## United States Environmental Protection Agency
**Pacific Southwest**

**– Region 9**  **Clean Air Act Permit Federal Indian Country Minor New Source Review Program**  http://www.epa.gov/ caa

- permitting/tribal

- nsr

- permits

- region

- 9



## Instructions for Request for Coverage under the General Air Quality Permit
**for New or Modified Minor Source**  **Gasoline Dispensing Facilities in Indian**  **Country with**  **in California** 

Version 1.0
Last Modified : September 28, 2016

If you wish to notify the reviewing authority o f your int ent to operate under the ‘General Air Quality Permit for
New or Modified Minor Source Gasoline Dispens ing Facilities in Indian Country within California ’ (the General Permit)

, please complete the form ‘ Request for Coverage under the General Air Quality Permit for New or
Modified Minor Source Gasoline Dispensing Facilities in Indian Country with in California’ (Request for Coverage)

.

The General Permit implement s the requirements of the minor New Source Review (NSR) rule as described
under 40 CFR part 49.

These instructions are intended to provide you with information that may be useful in completing the Request
for Coverage f orm. In the form, please provide information on all existing, new and modified units.



### Helpful Definitions f **r om the Federal**  **Indian Country Minor**  **NSR Rule (40 CFR 49.152)**

**–** This is not a comprehensive list.

• Modification means any physical or operational change at a source that would cause an increase in the allowable emissions of the affected emissions units for any regulated NSR pollutant or that would cause the emission of any regulated NSR pollutant not previously emitted. [ 40 CFR 49.152(d) ]

The following exemptions apply:

(1) A physical or operational change does not include routine maintenance, repair, or replacement. (2) An increase in the hours of operation or in the production rate is not considered an operational change unless such increase is prohibited under any federally

- enforceable permit condition or other permit condition that is enforceable as a practical matter. (3) A change in ownership at a source is not considered a modification.

• Potential to Emit (PTE) means the maximu m capacity of a source to emit a pollutant under its physical and operational design. Any physical or operational limitation on the capacity of the source to emit a pollutant, including air pollution control equipment and restrictions on hours of operation or on the type or amount of material combusted, stored or processed, shall be treated as part of its design if the limitation or the effect it would have on emissions is enforceable as a practical matter. Secondary emissions, as defined at 40 CFR 52.21(b) (18) of this chapter, do not count in determining the PTE of a source.

• Allowable emissions is as defined in 40 CFR 52.21(b)(16), except that the allowable emissions for any emissions unit are calculated considering any emission limitations that are enforceable as a practical matter on the emissions unit's potential to emit.I nstructions for Request for Coverage Gasoline Dispensing Facilities within California Page 2 of 5 • CARB Certified or certified by CARB means a vapor recovery system, equipment, or any component thereof, for which the California Air Resources Board (CARB) has evaluated its perf ormance and issued a valid Executive Order pursuant to California Health and Safety Code, Section 41954. Each component of a system is a separate CARB certified item and cannot be replaced with a non

- certified item or other
items that are not certified for use with the particular system. Except for qualified repairs, a CARB certified component shall be as supplied by the qualified manufacturer. A rebuilt component shall not be deemed as CARB certified unless the person who rebuilds the component is authoriz ed by CARB to rebuild the designated CARB certified component.



### Information collected in the Request for Coverage includes the following:

**Section 1: Contact Information** 

1. Business Name: Provide the complete company name. For corporations, include applicable divisions or subsidiary name, if any.

2. Source Name : Provide the specific name of the site that will be covered by the General Permit. If the
source name is the same as the business state: “Same as business name.”

3. Physical Address: Provide the a ctual address of where the source is operating or proposing to operate and not the mailing address. Include the state and the zip code.

4. Reservation or O ther Area of Indian Country : Identify the Indian reservation, or other area of Indian country, as defined in 18 U.S.C. 1151, over which an Indian tribe, or the EPA, has demonstrated that the Tribe has jurisdiction, where the source is or will be located.

5. Owner : Provide the name of the o wner of the source

.

6. Telep hone Number and Email Address of Owner : Provide a telephone number and email address where
the owner can be reached during business hours.

7. Mailing Address for Owner : Provide the mailing address for the owner, including state and zip code.

8. Name of Operator or Contact a t Site (if different from owner) : Provide the operator , or other contact at
the site where the source is or will be located if the owner is the operator.

