FORM A-1

COMPANY INFORMATION

I. Parent Company / Legal Corporate Owner Information

1. Legal Parent Company / Legal Corporate Name

2. Mailing Address

3. City

4. State

5. Zip Code

6. County

7. Size of Company (approximate number of employees 

including all subsidiaries, branches, and related 

establishments owned):

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM A-2

FACILITY INFORMATION

II. Polyvinyl Chloride and Copolymers (PVC) Production Facility Information

1. Facility Name

Facility Address

a. Street

b. City

c. State

d. Zip Code

e. County

Facility Coordinates (Decimal Degrees to the 5th decimal place)

f. Latitude

g. Longitude

2. Number of employees attached to the PVC 

production facility:

III. Technical Contact

1. Name

2. Technical Contact Title

3. Telephone

4. Facsimile

5. Email

IV. Other

1. Is the facility a major source of HAP?

2. If No, did the facility take a limit of its 

potential HAP emissions to avoid classification 

as a major source?

3. If the facility took a limit of its potential HAP 

emissions to avoid classification as a major 

source, provide the date on which the limit was 

taken (MM/DD/YYYY).

4. Does the facility manufacture other products 

in addition to PVC resin?

5. If Yes, list the other products manufactured 

at the facility.

6. Are there any HAP emissions associated 

with any co-located facilities?

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM C

ECONOMIC LIFE AND APPLICABLE REGULATIONS FOR PVC PRODUCTION UNIT

Year Facility Commenced PVC Production: years

Remaining Economic Life PVC Production Unit: years

Table 1. Federal, State, and Local Regulations (list, include all regulations that apply to any part of the process unit)

Table 2. Federal, State, and Local Permits

Regulation Citation Regulation Title Regulated Process Equipment/Control Device/Recovery Equipment (list ID provided in Form B)

Permit ID Permit Type Regulated Process Equipment/Control Device/Recovery Equipment (list ID provided in Form B)

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM D-2

30 DAY RESIN SAMPLING - STRIPPER OUTLET(S)

Instructions

2. Do not submit partial data for any day: each day must include (at a minimum) concentration analysis results for all HA

3. Complete columns 1 through 30. Enter the sample date, resin type, daily resin production, number of samples compo

4. Provide the total daily production from the resin strippers samples for the type of resin. If your final product is sold as a 

4. Enter any other HAP expected to be present (that are not listed in Table 10 to Subpart HHHHHHH of 

5. For compounds that were not detected, indicate as such in the "Non-Detect?" column and provide the method detecti

6. Enter any notes or additional information relevant to the sampling or analysis.

7. Refer to Attachment B of Enclosure 1 "Summary of Test Procedures, Methods, and Reporting Requirements For Res

CAS No. HAP

107211 Ethylene glycol

67561 Methanol

75070 Acetaldehyde

50000 Formaldehyde

51285 2,4-dinitrophenol

98862 Acetophenone

117817 Bis(2-ethylhexyl) phthalate (DEHP)

123319 Hydroquinone

108952 Phenol

79345 1,1,2,2-tetrachloroethane

106990 1,3-butadiene

540841 2,2,4-trimethylpentane

71432 Benzene

108907 Chlorobenzene

67663 Chloroform

126998 Chloroprene

98828 Cumene

75003 Ethyl chloride (Chloroethane)

100414 Ethylbenzene

107062 Ethylene dichloride (1,2-Dichloroethane)

75343 Ethylidene dichloride (1,1-Dichloroethane)

74873 Methyl chloride (Chloromethane)

75092 Methylene chloride

110543 n-Hexane

108883 Toluene

71556 Methyl chloroform (1,1,1-Trichloroethane)

79005 1,1,2-Trichloroethane

If Other, Please Provide a Description of the Resin Type -->

Number of Resin Strippers Sampled to Obtain Composite

Number of Samples Composited for Analysis

Total Daily Resin Production Rate (lbs of resin per day from sampled resin strippers)

Resin Type (suspension, dispersion, bulk, etc.) -->

1. Complete the table below for each resin type produced by the facility during the 30 days of sampling. If the facility prod

not enter data for multiple resin types on a single worksheet.
108054 Vinyl acetate

