

Alternative

FACILITY and KILN IDs

FORM D - Page 3 of 4
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM D - KILN APCD INFORMATION (Continued)

WET SCRUBBER

OTHER CONTROL (please identify parameters and units monitored to 

verify control is functioning properly)

Facility ID Kiln ID(s) (a)

Type of scrubber 

(e.g., venturi)

Liquid 

flow rate 

(gpm)

Pressure drop 

across scrubber 

(inches of water)

pH range of 

scrubbing 

liquid

Reagents used to 

maintain pH in 

desired range

Total annual 

reagent usage 

Units / 

Time

Design or 

Monitoring 

Parameter

Units / 

Time

Design or 

Monitoring 

Parameter

Units / 

Time

Design or 

Monitoring 

Parameter

Units / 

Time

FACILITY and KILN IDs

FORM D - Page 4 of 4
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM E - GLAZE LINE APCD INFORMATION

FACILITY and GLAZE LINE IDs CONTROL DEVICE INFORMATION

Facility ID

Glaze Line ID(s) 

(a) Control ID (b) Type (c) Reason Control was Installed

Number of 

spray booths 

vented to this 

control device

Year 

control 

device was 

installed

(a) Use the ID from your permit or assign using GZ-1, 2, etc.

(c) Enter One: Water Curtain, Wet Scrubber, Fabric Filter, Other.

(b) Assign based on ID used in Title V or using CD-1, 2, etc.

FORM E - Page 1 of 3
FORM E - Page 1 of 3
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM E - GLAZE LINE APCD INFORMATION (Continued)

FACILITY and GLAZE LINE IDs BAGHOUSE/FABRIC FILTER WET SCRUBBER

Facility ID

Glaze Line ID(s) 

(a)

Total bag 

surface area 

(ft2)

Bag - material of 

construction

Avg. Life of 

bags (yrs) Cleaning method

Type of scrubber (e.g., 

venturi)

Liquid flow rate 

(gpm)

Pressure drop 

across scrubber 

(inches of water)

(a) Use the ID from your permit or assign using GZ-1, 2, etc.

FORM E - Page 2 of 3
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM E - GLAZE LINE APCD INFORMATION (Continued)

FACILITY and GLAZE LINE IDs WATER CURTAIN

OTHER CONTROL (please identify parameters and units monitored to verify control is functioning 

properly)

Facility ID

Glaze Line ID(s) 

(a)

Water flow 

rate (gpm)

Width of water 

curtain (ft)

Equipped with baffle or 

mist eliminator? (b)

Design or 

Monitoring 

Parameter Units / Time

Design or 

Monitoring 

Parameter Units / Time

Design or 

Monitoring 

Parameter Units / Time

(b) Enter One: Baffles, Mist Eliminator, Both, or Neither.

(a) Use the ID from your permit or assign using GZ-1, 2, etc.

FORM E - Page 3 of 3
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM F - TEST DATA

GENERAL INFORMATION TEST INFORMATION

FAC ID Control ID

Kiln/Glaze 

Line/Stack 

ID Test Date Report Date Type of Test - Circle One HF HCl PM

HAP 

Metals Other (list below) Other (list below) Other (list below)

Uncontrolled (or inlet to 

control) Controlled 

Both

Uncontrolled (or inlet to 

control) Controlled 

Both

Uncontrolled (or inlet to 

control) Controlled 

Both

Uncontrolled (or inlet to 

control) Controlled 

Both

Uncontrolled (or inlet to 

control) Controlled 

Both

Uncontrolled (or inlet to 

control) Controlled 

Both

Uncontrolled (or inlet to 

control) Controlled 

Both

Uncontrolled (or inlet to 

control) Controlled 

Both

Uncontrolled (or inlet to 

control) Controlled 

Both

Uncontrolled (or inlet to 

control) Controlled 

Both

POLLUTANTS TESTED (Please put X in box to indicate pollutant was tested)

Note: Please provide copies of full test reports to minimize the need for future information requests. Field notes and raw reading sections can be omitted. However, please include all other 

sections of the reports, including sample calculations, laboratory data, run-by-run emission data, and a description of any deviations from test methods or other anomalies that occurred with the 

process or control device operations during the test. Please also provide information on the following for each test: production rate in units of fired product (tph); APCD parameters monitored 

and monitored values; and any anecdotal information you believe would potentially be helpful to us. 