9. Telephone Number and Email A ddress of Operator or Contact at Site (if different from owner): Provide
the telephone number and email address where the operator can be reached during business hours. If the owner is the operator, provide such information for a contact at the site where the source is or will
be located

.

10. Correspondence Address: Provide the mailing address of the authorized contact person for the Request for Coverage . Include the state and the zip code.

11. Authorized Contact Person: Provide the name, title, phone number, and email address of the authorized
contact person. The authorized contact is the person authorized to receive re quests for data and other information related to the Request for Coverage.I nstructions for Request for Coverage Gasoline Dispensing Facilities within California Page 3 of 5 

### Section 2: **Facility Information**  **for Request**  **ing Coverage u**  **nder General**  **Air Quality Permit**  **for New or Modified Minor Source Gasoline Dispensing Facilities within California**

12. Description of Your Gasoline Dispensing Facility: Identify whether the Request for Coverage is for a new GDF or a modification to an existing source. An existing source could be an existing GDF or other emission units not part of the GDF. If this is a new GDF , describe the proposed new source. If this is a modification, describe the modification proposed

.

13. North American Industry Classification System (NAICS)/Standard Industrial Classification (SIC) Code and Description: Provide the NAICS/SIC Code and/or description for the facility (check all that apply)

.

14. Ozone Attainment Status: Indicate if this facility is located in an ozone nonattainment area and specify the classification of the ozone nonattainment area. If part of a tribe’s land area is designated as

attainment , unclassifiable, or attainment /unclassifiable and another part as nonattainment, the answer to this question should be based on the designation of the area where the source would be located. If
the source straddles two areas with different attainment classifications , the more stringent classification applies. Information on the ozone attainment status of the area where your facility is located can be
found at: http://www.epa.gov/airquality/greenbook/

. Please contact the reviewing authority if you have questions about an area’s attainment status.

15. Exemption from the Minor NSR Program: For a new facility, calculate the PTE of all proposed emission
units and determine if the PTE for the proposed source is below the applicability thres holds in the Indian Country Minor NSR Program (the thresholds listed in 40 CFR 49.153). For a modification to an existing

source , calculate the emissions increase from your new or modified emission units and determine if the proposed construction or modification is below the thresholds listed. For a new emissions unit

, the emissions change is the PTE of the new unit. For a modified emissions unit, the emissions change is the change in allowable emissions of the unit

.

You only need to consider the thr esholds for nonattainment areas if your source is (or will be) located in an area designated nonattainment. If in a nonattainment area, then you only need to consider the nonattainment threshold for the pollutant(s) for which the area is designated nonatta inment.

If the PTE of your new facility or the emissions increase at your existing facility is below the applicable thresholds listed for ALL pollutants, the new or modified source is exempt from the Indian Country

M inor NSR P rogram. You do not need a pe rmit for this source or modification . The EPA is providing a
PTE calculator to assist with this task. The calculator is available online at: https://www.epa.gov/caa

permitting/california

- tribal

- gasoline

- permits

. T his calculator covers only the types of emission units commonly found at a GDF. If your new or modified source includes other types of emission units, the

PT E for those units must be c alculated separately and added to the PTE for the units covered by the
calculator and included in the Request for Coverage

.

16. Qualification for General Permit : C alculate the PTE of your entire facility (include new, modified, and existing units) and determine if the PTE for all regulated NSR pollutants at your source is below the NSR major source threshold of 250 tons per year ( tpy ) . If the PTE of the proposed fac ility is equal or above

250 t py for ANY pollutant, this new or modified source does not qualify for coverage under this G eneral

P ermit . The EPA is providing a PTE calculator to assist with this task. The calculator is available online at : https://www.epa.gov/caa

- permitting/california

- tribal

- gasoline

- permits

. T his calculator covers only theI nstructions for Request for Coverage Gasoline Dispensing Facilities within California Page 4 of 5 types of emission units commonly found at a GDF. If your source incl udes other types of emission units, the PTE for those units must be calculated separately and added to the PTE for the units covered by the
calculator and included in the Request for Coverage

.

