AEROSPACE MANUFACTURING AND REWORK INDUSTRY

INFORMATION REQUEST QUESTIONNAIRE

INSTRUCTIONS FOR COMPLETING THE QUESTIONNAIRE

The reporting year for this information request is 2008. If you cannot provide 2008 data, 

you must contact Kim Teal of the U.S. EPA at 919-541-5580 or teal.kim@epa.gov prior to 

completing this information request to explain why 2008 data are not available and obtain 

permission to submit data from another year.

The public reporting and recordkeeping burden for this collection of information is estimated to average 

228 hours per reponse. Send comments on the Agency's need for the information, the accuracy of the 

provided burden estimates, and any suggested methods for minimizing respondent burden, including 

through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. 

Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. 

Include the OMB control number in any correspondence. Do not send the completed survey to this 

address.

OMB Control No. 2060-NEW

Approval Expires XX/XX/XXXX

This information request is to be completed for operations that comprise the Aerospace 

Manufacturing and Rework source category at your facility. The Aerospace Manufacturing and 

Rework source category includes any facility engaged, either in whole or in part, in the 

manufacture or rework of commercial, civil, or military aerospace vehicles or components. 

Aerospace vehicle component means any fabricated part, processed part, assembly of parts, 

or completed unit, with the exception of electronic components, of any aircraft including but not 

limited to airplanes, helicopters, missiles, rockets, and space vehicles.

The North American Industrial Classification System (NAICS) codes that describe facilities that 

may manufacture or rework aerospace vehicle, components, or parts are listed in the table 

below. This table is not meant to be exhaustive; facilities classified under other NAICS codes 

may also be required to complete this information request if they perform activities as defined 

above.
AEROSPACE MANUFACTURING AND REWORK INDUSTRY

INFORMATION REQUEST QUESTIONNAIRE

INSTRUCTIONS FOR COMPLETING THE QUESTIONNAIRE

Aircraft Manufacturing

Aircraft Engine and Engine Parts Manufacturing

Guided Missile and Space Vehicle Manufacturing

Nonscheduled Chartered Freight Air Transportation

Other Nonscheduled Air Transportation

Scheduled Passenger Air Transportation

Scheduled Freight Air Transportation

481111

481112

481211

Other Guided Missile and Space Vehicle Parts and Auxiliary Equipment

481212

481219

336411

336412

336413

Guided Missile and Space Vehicle Propulsion Units and Parts

You must complete this information request for ALL manufacturing operations that constitute 

aerospace manufacturing and rework at your facility, regardless of whether the operations are 

presently regulated under the National Emission Standards for Hazardous Air Pollutants for 

Aerospace Manufacturing and Rework Facilities (aerospace NESHAP). For example, 

information must be submitted for the following operations even though they are not regulated 

by the aerospace NESHAP: chemical milling, metal finishing, electrodeposition, composites 

processing, manufacture of aircraft transparencies, and wastewater operations, among others. 

Additionally, you must submit information for operations that may be exempt from regulation 

under the aerospace NESHAP including, but not limited to, low volume usage coatings, 

activities associated with the manufacture or rework of space vehicles, certain waterborne 

coatings, certain cleaning operations, certain primer and topcoat operations, specialty 

coatings, and certain depainting operations. Finally, you must submit information where 

control requirements are not specified for operations under the aerospace NESHAP, including 

the use of specialty coatings, adhesives, adhesive bonding primers, or sealants.

Nonscheduled Chartered Passenger Air Transportation

336414

336415

336419

Other Aircraft Parts and Auxiliary Equipment Manufacturing

North American Industrial Classification System Codes for the

Aerospace Manufacturing and Rework Industry

NAICS Code Description
AEROSPACE MANUFACTURING AND REWORK INDUSTRY

INFORMATION REQUEST QUESTIONNAIRE

INSTRUCTIONS FOR COMPLETING THE QUESTIONNAIRE

However, this information request does not apply to aerospace manufacturing or rework 

operations that are regulated under NESHAP other than the aerospace NESHAP, with the 

exception of the Halogenated Solvent NESHAP. For example, you should not include in your 

response information regarding chromium electroplating operations regulated under the 

chromium electroplating NESHAP.
FORM A-1

PARENT COMPANY INFORMATION

I. Parent Company / Legal Corporate Owner Information

 1. Legal Parent Company / Legal Corporate Name. If your facility is a 

subsidiary of a larger corporation, franchise, etc. or if you are the owner of 

multiple facilities, please provide the name of the corporation, franchise, 

etc. Otherwise, you may respond with N/A.