593602 Vinyl bromide

75014 Vinyl chloride

75354 Vinylidene chloride (1,1-Dichloroethylene)

1330207 Xylenes (isomers and mixtures)
st include (at a minimum) concentration analysis results for all HAP in Table 10 to Subpart HHHHHHH of 40 CFR Part 63.

date, resin type, daily resin production, number of samples composited, number of resin strippers sampled, analysis date, lab report ID, and 

pers samples for the type of resin. If your final product is sold as a dried resin, report production on a dry basis. If your final product is sold as 

re not listed in Table 10 to Subpart HHHHHHH of 40 CFR Part 63) in the table below.

such in the "Non-Detect?" column and provide the method detection limit, in ppmw, in the "Concentration (ppmw)" column.

 the sampling or analysis.

Test Procedures, Methods, and Reporting Requirements For Resin and Process Wastewater Sampling and Analysis at Polyvinyl Chloride a

Analysis Method Concentration 

(ppmw) Non-Detect?

SW-846-8015C

SW-846-8015C

SW-846-8315A

SW-846-8315A

SW-846-8270D

SW-846-8270D

SW-846-8270D

SW-846-8270D

SW-846-8270D

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

her, Please Provide a Description of the Resin Type -->

Lab Sample ID -->

Lab Report ID -->

mber of Resin Strippers Sampled to Obtain Composite

Analysis Date -->

Number of Samples Composited for Analysis

ate (lbs of resin per day from sampled resin strippers)

Resin Type (suspension, dispersion, bulk, etc.) -->

Sample Date -->

ced by the facility during the 30 days of sampling. If the facility produced more than one resin type during the 30 days, create multiple copies 
SW-846-8260B

SW-846-8260B

EPA Method 107

SW-846-8260B

SW-846-8260B
Subpart HHHHHHH of 40 CFR Part 63.

 resin strippers sampled, analysis date, lab report ID, and lab sample ID. Enter the concentration results for each HAP listed.

ort production on a dry basis. If your final product is sold as a wet resin report production on a wet basis.

, in the "Concentration (ppmw)" column.

Wastewater Sampling and Analysis at Polyvinyl Chloride and Copolymer (PVC) Facilities" for additional instructions and information.

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

1 2

 one resin type during the 30 days, create multiple copies of this worksheet as necessary and complete one worksheet for each resin type. D

 and information.

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

3

heet for each resin type. Do 

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

4 5

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

6

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

7 8

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

9

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

10 11

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

12

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

13 14

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

15

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

16 17

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

18

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

19 20

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

21

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

22 23

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

24

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

25 26

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

27

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

28 29

Concentration 

(ppmw) Non-Detect? Note(s)

30

FORM E-1-a

PROCESS WASTEWATER

Instructions

2. Complete a row in Table 2 below for each PVC process wastewater stream that exits a PVC process wastewater trea

3. For each wastewater steam stripper identified in Table 2 of Form B-3, provide the requested information in Table 3 be

4. In Table 5, please provide the source, flow rates, and the ID of the PVC process wastewater treatment system for ea

5. Refer to "Enclosure 1" for additional instructions and details.

Table 1. Process Wastewater Streams Not Treated by a PVC Process Wastewater Treatment System

2

PVC Process 

Wastewater Stream ID

(W-x...ID should match 

those provided in the 

process flow diagram)

1. Complete a row in Table 1 below for each PVC process wastewater stream generated within the PVC production faci

the PVC production facility.

Name of PVC Process Wastewater Stream

1
Table 2. Process Wastewater Streams Exiting a PVC Process Wastewater Treatment System

1 2 3 4 5

Min Max

Table 3. Wastewater Steam Strippers

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

Table 4. PVC Process Wastewater Destination Codes Table

Onsite wastewater treatment system with biological treatment process

Equipment Currently Regulated Under (cite regulations):

Year Equipment Installed:

Stripping Factor:

Overall Calculated Tray Efficiency:

Column Height (meters):

Number of Actual Trays:

Flow configuration (countercurrent, cocurrent):

Wastewater Operating Feed Rate (liters/hr):

Wastewater Operating Feed Rate (lb/hr):

Operating Temperature (°F):

Operating Pressure (psig):

Total Number of Stages:

1

Destination Description

PVC Process 

Wastewater 

Treatment 

System ID

PVC Process 

Wastewater 

Stream ID

(W-x...ID should 

match those 

provided in the 

process flow 

diagram)

Is this process 

wastewater 

treatment system 

batch or continuous 

operation?