17. Qualification for General Permit

– Facility in Nonattainment Area : If located in a nonattainment area, calculate the PTE of your entire source (include new, modified, and existing units) and determine if the PTE for your source is below the NSR major source thresholds listed in the Request for Coverage . Note
the NSR major source classification is pollutant specific. You only need to consider the nonattainment area thresholds for the particular pollutant s for which the area is designat ed as nonattainment. If the PTE of the proposed facility is equal to or above the th reshold for ANY pollutant for which the area is designated as nonattainment

, then this new or modified source does not qualify for coverage under the

G eneral P ermit . The EPA is providing a PTE calculator to assist with this task. The calculator is available
online at: https://www.epa.gov/caa

- permitting/california

- tribal

- gasoline

- permits

. T his calculator covers only the types of emission units commonly found at a GD F. If your source includes other types of emission units, the PTE for those units must be calculated separately and added to the PTE for the units covered by the calculator and included in the Request for Coverage.

18. Complying with the R equirements in the General Permit : The General Permit is available online at https://www.epa.gov/caa

- permitting/california

- tribal

- gasoline

- permits

. Some of these requirements are applicable to sources based on size and location, gasoline throughput, presence or absence of controls,
and whether the source i s located in an ozone nonattainment area. Examine the requirements of the

Gene r al Permit and determine if you are able and willing to comp ly with them. If you do not believe you can comply with these requirements , you must obtain a source

- specific permit from the reviewing authority

.



### Section 3: **Technical Information for the Request for Coverage under the General Air**  **Quality Permit for New or Modified Minor Source Gasoline Dispensing Facilities within** 
**California**

19. Emission Units: For each emission unit at your facility include:

• A unique unit identification number

.

• A description of the equipment or process (include any input m aterials or fuels used )

.

• The maximum rated capacity or production rate of the equipment/process

.

• Description of any pollution control equipment

.

• Whether the equipment is existing, new, or modified. F or existing equipment, identify the installation
date and the most recent actual annual emissions

. For engines, include the model year.

• Specify yes or no as to whether your equipment is CARB certified, and the specific executive order
under which it was certified. Not all equipment at your GDF is required to be CARB

- certified. As such, this information only affects your eligibility to seek coverage under the General Permit for that equipment which is required to be CARB certified under the General Permit

.

• You must also include equipment ex empted under 40 CFR 49.153(c). In order to maintain eligibility under the General Permit, only sources with new or modified emergency engines that are exempt under 40 CFR 49.153(c) are eligible for coverage under the General Permit.

o Exempt engines include emergency generator engines designed solely for the purpose of providing electrical power during power outages, and:

 In attainment areas, the total maximum manufacturer’s site

- rated horsepower of all emergency generator engines be below 1,000 ;I nstructions for Request for Coverage Gasoline Dispensing Facilities within California Page 5 of 5  In nonattainment areas classified as marginal, moderate, or serious, the total maximum

manufacturer’s site

- rated horsepower of all emergency generator engines be below

500 ;

 In nonattainment areas c lassified as severe or extreme there is no exemption, so n o new or modified emergency generator engines located may be located at the source

.

Typical equipment associated with this source category may include gasoline storage tanks , gasoline

pumps and emergency engines , but you must also include any other types of emissions units at your

source

.

For each emission unit, you must also su b mit your supporting documentation for your PTE calculations. And, for any existing emission unit you must also include information on the actual annual emissions.



### Section 4 **: Information for Completing Screening Processes that Must Be Satisfied to**  **Request Coverage under the General Permit**

20. Threatened or Endangered Species : To request coverage under this G eneral P ermit, owners and
operators must demonstrate that they have satisf actorily completed the screening procedures related
to threa tened and endangered species for their proposed new or modified source . The EPA is providing procedures to assist with this task in Appendix A of the Request for Coverage

. The EPA must provide
confirmation that the owner or operator has satisfactorily c o m pl e t ed t hi s s c ree nin g p r o c e s s in order for
the source to be eligible for coverage under the General Permit

.

21. Historic Properties : To request coverage under this G eneral P ermit, owners and operators must demonstrate that they have satisfactorily completed the screening procedures related to the potential to cause effects to historic properties for their proposed new or modified source . The EPA is providing procedures to ass ist with this task in Appendix B of the Request for Coverage

. The EPA must provide
confirmation that the owner or operator has satisfactorily c o m pl e t ed t hi s s c ree nin g p r o c e s s in order for
the source to be eligible for coverage under the General Permit

.



### Section **5 :**  **Additional Information**

This section illustrates the annual VOC emissions rates that the limitations in the permit are expected to ensure the GDF ’s emissions are below

. No specific information is required to be submitted as part of this section.



### Section **6 :**  **Applicant’s Statement**

Certify that the information supplied in the application is correct, then sign the document, print your name, and date the document in the spaces provided.