 2. Address 1

 3. Address 2

 4. City

 5. State

 6. Zip Code

 7. County

 8. Size of Parent Company (approximate total number of full-time and 

part-time employees including all subsidiaries, branches, and related 

establishments owned):

Complete this form to identify the parent company of this facility. Your response to Section I, Question 8 (Size of parent company) is an important 

factor that EPA will use in an economic analysis and to identify small businesses. Please note that the total of all full-time and part-time employees 

should be reported. This information is required for the parent company, not just this facility.

If your facility is a subsidiary or a branch of a larger company, please ensure the response in Section I contains information about the ultimate owner of 

this facility and all of its operations.

FORM A-2

FACILITY INFORMATION

I. Facility Information

1. Facility Name and Location

 Facility Physical Address

 Street

 City

 State

 Zip Code

 County

 Facility Mailing Address

 Address 1

 Address 2

 City

 State

 Zip Code

 Facility Coordinates. Latitude and longitude must be reported in 

decimal degrees to six decimal places. For example, EPA 

Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. 

is 38.894907 latitude and -77.028625 longitude at the front door. 

You may use the Satellite function of Google Maps to identify 

latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees, six decimal places)

 Longitude (decimal degrees, six decimal places)

 Specific location represented (e.g., front door of main building, 

centroid of property, etc.)

Complete this for for this specific facility.
2. Does this facility manufacture, repair, rework, or otherwise 

modify parts or assemblies for the aerospace industry? If you 

answer “No” to this question, please provide an explanation in the 

Comments section of what activities are carried out at this facility

and why you should not be considered an aerospace manufacturing 

or rework facility. If you answer “No” then you do not have to 

complete any other parts of this information request other than 

Forms A-1 and A-2.

3. If "Yes," what NAICS codes describe your aerospace 

operations? NAICS codes may be found at 

http://www.census.gov/eos/www/naics/. Do not enter Standard 

Industrial Classification (SIC) codes.

 Primary NAICS Code

 Other NAICS Code

 Other NAICS Code

4. Number of employees (full-time and part-time combined)

 Total number of employees at this facility

 Total number of employees performing aerospace operations

5. Do you manufacture or rework aerospace components or parts 

for the following market segments?

 Original equipment manufacturing - commercial

 Original equipment manufacturing - military

 Rework - commercial

 Rework - military

6. Operation schedule

 hrs/day

 days/yr

II. Technical Contact

The technical contact should be able to answer inquires from EPA 

concerning any information provided in your response.

 Name

 Technical Contact Title

 Telephone
 Facsimile (Fax)

 Email

III. Other

1. Is the facility a major source of HAP? A major source of HAP 

is defined as any stationary source or group of stationary sources 

located within a contiguous area and under common control that 

emits or has the potential to emit considering controls, in the 

aggregate, 10 tons per year or more of any hazardous air pollutant.

 

2. If "No", did the facility take a federally enforceable permit limit 

of its potential HAP emissions to avoid classification as a major 

source? If you did take permit limits, specify those limits in the 

Comments section.

3. Does the facility manufacture other products in addition to 

aerospace products?

4. If "Yes", list the other products manufactured at the facility.

5. Multiplier to scale up average hourly emissions to maximum 

hourly emissions (see instructions)

6. Comments (include description of how the maximum hourly

emissions multipier listed in #5 was determined)
FORM B-1

SPRAY BOOTH INFORMATION

Booth 1 Booth 2 Booth 3 

I. Booth Description and Location

1. Identification No.

2. Booth Type

3. Booth Location

Latitude and longitude must be reported in decimal degrees to six decimal 

places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in 

Washington, D.C. is 38.894907 latitude and -77.028625 longitude at the 

front door. You may use the Satellite function of Google Maps to identify 

latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees to at least six decimal places)

 Longitude (decimal degrees to at least six decimal places)

4. Dimensions of Building in Which Booth is Located (NOT the dimensions 

of the booth itself)

 Length (ft)

 Width (ft)

 Height (ft)

5. Airflow Direction in Booth

6. Average Daily Operating Hours

II. Particulate Filters

1. Type of Filter System

2. Filter Control Efficiency (percent)

3. How was the filter control efficiency determined (indicate yes where 

appropriate)