PVC Process Wastewater Stream Flow Rate (gallons 

per day)

PVC Process Wastewater Treatment Equipment ID:

Wastewater Maximum Design Feed Rate for Batch Strippers (liters)

Wastewater Maximum Design Feed Rate (liters/hr):

Wastewater Maximum Design Feed Rate (lb/hr):

Steam to Feed Ratio (kg steam/liter of wastewater):

Steam Feed Rate (lb/hr):

Feed Inlet Pressure (psia):

Feed Temperature (°F):

Wastewater Operating Feed Rate for Batch Strippers (liters)
Onsite wastewater treatment system without biological treatment process

Discharge without treatment by pipeline, sewer, or other conveyance to surface water

Discharge to POTW, no treatment

Discharge to PrOTW, no treatment

Zero discharge or alternative disposal method

Recycle to process

Other

Table 5. Non-PVC Production Process Wastewater Streams Entering a PVC Process Wastewater Treatment System

2

Min

Process Wastewater Stream Flow Rate (g

Source of Process Wastewater Stream

1
a PVC process wastewater treatment system (identified in Form B-3).

ested information in Table 3 below.

ewater treatment system for each stream that enters a PVC process wastewater treatment system but that does not originate from the PVC 

atment System

3 4 5 6 7

Min Max Average

 within the PVC production facility that exits a control device, a piece of recovery equipment, or process equipment and is not treated to redu

Operating Days Per 

Year

Flow Rate 

Determination 

Method

PVC Process Wastewater Stream Flow Rate 

(gallons per day)
6 7 8 9 10

Average

2

Code

OSWWT-w-Biotrt

Stream Flow Rate (gallons 

Flow Rate 

Determination 

Method

Associated 

Destination 

Information

(Refer to Table 3 below)

Operating Days 

Per Year

PVC Process 

Wastewater 

Stream 

Destination 

Code

(Refer to Table 4 

below)
OSWWT-w/o-Biotrt

SW

POTWRAW

PrOTWRAW

ZEROALT

RECYC

OTHER

Wastewater Treatment System

3 4 5 6 7

Max Average

Flow Rate 

Determination 

Method

PVC Process 

Wastewater Treatment 

System ID

Operating Days 

Per Year

stewater Stream Flow Rate (gallons per day)
but that does not originate from the PVC production facility.

8 9

cess equipment and is not treated to reduce the concentration of vinyl chloride or any other HAP before being discharged from 

Type of Originating 

Equipment/Device

Originating PVC Equipment/Device 

ID
11

Provide name of the wastewater treatment system

3

Process Wastewater Destination Details to Provide in Column 12 of Table 1 and Column 11 of Ta

Is this PVC process wastewater 

stream exposed to the atmosphere 

at any point between the outlet of 

the PVC process wastewater 

treatment system and its 

destination?
Provide name of the wastewater treatment system

Provide name of outfall

Provide name of POTW

Provide name of PrOTW

Describe method

Describe where in the process the stream is recycled

Describe
10 11

 or any other HAP before being discharged from 

PVC Process Wastewater Stream 

Destination Code

(Refer to Table 4 below)

Associated Destination Information
3

s to Provide in Column 12 of Table 1 and Column 11 of Table 2

12

Is this PVC process wastewater 

stream exposed to the atmosphere 

at any point between the 

originating PVC process equipment 

and its destination?

FORM E-1-b

MAINTENANCE WASTEWATER

Is your facility subject to any Federal, State, local or 

other requirements to collect, store, treat, or otherwise 

handle maintenance wastewater?

