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 within California

Version 1.0

Last Modified: September 28, 2016

If you wish to notify the reviewing authority of your intent to operate under the ‘General Air Quality Permit for 

New or Modified Minor Source Gasoline Dispensing 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 within California’ (Request for Coverage).

The General Permit implements 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 form. In the form, please provide information on all existing, new and modified units.

Helpful Definitions from 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 maximum 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.
Instructions 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 performance 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 authorized 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 actual 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 Other 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 owner of the source. 

6. Telephone 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 at 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 Address 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 requests for data and other 

information related to the Request for Coverage.
Instructions for Request for Coverage

Gasoline Dispensing Facilities within California Page 3 of 5

Section 2: Facility Information for Requesting Coverage under 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 thresholds 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 thresholds 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 nonattainment. 

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 

Minor NSR Program. You do not need a permit 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/caapermitting/california-tribal-gasoline-permits. This 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 

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.

16. Qualification for General Permit: Calculate 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 facility is equal or above 

250 tpy for ANY pollutant, this new or modified source does not qualify for coverage under this General 

Permit. 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. This calculator covers only the 
Instructions 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 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.

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 pollutants for which the area is designated as nonattainment. If the 

PTE of the proposed facility is equal to or above the threshold for ANY pollutant for which the area is 

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

General Permit. 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. This calculator covers 

only the types of emission units commonly found at a GDF. 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 Requirements 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 is located in an ozone nonattainment area. Examine the requirements of the 

General Permit and determine if you are able and willing to comply 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 materials 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. For 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 exempted 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;
Instructions 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 classified as severe or extreme there is no exemption, so no 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 submit 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 General Permit, owners and 

operators must demonstrate that they have satisfactorily completed the screening procedures related 

to threatened 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 completed this screening process in order for 

the source to be eligible for coverage under the General Permit.

21. Historic Properties: To request coverage under this General Permit, 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 assist with this task in Appendix B of the Request for Coverage. The EPA must provide 

confirmation that the owner or operator has satisfactorily completed this screening process 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.