 Testing (specify method)

 Filter Manufacturer's Specifications

 Engineering Estimate

III. Exhaust Stack

1. Exhaust Stack Location
Latitude and longitude must be reported in decimal degrees to six decimal 

places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in 

Washington, D.C. is 38.894907 latitude and -77.028625 longitude at the 

front door. You may use the Satellite function of Google Maps to identify 

latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees to at least six decimal places)

 Longitude (decimal degrees to at least six decimal places)

2. Exhaust Stack Diameter (ft)

3. Exhaust Stack Height (ft)

4. Exhaust Stream Temperature (°F)

5. Exhaust Stream Flow Rate (acfm)

IV. Control Device for Organic Emissions

Complete this section if this spray booth is vented to a control device that 

reduces the amount of organic emissions.

1. Identification No. (must correspond to ID No. of one of the control 

devices for which a Form J was completed)

2. Type of Control Device

3. Capture Efficiency

4. How was capture efficiency determined?

 Testing (specify method)

 Filter Manufacturer's Specifications

 Engineering Estimate

V. Comments

 Use this section to explain any of the above responses or to provide 

additional information
Booth 4 Booth 5 Booth 6 Booth 7 Booth 8

Booth 9 Booth 10

FORM C-1

COATINGS

Use Form C-1 for entering coating information in English units 

(pounds, gallons, etc.). Use Form C-2 for enterning coating 

information in metric units (kilograms, liters, etc.). DO NOT 

complete both Form C-1 and Form C-2.

This form has space for entering data for 20 coatings. If you 

are providing data for more than 20 coatings, please add 

additional columns as necessary.

Coating 1 Coating 2 Coating 3

I. Coating Information

1. Identification No.

2. Manufacturer

3. Product Name

4. Is this coating regulated under the Aerospace Manufacturing 

and Rework Operations National Emission Standards for 

Hazardous Air Pollutants (40 CFR 63, subpart GG)?

5. If "Yes," what is the coating type?

6. If "No," what is the specialty coating type?

II. Coating Usage and Physical Properties

1. Total Volume Used for the Reporting Year for all coating 

operations (gals)

2. As-Applied Coating Physical Properties

 Coating Density (lb coating/gal coating)

 Total Organic HAP Mass Fraction (lb HAP/lb coating)

 Total Inorganic HAP Mass Fraction (lb HAP/lb coating)

 Solids Mass Fraction (lb solids/lb coating)

 Solids Volume Fraction (gal solids/gal coating)

3. Speciated HAP (Organic and Inorganic) Content
To avoid double counting, do not report the same HAP 

emissions under different CAS numbers or as different 

compounds. For example, do not report both "total chromium" 

and "hexavalent chromium" for a single chromium compound 

contained in a coating. The correct reporting method, 

particularly for chromium compounds, glycol ethers, and 

polycyclic organic matter, is to report the specific compound 

(e.g., strontium chromate, ethylene glycol dibutyl ether) rather 

than the general class of HAP (e.g., chromium compounds, 

glycol ethers).

 HAP Name

 CAS No.

 HAP Mass Fraction (lb HAP/lb coating)

 HAP Name

 CAS No.

 HAP Mass Fraction (lb HAP/lb coating)

 HAP Name

 CAS No.

 HAP Mass Fraction (lb HAP/lb coating)

 HAP Name

 CAS No.

 HAP Mass Fraction (lb HAP/lb coating)

 HAP Name

 CAS No.

 HAP Mass Fraction (lb HAP/lb coating)

III. Coating Usage by Spray Booth

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)
 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Application of Coating Outside of a Spray Booth - Application 

Method

 Portion of Annual Coating Usage Applied Outside of a Booth 

(percent)

IV. Comments

 Use this section to explain any of the above responses or to 

provide additional information
Coating 4 Coating 5 Coating 6 Coating 7 Coating 8


Coating 9 Coating 10 Coating 11 Coating 12 Coating 13


Coating 14 Coating 15 Coating 16 Coating 17 Coating 18


Coating 19 Coating 20


FORM C-2

COATINGS

Use Form C-1 for entering coating information in English units 

(pounds, gallons, etc.). Use Form C-2 for enterning coating 

information in metric units (kilograms, liters, etc.). DO NOT 

complete both Form C-1 and Form C-2.

This form has space for entering data for 20 coatings. If you 

are providing data for more than 20 coatings, please add 

additional columns as necessary.