FORM F - Page 1 of 2
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM F - TEST DATA (Continued)

GENERAL INFORMATION

FAC ID Control ID

Kiln/Glaze 

Line/ Stack 

ID Reasons for Test APCD Parameters Monitored During Test Notes

ADDITIONAL INFORMATION

FORM F - Page 2 of 2
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM G - MONITORING AND OTHER COSTS

Facility ID

Unit Costs for January 2008

Parameter Cost

Electricity cost, $/kwh

Reagent:

Reagent Cost, $/ton

Waste Reagent disposal cost, $/ton or $/yr

Water treatment costs, $/gal

Activity Required by Activity

Estimated 

Hours Frequency

Staff Level - Select One 

Operator, Maintenance, Engineer, Manager

Develop a start-up, shutdown, and 

malfunction plan Develop plan and educate staff 

Develop and implement an operating, 

maintenance, and monitoring plan Develop plan and educate staff 

Bag replacement Replace single bag

Bag replacement Replace all bags

Maintain free-flowing lime (Describe 

action in next box and then add 

estimated hours, frequency, and staff 

level)

Meet requirement to "maintain adequate 

amount of limestone in hopper." 

(Describe action taken in next box, then 

add estimated hours, frequency, and 

staff level). If different approaches are 

taken at different plants, please add rows 

and provide information on each 

approach

Control Device: 

Compliance demonstration Activity 

(describe and estimate hours, frequency, 

and staff level)

Compliance demonstration Activity 

(describe and estimate hours, frequency, 

and staff level)

Standard Activities- DLA (limestone)

Standard Activities- Baghouse/DIFF/DLS

Standard Activities- Wet Scrubber or Other Control

FORM G - Page 1 of 2
Activity Required by Activity

Estimated 

Hours Frequency

Staff Level - Select One 

Operator, Maintenance, Engineer, Manager

Compliance demonstration Activity 

(describe and estimate hours, frequency, 

and staff level)

FORM G - Page 1 of 2
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM G - MONITORING AND OTHER COSTS (Continued)

Facility ID

Activity Required by Activity

Estimated 

Hours Frequency

Staff Level - Select One 

Operator, Maintenance, Engineer, 

Manager

Daily Maintenance (list activity(ies) in next column)

Weekly Maintenance (list activity(ies) in next column)

Monthly Maintenance (list activity(ies) in next column)

Semi-Annual Maintenance (list activity(ies) in next 

column)

Yearly Maintenance (list activity(ies) in next column)

Other Frequency Maintenance (specify frequency and 

list activity(ies) in next column)

Stack Test Costs for the Previous 3 Years

Stack Test Year

Test Methods (please list all test methods conducted 

during stack test)

Uncontrolled 

(include 

uncontrolled 

stack or 

APCD inlet)? 

Controlled? 

Both? Select 

One Cost ($)

Notes (Include Any site/preparation costs 

not included in estimate)

Please also provide separately an itemized list of site/preparation costs not included in the estimate (e.g., costs for drilling ports in stack, costs for installing permanent access to sampling 

ports, etc.)

Standard Activities- All Controls

FORM G - Page 2 of 2
INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM H - ECONOMICS IMPACT INFORMATION

Facility ID Product type

Average Selling 

Price per Ton ($)

Reporting Year for 

Selling Price (if not 

2007)

Operator wage 

rate, $/hr

Maintenance wage 

rate, $/hr

Engineer wage 

rate, $/hr

Managerial/Supervisory 

wage rate, $/hr

Product Selling Price Labor Rates as of January 2008

FORM H - Page 1 of 1
Response

1.

Please provide a copy of the cost estimate for your selected 

control device and explain any differences between the estimated 

and final installed costs. Costs should include costs for ancillary 

equipment, such as reconditioning drums, water treatment 

systems, etc

2.

Do you currently do any work or operating practices (i.e., other 

than the use of an air pollution control device) that would have an 

impact on HF, HCl, or PM emissions from your kilns? If yes, 

please explain.

3.

If you operate periodic kilns, please provide a time-temperature 

profile for each typical batch cycle. The profiles should show the 

duration of each temperature phase of the cycle from the time the 

kiln is fired to the time when the fired shapes can be removed 

from the kiln. (See instructions for example profile.) 

4.

If you operate periodic kilns, do you have any information 

regarding technological and/or economic limitations to testing 

those kilns?

5. Please provide a copy of a process flow diagram for your facility, if 

available.

Question 

INFORMATION COLLECTION REQUEST FOR THE CLAY CERAMICS MANUFACTURING INDUSTRY

FORM I - ADDITIONAL QUESTIONS

FORM I - Page 1 of 1