If "Yes," please provide the regulation citation or permit 

requirement as appropriate:

(If you answered "No," please provide responses to the 

questions below).

Provide a detailed description of the activities that create 

maintenance wastewater.

Procedures followed to collect, handle, manage, and 

treat maintenance wastewater? Include any further 

processing steps.

Is the maintenance wastewater exposed to the 

atmosphere at any point?

Describe procedure for controlling HAP emissions from 

the maintenance wastewater (if any):

Page 1 of 1

DRAFT PVC Section 114 Survey Part 2

06/23/2009
FORM E-2-a

30 DAY PVC PROCESS WASTEWATER SAMPLING AND ANALYSIS DATA

Instructions

1. Complete the table below for each PVC process wastewater steam exiting a process wastewater treatment system 

2. Enter the PVC process wastewater treatment system ID for the stream that was sampled and analyzed. The ID mu

3. Complete columns 1 through 30. Enter the sample date, resin type, stream flow rate, basis for flow rate determinat

4. Enter any other HAP expected to be present (that are not listed in Table 10 to Subpart HHHHHHH of 40 CFR Part 6

5. For compounds that were not detected, indicate as such in the "Non-Detect?" column and provide the method dete

6. Enter any notes or additional information relevant to the sampling or analysis.

7. Refer to Attachment B of Enclosure 1 "Summary of Test Procedures, Methods, and Reporting Requirements For R

PVC Process Wastewater Treatment System ID

CAS No. HAP

107211 Ethylene glycol

67561 Methanol

75070 Acetaldehyde

50000 Formaldehyde

51285 2,4-dinitrophenol

98862 Acetophenone

117817 Bis(2-ethylhexyl) phthalate (DEHP)

123319 Hydroquinone

108952 Phenol

79345 1,1,2,2-tetrachloroethane

106990 1,3-butadiene

540841 2,2,4-trimethylpentane

71432 Benzene

108907 Chlorobenzene

67663 Chloroform

126998 Chloroprene

98828 Cumene

75003 Ethyl chloride (Chloroethane)

100414 Ethylbenzene

107062 Ethylene dichloride (1,2-Dichloroethane)

75343 Ethylidene dichloride (1,1-Dichloroethane)

74873 Methyl chloride (Chloromethane)

75092 Methylene chloride

110543 n-Hexane

108883 Toluene

71556 Methyl chloroform (1,1,1-Trichloroethane)

Stream Flow Rate Exiting the Treatment System (gallons per minute) -->

Resin Type (suspension, dispersion, bulk, etc.) -->

If Other, Please Provide a Description of the Resin Type -->
79005 1,1,2-Trichloroethane

108054 Vinyl acetate

593602 Vinyl bromide

75014 Vinyl chloride

75354 Vinylidene chloride (1,1-Dichloroethylene)

1330207 Xylenes (isomers and mixtures)
 ANALYSIS DATA

stewater steam exiting a process wastewater treatment system that was sampled and analyzed. Complete one worksheet for each single st

m ID for the stream that was sampled and analyzed. The ID must match the IDs listed in Table 2 of Form 

date, resin type, stream flow rate, basis for flow rate determination, stream temperature, sample type, analysis date, lab report ID, and lab sa

re not listed in Table 10 to Subpart HHHHHHH of 40 CFR Part 63) in the table below.

such in the "Non-Detect?" column and provide the method detection limit, in ppmw, in the "Concentration (ppmw)" column.

 the sampling or analysis.

Test Procedures, Methods, and Reporting Requirements For Resin and Process Wastewater Sampling and Analysis at Polyvinyl Chloride a

Analysis Method Concentration 

(ppmw) Non-Detect?