Coating 1 Coating 2 Coating 3

I. Coating Information

1. Identification No.

2. Manufacturer

3. Product Name

4. Is this coating regulated under the Aerospace Manufacturing 

and Rework Operations National Emission Standards for 

Hazardous Air Pollutants (40 CFR 63, subpart GG)?

5. If "Yes," what is the coating type?

6. If "No," what is the specialty coating type?

II. Coating Usage and Physical Properties

1. Total Volume Used for the Reporting Year for all coating 

operations (liters)

2. As-Applied Coating Physical Properties

 Coating Density (kg coating/L coating)

 Total Organic HAP Mass Fraction (kg HAP/kg coating)

 Total Inorganic HAP Mass Fraction (kg HAP/kg coating)

 Solids Mass Fraction (kg solids/kg coating)

 Solids Volume Fraction (L solids/L coating)

3. Speciated HAP (Organic and Inorganic) Content
To avoid double counting, do not report the same HAP 

emissions under different CAS numbers or as different 

compounds. For example, do not report both "total chromium" 

and "hexavalent chromium" for a single chromium compound 

contained in a coating. The correct reporting method, 

particularly for chromium compounds, glycol ethers, and 

polycyclic organic matter, is to report the specific compound 

(e.g., strontium chromate, ethylene glycol dibutyl ether) rather 

than the general class of HAP (e.g., chromium compounds, 

glycol ethers).

 HAP Name

 HAP Mass Fraction (kg HAP/kg coating)

 HAP Name

 HAP Mass Fraction (kg HAP/kg coating)

 HAP Name

 HAP Mass Fraction (kg HAP/kg coating)

 HAP Name

 HAP Mass Fraction (kg HAP/kg coating)

 HAP Name

 HAP Mass Fraction (kg HAP/kg coating)

III. Coating Usage by Spray Booth

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)
 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Application of Coating Outside of a Spray Booth - Application 

Method

 Portion of Annual Coating Usage Applied Outside of a Booth 

(percent)

IV. Comments

 Use this section to explain any of the above responses or to 

provide additional information
Coating 4 Coating 5 Coating 6 Coating 7 Coating 8


Coating 9 Coating 10 Coating 11 Coating 12 Coating 13


Coating 14 Coating 15 Coating 16 Coating 17 Coating 18


Coating 19 Coating 20


FORM D-1

CHEMCIAL MILLING AND METAL FINISHING OPERATIONS

Complete this form for each processing tank that contains HAP in chemical 

milling and metal finishing operations. If your facility does not have 

chemical milling or metal finishing operations, state that in the Comments 

section.

Tank 1 Tank 2 Tank 3

I. Processing Tank Description and Location

1. Tank Identification No.

2. Location of Tank

Latitude and longitude must be reported in decimal degrees to six decimal 

places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in 

Washington, D.C. is 38.894907 latitude and -77.028625 longitude at the 

front door. You may use the Satellite function of Google Maps to identify 

latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees to at least six decimal places)

 Longitude (decimal degrees to at least six decimal places)

3. Dimensions of Building in Which Tank is Located

 Length (ft)

 Width (ft)

 Height (ft)

4. Purpose of this Tank

5. Average Daily Hours of Operation

 Average Days per Year of Operation

II. HAP Emissions and Controls
To avoid double counting, do not report the same HAP emissions under 

different CAS numbers or as different compounds. For example, do not 

report both "total chromium" and "hexavalent chromium" for a single 

chromium compound contained in a coating. The correct reporting 

method, particularly for chromium compounds, glycol ethers, and polycyclic 

organic matter, is to report the specific compound (e.g., strontium 

chromate, ethylene glycol dibutyl ether) rather than the general class of 

HAP (e.g., chromium compounds, glycol ethers).

1. HAP Emissions

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

2. Control Device Identification No. (must correspond to ID No. of one of 

the control devices for which a Form J was completed)

3. Type of Control Device

4. Capture Efficiency

5. How was capture efficiency determined?

 Testing (specify method)

 Manufacturer's Specifications

 Engineering Estimate
III. Work Practices

 Describe any work practices that you use to reduce emissions from this 

tank

IV. Comments

 Use this section to explain any of the above responses or to provide 

additional information
Tank 4 Tank 5 Tank 6 Tank 7 Tank 8


Tank 9 Tank 10


FORM E-1

BLAST DEPAINTING/CLEANING OPERATIONS

Complete this form for each depainting or cleaning operation that utilizes a 

blasting method (plastic beads, metal shot, sodium bicarbonate, carbon 

dioxide, etc.) to depaint or clean aerospace components. If your facility 

does not have blast depainting/cleaning operations, state that in the 

comments section.

Operation 1 Operation 2 Operation 3

1. Process Identification No.

2. Location of Blasting Operation

Latitude and longitude must be reported in decimal degrees to six decimal 

places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in 

Washington, D.C. is 38.894907 latitude and -77.028625 longitude at the 

front door. You may use the Satellite function of Google Maps to identify 

latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees to at least six decimal places)

 Longitude (decimal degrees to at least six decimal places)

3. Identify where blasting occurs (e.g., outside, in a partially enclosed 

booth, in a fully enclosed booth, etc.)

4. Identify the type of blasting media used (be specific)

5. Dimensions of Building in Which Operation is Located

 Length (ft)

 Width (ft)

 Height (ft)

6. Purpose of this Blasting Operation

7. Average Daily Hours of Operation

 Average Days per Year of Operation

II. HAP Emissions and Controls
To avoid double counting, do not report the same HAP emissions under 

different CAS numbers or as different compounds. For example, do not 

report both "total chromium" and "hexavalent chromium" for a single 

chromium compound contained in a coating. The correct reporting 

method, particularly for chromium compounds, glycol ethers, and 

polycyclic organic matter, is to report the specific compound (e.g., 

strontium chromate, ethylene glycol dibutyl ether) rather than the general 

class of HAP (e.g., chromium compounds, glycol ethers).

1. HAP Emissions

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

2. Control Device Identification No. (must correspond to ID No. of one of 

the control devices for which a Form J was completed)

3. Type of Control Device

4. Capture Efficiency

5. How was capture efficiency determined?

 Testing (specify method)

 Manufacturer's Specifications

 Engineering Estimate
III. Work Practices

 Describe any work practices that you use to reduce emissions from this 

process

IV. Comments

 Use this section to explain any of the above responses or to provide 

additional information
FORM E-2

SOLVENT DEPAINTING OPERATIONS

Complete this form for each depainting operation that utilizes solvent 

(liquid) materials to depaint aerospace components. If your facility does 

not have any solvent depainting operations, state that in the Comments 

section.

Operation 1 Operation 2 Operation 3

1. Process Identification No.

2. Location of Depainting Operation

Latitude and longitude must be reported in decimal degrees to six decimal 

places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in 

Washington, D.C. is 38.894907 latitude and -77.028625 longitude at the 

front door. You may use the Satellite function of Google Maps to identify 

latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees to at least six decimal places)

 Longitude (decimal degrees to at least six decimal places)

3. Dimensions of Building in Which Operation is Located

 Length (ft)

 Width (ft)

 Height (ft)

4. Purpose of this Depainting Operation

5. Average Daily Hours of Operation

 Average Days per Year of Operation

II. HAP Emissions and Controls
To avoid double counting, do not report the same HAP emissions under 

different CAS numbers or as different compounds. For example, do not 

report both "total chromium" and "hexavalent chromium" for a single 

chromium compound contained in a coating. The correct reporting 

method, particularly for chromium compounds, glycol ethers, and 

polycyclic organic matter, is to report the specific compound (e.g., 

strontium chromate, ethylene glycol dibutyl ether) rather than the general 

class of HAP (e.g., chromium compounds, glycol ethers).

1. HAP Emissions

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

2. Control Device Identification No. (must correspond to ID No. of one of 

the control devices for which a Form J was completed)

3. Type of Control Device

4. Capture Efficiency

5. How was capture efficiency determined?

 Testing (specify method)

 Manufacturer's Specifications

 Engineering Estimate
III. Work Practices

 Describe any work practices that you use to reduce emissions from this 

process

IV. Comments

 Use this section to explain any of the above responses or to provide 

additional information
FORM E-3

SOLVENT CLEANING OPERATIONS - POINT SOURCES AND FUGITIVE 

SOURCES

Complete this form for each cleaning operation that utilizes solvent (liquid) 

materials to clean aerospace components. If your facility does not have 

any solvent cleaning operations, state that in the Comments section. Do 

not report solvent cleaning operations that are subject to the Halogenated 

Solvent Cleaning NESHAP (40 CFR part 63, subpart T) on this form. Use 

Form E-4 to report halogenated solvent cleaning covered under subpart T. 