SW-846-8015C

SW-846-8015C

SW-846-8315A

SW-846-8315A

SW-846-8270D

SW-846-8270D

SW-846-8270D

SW-846-8270D

SW-846-8270D

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

SW-846-8260B

Flow Rate Determination Method -->

Lab Sample ID -->

Lab Report ID -->

Analysis Date -->

Stream Temperature (degrees F) -->

 Exiting the Treatment System (gallons per minute) -->

Resin Type (suspension, dispersion, bulk, etc.) -->

Sample Date -->

her, Please Provide a Description of the Resin Type -->
SW-846-8260B

SW-846-8260B

SW-846-8260B

EPA Method 107

SW-846-8260B

SW-846-8260B
and analyzed. Complete one worksheet for each single stream (make copies of this worksheet if necessary).

sted in Table 2 of Form B-3.

ature, sample type, analysis date, lab report ID, and lab sample ID. Enter the concentration results for each HAP listed.

, in the "Concentration (ppmw)" column.

Wastewater Sampling and Analysis at Polyvinyl Chloride and Copolymer (PVC) Facilities" for additional instructions and information.

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

1 2

 and information.

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

3

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

4 5

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

6

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

7 8

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

9

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

10 11

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

12

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

13 14

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

15

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

16 17

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

18

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

19 20

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

21

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

22 23

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

24

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

25 26

Concentration 

(ppmw) Non-Detect? Note(s) Concentration (ppmw) Non-Detect?

27

Note(s) Concentration 

(ppmw) Non-Detect? Note(s)

28 29

Concentration 

(ppmw) Non-Detect? Note(s)

30

FORM E-2-b

30 DAY PVC PRODUCTION PROCESS WASTEWATER SAMPLING PRODUCTION DATA

Instructions

1. Please complete this worksheet for your PVC production facility. 

2. For the complete time period covering your PVC process wastewater treatment system(s) sampling, provide the total 

4. Refer to "Enclosure 1" for additional instructions and details.

1.) Sampling Start Date:

2.) Sampling End Date:

3). Total resin production from sampling start date to sampling end date and the type of resin produced:

3.a.) Total Resin Produced:

3.b.) Resin Type Produced:

3.c.) If Other, Specify:

4.a.) Total Resin Produced:

4.b.) Days of Production:

4.b.) Resin Type Produced:

4.c.) If Other, Specify:

5.) Total DAILY maximum PVC production capacity:

3. If the process wastewater treatment system(s) is/are treating process wastewater that was generated by the PVC prod

the amount of resin produced during the period prior to the start of sampling and indicate how many days of production th

4.) Total resin produced and number of days of production prior to the start of the sampling period

generated by the process and treated during the sampling period:
stem(s) sampling, provide the total resin production from your PVC production facility.

 of resin produced:

 pounds

 pounds

 days

 pounds per day (max)

hat was generated by the PVC production facility PRIOR to the start of the sampling period, then also include 

ate how many days of production that represents.

mpling period and for which process wastewater was 
FORM F-1

CONTROL DEVICES - ABSORBER

Instructions

1. Complete the form for each absorber used as a control device within the PVC production facility, or for any absorber that emits directly to atmosphere.

2. Refer to "Enclosure 1" for additional instructions and details.

1 Type of Equipment or Device

2 Equipment of Device ID

3 Type of Absorber

4 If other, provide a description:

5 Gas inlet flow rate (dscfm):

6 Gas inlet temperature (°F):

7 Pressure drop (in H2O):

8 Liquid-to-gas ratio (gal/103

 acfm):

Inlet scrubbing liquor

9 Liquor used:

10 pH:

11 Percent solids:

12 Type of alkali added, if any:

13 Addition rate (lb/gal):

14 Wastewater generation rate (gal/min):

15 Year Equipment Installed:

16 Equipment Currently Regulated Under (cite regulations):

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM F-2

CONTROL DEVICES - THERMAL OR CATALYTIC OXIDIZER

1 Control Device ID:

2 Number of operating hours per year (hours/year):

3 Is this emergency equipment?

4 Type (Thermal Oxidizer or Catalytic Oxidizer)

5 Oxidizer Inlet Flow Rate (dscfm):

6 Average percentage of total flow originating from the production facility:

7

Combustion chamber temperature (°F): (please note if temperature 

measurement is not in chamber)

8 Excess air (%):

9 Nominal residence time (s):

Heat recovery

10 Recuperative, percent heat recovery

11 Regenerative, percent heat recovery

12 Design Capacity (Heat Input) (MMBtu/hr):

13 Fuel Basis for Design Capacity:

14 Heat Release Rate (Btu/scf):

15 Is the unit subject to NSPS?

16 If yes, indicate the year:

Start-up Fuel/Material

17 Start-up fuel:

18 Number of start-ups per year:

19 Typical length of time for start-up (hours):

20 Higher heating value (HHV):

Fuels/Materials Combusted During Normal Operations (include solid, liquid, and gas waste streams)

21 Fuel 1:

22 Hours used per year:

23 Higher heating value (HHV):

24 Fuel 2:

25 Hours used per year:

26 Higher heating value (HHV):

27 Fuel 3:

28 Hours used per year:

29 Higher heating value (HHV):

30 Fuel 4:

31 Hours used per year:

32 Higher heating value (HHV):

33 Fuel 5:

34 Hours used per year:

35 Higher heating value (HHV):

36 Year Equipment Installed:

37 Equipment Currently Regulated Under (cite regulations):

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM F-3

CONTROL DEVICES - CONDENSERS

Instructions

1. Complete the form for each condenser used as a control device within the PVC production facility, or for any condenser that emits directly to atmosphere.

2. Refer to "Enclosure 1" for additional instructions and details.

1 Type of Equipment or Device

2 Equipment of Device ID

3 Type of Condenser

4 If other, provide a description:

5 Is the condenser refrigerated?

6 Describe the materials condensed:

7 Describe the fate of the non-condensed gas stream:

8 Describe the fate of the condensate outlet stream:

9 Gas inlet flow rate (dscfm):

10 Gas inlet temperature (°F):

11 Gas outlet temperature (°F):

12 Liquid outlet for rate (gpm):

15 Year Equipment Installed:

16 Equipment Currently Regulated Under (cite regulations):

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM G

COOLING TOWERS AND HEAT EXCHANGE SYSTEMS

Instructions

3. Refer to "Enclosure 1" for additional instructions and details.

Table 1.a Cooling Tower Identification

Cooling Tower ID

Total CT Return Flow Rate 

(gal/min):

Number of processes served by

cooling tower:

Number of these from a PVC 

production process unit:

Is the heat exchange system 

monitored for the presence of one 

or more HAP or VOC in the cooling 

water?

Table 1.b Cooling Tower Emission Reductions

For this cooling tower (if the single combined inlet line is monitored), OR for each heat exchange system from a PVC proces

(list sequentially beginning with "H1")

PVC HTEX System No.

Is the heat exchange 

system currently

regulated?

If Yes, cite the 

regulation(s):

1. Please complete one worksheet for each cooling tower, providing as much of the requested information as possible. C

2. Using the table beginning on row 23, provide the requested information for the cooling tower. If only the single combin

enter information for the cooling tower. If cooling tower return lines are monitored individually, please provide informatio

paste more rows to the table to add additional processes. 
[ADD MORE ROWS TO THIS TABLE FOR ADDITIONAL HTEX SYSTEMS FOR THIS COOLING TOWER]
Table 2. Once-through Heat Exchange Systems

r each heat exchange system from a PVC process unit (if individual CT return lines are monitored individually), please provide the following:

(gal/min) (list speciation and/or 

group)

(e.g., continuous, daily, 

weekly, monthly, yearly, 

other)

(e.g., visual 

inspection, 

surrogate 

monitoring, 

water 

sampling, air 

stripping, 

other)

(e.g., EPA 

Method 601, 

EPA 

Method 624, 

Mod El 

Paso, etc.)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

CT Return Flow Rate for 

HTEX System List ALL Compounds 

Analyzed: Monitoring frequency Type of monitoring

Monitoring, 

sampling, or 

air stripping 

analysis 

 much of the requested information as possible. Copy and paste additional worksheets for each cooling tower. 