Please see the instructions for further information before completing 

Forms E-3 and E-4.

PART A - POINT SOURCES. Complete this section for each cleaning 

operation that occurs within an enclosure that is vented through a stack 

outside of the building

I. General Information

Operation 1 Operation 2 Operation 3

1. Process Identification No.

2. Exhaust Stack Location

Latitude and longitude must be reported in decimal degrees to six decimal 

places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in 

Washington, D.C. is 38.894907 latitude and -77.028625 longitude at the 

front door. You may use the Satellite function of Google Maps to identify 

latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees to at least six decimal places)

 Longitude (decimal degrees to at least six decimal places)

3. Exhaust Stack Diameter (ft)

4. Exhaust Stack Height (ft)

5. Exhaust Stream Temperature (°F)

6. Exhaust Stream Flow Rate (acfm)
7. Dimensions of Building in Which Operation is Located

 Length (ft)

 Width (ft)

 Height (ft)

8. Purpose of this Cleaning Operation

9. Average Daily Hours of Operation

 Average Days per Year of Operation

II. HAP Emissions and Controls

To avoid double counting, do not report the same HAP emissions under 

different CAS numbers or as different compounds. For example, do not 

report both "total chromium" and "hexavalent chromium" for a single 

chromium compound contained in a coating. The correct reporting 

method, particularly for chromium compounds, glycol ethers, and 

polycyclic organic matter, is to report the specific compound (e.g., 

strontium chromate, ethylene glycol dibutyl ether) rather than the general 

class of HAP (e.g., chromium compounds, glycol ethers).

1. HAP Emissions

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)
 HAP Name

 CAS No.

 Emissions (lb/yr)

2. Control Device Identification No. (must correspond to ID No. of one of 

the control devices for which a Form J was completed)

3. Type of Control Device

4. Capture Efficiency

5. How was capture efficiency determined?

 Testing (specify method)

 Manufacturer's Specifications

 Engineering Estimate

III. Work Practices

 Describe any work practices that you use to reduce emissions from this 

process

IV. Comments

 Use this section to explain any of the above responses or to provide 

additional information

B. FUGITIVE SOURCES - Complete this section for cleaning operations that 

are not vented outside of the building. Combine all fugitive solvent 

cleaning operations in a building in a single entry.

I. General Information

1. Building Identification

2. Building Location (center of building)
Latitude and longitude must be reported in decimal degrees to six decimal 

places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in 

Washington, D.C. is 38.894907 latitude and -77.028625 longitude at the 

front door. You may use the Satellite function of Google Maps to identify 

latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees to at least six decimal places)

 Longitude (decimal degrees to at least six decimal places)

3. Dimensions of Building

 Length (ft)

 Width (ft)

 Height (ft)

4. Purpose of this Cleaning Operation

5. Average Daily Hours of Operation

 Average Days per Year of Operation

II. HAP Emissions

To avoid double counting, do not report the same HAP emissions under 

different CAS numbers or as different compounds. For example, do not 

report both "total chromium" and "hexavalent chromium" for a single 

chromium compound contained in a coating. The correct reporting 

method, particularly for chromium compounds, glycol ethers, and 

polycyclic organic matter, is to report the specific compound (e.g., 

strontium chromate, ethylene glycol dibutyl ether) rather than the general 

class of HAP (e.g., chromium compounds, glycol ethers).

1. HAP Emissions

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name
 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

 HAP Name

 CAS No.

 Emissions (lb/yr)

III. Work Practices

 Describe any work practices that you use to reduce emissions from this 

process

IV. Comments

 Use this section to explain any of the above responses or to provide 

additional information
FORM E-4

SOLVENT CLEANING OPERATIONS

Complete this form for each cleaning operation that is subject to the 

Halogenated Sovent Cleaning NESHAP (40 CFR part 63, subpart T) and NOT 

subject to the aerospace manufacturing and rework operations NESHAP. If 

your facility does not have any cleaning operations subject to subpart T, 

state that in the Comments section. Do not report solvent cleaning 

operations that are subject to the Aerospace Manufactuing and Rework 

Operations NESHAP on this form. Use Form E-3 to report solvent cleaning 

covered under the aeropsace NESHAP. Please see the instructions for 

further information before completing Forms E-3 and E-4.

Operation 1 Operation 2 Operation 3

1. Process Identification No.

2. Location of Cleaning Operation

Latitude and longitude must be reported in decimal degrees to six decimal 

places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in 

Washington, D.C. is 38.894907 latitude and -77.028625 longitude at the 

front door. You may use the Satellite function of Google Maps to identify 

latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees to at least six decimal places)

 Longitude (decimal degrees to at least six decimal places)

3. Dimensions of Building in Which Operation is Located

 Length (ft)

 Width (ft)

 Height (ft)

4. Purpose of this Cleaning Operation

5. Average Daily Hours of Operation

 Average Days per Year of Operation

II. HAP Emissions and Controls

1. HAP Emissions
 Methylene Chloride

 CAS No. 75-09-02

 Emissions (lb/yr)

 Perchloroethylene

 CAS No. 127-18-4

 Emissions (lb/yr)

 Trichloroethylene

 CAS No. 79-01-6

 Emissions (lb/yr)

 1,1,1-Trichloroethane

 CAS No. 71-55-6

 Emissions (lb/yr)

 Carbon Tetrachloride

 CAS No. 56-23-5

 Emissions (lb/yr)

 Chloroform

 CAS No. 67-66-3

 Emissions (lb/yr)

2. Control Device Identification No. (must correspond to ID No. of one of 

the control devices for which a Form J was completed)

3. Type of Control Device

4. Capture Efficiency

5. How was capture efficiency determined?

 Testing (specify method)

 Manufacturer's Specifications

 Engineering Estimate

III. Work Practices

 Describe any work practices that you use to reduce emissions from this 

process

IV. Comments
 Use this section to explain any of the above responses or to provide 

additional information
FORM F-1

Composite Processing Operations

Use Form F-1 for entering resin information in English units (pounds, 

gallons, etc.). Use Form F-2 for enterning resin information in metric 

units (kilograms, liters, etc.). DO NOT complete both Form F-1 and 

Form F-2. 

This form has space for entering data for 10 resins. If you are providing 

information on more than 10 resins, please add additional columns. If 

your facility does not have any composite processing operations, state 

that in the Comments section.

Resin 1 Resin 2 Resin 3

I. Resin Information

1. Identification No.

2. Manufacturer

3. Product Name

II. Resin Usage and Physical Properties

1. Total Volume Used for the Reporting Year (gals)

2. As-Applied Resin Physical Properties

 Resin Density (lb coating/gal coating)

 Total Organic HAP Mass Fraction (lb HAP/lb coating)

 Total Inorganic HAP Mass Fraction (lb HAP/lb coating)

 Solids Mass Fraction (lb solids/lb coating)

 Solids Volume Fraction (gal solids/gal coating)

3. Speciated HAP (Organic and Inorganic) Content

To avoid double counting, do not report the same HAP emissions under 

different CAS numbers or as different compounds. For example, do not 

report both "total chromium" and "hexavalent chromium" for a single 

chromium compound contained in a coating. The correct reporting 

method, particularly for chromium compounds, glycol ethers, and 

polycyclic organic matter, is to report the specific compound (e.g., 

strontium chromate, ethylene glycol dibutyl ether) rather than the 

general class of HAP (e.g., chromium compounds, glycol ethers).
 HAP Name

 CAS No.

 HAP Mass Fraction (lb HAP/lb coating)

 HAP Name

 CAS No.

 HAP Mass Fraction (lb HAP/lb coating)

 HAP Name

 CAS No.

 HAP Mass Fraction (lb HAP/lb coating)

 HAP Name

 CAS No.

 HAP Mass Fraction (lb HAP/lb coating)

 HAP Name

 CAS No.

 HAP Mass Fraction (lb HAP/lb coating)

4. Estimated Percent of Organic HAP Emitted

III. Resin Usage by Spray Booth

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Application of Coating Outside of a Spray Booth - Application Method

 Portion of Annual Coating Usage Applied Outside of a Booth (percent)

IV. Control Device for Organic Emissions
1. Identification No. (must correspond to ID No. of one of the control 

devices for which a J Form was completed)

2. Type of Control Device

3. Capture Efficiency

4. How was capture efficiency determined?

 Testing (specify method)

 Manufacturer's Specifications

 Engineering Estimate

V. Comments

 Use this section to explain any of the above responses or to provide 

additional information
Resin 4 Resin 5 Resin 6 Resin 7 Resin 8


Resin 9 Resin 10


FORM F-2

Composite Processing Operations

Use Form F-1 for entering resin information in English units (pounds, 

gallons, etc.). Use Form F-2 for enterning resin information in metric 

units (kilograms, liters, etc.). DO NOT complete both Form F-1 and 

Form F-2. This form has space for entering data for 10 resins. If you 

are providing information on more than 10 resins, please add 

additional columns.