Does your PVC production facility use any once-through heat exchange systems?

on for the cooling tower. If only the single combined inlet line is monitored, you may delete rows 31 through 36 and 

 monitored individually, please provide information for each process. Identify the PVC process in column A. Copy and 
S FOR THIS COOLING TOWER]
ally), please provide the following:

Value Unit

(provide the 

numeric 

MDL)

(provide the 

MDL units)

(CT inlet, outlet, 

both) (ppbw) (days) (ppbw) (days)

Emission Reduction Measures

MDL Monitoring 

Location

Delay of Repair 

Threshold

Repair Time for 

Delayed Repairs

Leak 

Repair 

Threshold

Repair Time for 

Normal Leak 

Events

(#) (days)

Total 

Duration 

of All 

Repairs

Leaks in 2013

Number of 

Leaks in 

2013
FORM H

EQUIPMENT LEAKS

Instructions

1. Submit a copy of the leak detection and repair procedures for the PVC production facility and provide responses to the questions below.

2. Refer to "Enclosure 1" for additional instructions and details.

Table 1. LDAR Program

Table 2. Equipment Counts

In Source 

Category

Subtotal of Equipment Associated 

with Closed Vent System(s)

(Subset of count in source category)

In heavy liquid service

In gas, vapor, and light liquid service

Connectors

In heavy liquid service

In gas, vapor, and light liquid service

Agitators

In liquid service

In gas and vapor service

Pressure Relief Devices

Open ended valves and lines

Sampling connection systems

Compressors

Instrumentation systems

Valves

In heavy liquid service

In light liquid service

Pumps

40 CFR Part 61, Subpart V

Other Federal LDAR Regulation

Specify: 

State LDAR Regulation

Specify:

Provide the total cost to your facility for conducting the LDAR 

program at this process unit in 2013:

Equipment

In heavy liquid service

In gas, vapor, and light liquid service

Is there an equipment leak detection and repair (LDAR) 

program for all equipment at your facility included in the 

source category?

If "No," how are equipment leaks detected and repaired?

If "Yes," is the equipment subject to the requirements of:

40 CFR Part 63, Subpart UU

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM J

OFF-SPECIFICATION RESIN AND MATERIAL REMOVAL FROM EQUIPMENT

Instructions

1. Complete this form for 2013 only.

3. Provide copies of estimation worksheets and any other relevant documentation.

4. Complete this form for individual equipment, including equipment that is not assigned an equipment ID (e.g., in-line filters).

5. Refer to "Enclosure 1" for additional instructions and details.

Table 1.

Source Equipment Type:

Source Process Equipment ID (if applicable):

Equipment Description:

Total Pounds of Material Removed in 2013 (do not 

include the contribution of water or other fluids(s) to 

remove the material from the equipment) :

Describe the procedure for removal of the material 

from equipment:

Is the material exposed to the atmosphere at any 

point during or after removal from the equipment?

Describe procedure for controlling HAP emissions 

from the material during and after removal from the 

equipment:

Describe the fate/disposition of the material 

beginning from the time it is removed from the 

equipment. Include any further processing steps.

Table 2.

Minimum Maximum Average

(select HAP)

2. This form covers resin that is removed from equipment and is not processed further through the normal processing steps. Examples include, but are 

not limited to, off-specification resin removed from the polymerization reactor or any other downstream process equipment, resin removed from 

equipment during maintenance and cleanout operations, etc.

Concentration in Resin or Resin Slurry Immediately

Prior to Removal From Equipment and Before Being 

Mixed With Other Materials or Fluids (ppmw) Individual HAP Present Notes

Page 1 of 2

DRAFT PVC Section 114 Survey Part 2

06/23/2009
(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

Page 2 of 2

DRAFT PVC Section 114 Survey Part 2

06/23/2009
FORM K-1

TANKS, VESSELS AND PORTABLE CONTAINERS USED FOR FEEDSTOCK STORAGE, PRODUCT STORAGE, VENT GAS STORAGE, HOLDING, AND WASTEWATER

Instructions

1. Complete this form for 2013 only.

2. Provide copies of estimation worksheets and any other relevant documentation.

3. Complete this form for individual equipment, including equipment that is not assigned an equipment ID (e.g., portable containers).

4. Do not include gas holders on this form. Complete Form K-2 for gas holders.

4. Refer to "Enclosure 1" for additional instructions and details.

Table 1.

Table 2.

Vapor Pressure Total Emissions

(in H2O) Minimum Maximum Average (pounds)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

If Other, please specify, being as descriptive as possible:

Source Process Equipment ID (if applicable):

Equipment Description:

If not provided in the equipment description above, 

describe the tank, vessel, or container and indicate (if 

applicable) if the tank is a fixed, floating internal, or floating 

external roof. 

Select the purpose of the equipment:

If Yes, How Are The Emissions Controlled?

Concentration (ppmvd @ 3% O2)

How is the HAP Concentration Determined?

Are HAP Emissions Controlled?

Individual HAP Present

Source Equipment Type:

Number of turnovers:

Equipment volume (m3):

Notes

Storage Temperature (°F)

Page 1 of 1

DRAFT PVC Section 114 Survey Part 2

06/23/2009
FORM K-2

GAS HOLDERS

Instructions

1. Complete this form for 2013 only.

2. Provide copies of estimation worksheets and any other relevant documentation.

3. Refer to "Enclosure 1" for additional instructions and details.

Table 1.

Table 2.

Vapor Pressure Total Emissions

(in H2O) (pounds)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

Does your PVC production facility use gas holders:

Indicate the number of gas holders in use at your PVC production facility:

Are HAP Emissions Controlled?

If Yes, How Are The Emissions Controlled?

Individual HAP Present Notes

Page 1 of 1

DRAFT PVC Section 114 Survey Part 2

06/23/2009
FORM L

STARTUP, SHUTDOWN, AND MALFUNCTION

Instructions

1. Complete this form for 2013 only.

2. Submit with your response to this survey, copies of all records of emissions during periods of process startup, shutdown, and malfunctions for 2013 only.

3. Refer to "Enclosure 1" for additional instructions and details.

For a malfunction:

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

Total Emissions During Startup, Shutdown, 

or Malfunction Event

Were all of the emissions control devices 

operating for the entire duration of the startup, 

shutdown, or malfunction event?

Startup, Shutdown or Malfunction?

If startup or shutdown, what was the 

duration (hours):

Provide a short description of 

the malfunction and the 

circumstances:

If No, which control devices were not operating 

(Control Equipment ID), for how long, and why:

Were permitted emissions limits exceeded?

Provide a description of the 

procedures used to alert the 

owner/operator that the 

malfunction occurred. If the malfunction resulted in 

a release of emissions, 

describe any indicators used 

to signal and/or measure the 

release.

Is there a written startup, shutdown and/or 

malfunction plan for the process unit?

Provide a description of the systems and 

equipment in place that function to notify 

operators that a malfunction is occurring .

Applicable standard or regulation:

Describe what actions, if any, were taken to 

minimize emissions to the atmosphere:

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM M

FACTORS THAT AFFECT HAP/VOC EMISSION REDUCTIONS

Name of Unit Operation

Description of process change or 

other pollution prevention or source 

reduction measure:

Quantify emissions reductions (e.g. tons/year) resulting 

from the use of pollution or source reduction measures:

For each unit operation for which pollution reduction or source reduction measures have resulted in a decrease in HAP/VOC emissions since 1976, provide the following information.

If recovery or recycling of feedstocks is used, quantify the effect of the program (e.g., estimated annual purchase of feedstock in the absence of recovery/recycling compared to actual annual 

purchase):

Are you aware of any alternative processes (e.g., feedstock substitutions or eliminations) or control devices or techniques that could result in fewer impacts between environmental media (water, air, 

and land) or reduced total release to all environmental media (e.g., reduced wastewater or solid waste)? Discuss whether these processes could be adapted to the polyvinyl chloride and 

copolymers production source category and any experience you have with them:

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM N

MISCELLANEOUS

If any control or process change described on Form M was instituted as a result of new source review requirements pursuant to 40 CFR 

51.160, Subpart I, Review of New Sources and Modifications, provide the date at which the lowest achievable emission rate (LAER) came 

into effect:

Describe any factors not addressed in the questions in this survey that might serve to distinguish your facility from others in this source 

category for purposes of developing a separate source category or subcategory and MACT standards:

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009