This form has space for entering data for 10 resins. If you are providing 

information on more than 10 resins, please add additional columns. If 

your facility does not have any composite processing operations, state 

that in the Comments section.

Resin 1 Resin 2 Resin 3

I. Resin Information

1. Identification No.

2. Manufacturer

3. Product Name

II. Resin Usage and Physical Properties

1. Total Volume Used for the Reporting Year (liters)

2. As-Applied Resin Physical Properties

 Resin Density (kg coating/L coating)

 Total Organic HAP Mass Fraction (kg HAP/kg coating)

 Total Inorganic HAP Mass Fraction (kg HAP/kg coating)

 Solids Mass Fraction (kg solids/kg coating)

 Solids Volume Fraction (L solids/L coating)

3. Speciated HAP (Organic and Inorganic) Content
To avoid double counting, do not report the same HAP emissions under 

different CAS numbers or as different compounds. For example, do not 

report both "total chromium" and "hexavalent chromium" for a single 

chromium compound contained in a coating. The correct reporting 

method, particularly for chromium compounds, glycol ethers, and 

polycyclic organic matter, is to report the specific compound (e.g., 

strontium chromate, ethylene glycol dibutyl ether) rather than the 

general class of HAP (e.g., chromium compounds, glycol ethers).

 HAP Name

 HAP Mass Fraction (kg HAP/kg coating)

 HAP Name

 HAP Mass Fraction (kg HAP/kg coating)

 HAP Name

 HAP Mass Fraction (kg HAP/kg coating)

 HAP Name

 HAP Mass Fraction (kg HAP/kg coating)

 HAP Name

 HAP Mass Fraction (kg HAP/kg coating)

4. Estimated Percent of Organic HAP Emitted

III. Resin Usage by Spray Booth

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Spray Booth Identification No. (from Form B-1)

 Portion of Annual Coating Usage in this Booth (percent)

 Application of Coating Outside of a Spray Booth - Application Method
 Portion of Annual Coating Usage Applied Outside of a Booth (percent)

IV. Control Device for Organic Emissions

1. Identification No. (must correspond to ID No. of one of the control 

devices for which a Form J was completed)

2. Type of Control Device

3. Capture Efficiency

4. How was capture efficiency determined?

 Testing (specify method)

 Manufacturer's Specifications

 Engineering Estimate

V. Comments

 Use this section to explain any of the above responses or to provide 

additional information
Resin 4 Resin 5 Resin 6 Resin 7 Resin 8


Resin 9 Resin 10


FORM G-1

STORAGE TANKS

Use this form for each stationary storage tank that contains HAP. Do not 

report tanks that contain fuel for engines, boilers, or other comnustion 

device. If your facility does not have any storage tanks that contain HAP, 

state that in the Comments section.

Tank 1 Tank 2 Tank 3

I. Storage Tank Description and Location

1. Identification No.

2. Tank Type

3. Tank Location

Latitude and longitude must be reported in decimal degrees to six decimal 

places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in 

Washington, D.C. is 38.894907 latitude and -77.028625 longitude at the 

front door. You may use the Satellite function of Google Maps to identify 

latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees to at least six decimal places)

 Longitude (decimal degrees to at least six decimal places)

4. Dimensions of Tank

 Diameter (ft)

 Height (ft)

5. Liquid Stored in Tank

6. Dimensions of Building in Which Tank is Located

 Length (ft)

 Width (ft)

 Height (ft)

II. Throughput and Emissions

Emissions may be calculated using EPA's TANKS Emissions Estimation 

Software. If you use TANKS, you must provide all input values and model 

outputs.
1. Annual Throughput (gals)

2. HAP Emissions

To avoid double counting, do not report the same HAP emissions under 

different CAS numbers or as different compounds. For example, do not 

report both "total chromium" and "hexavalent chromium" for a single 

chromium compound contained in a coating. The correct reporting method, 

particularly for chromium compounds, glycol ethers, and polycyclic organic 

matter, is to report the specific compound (e.g., strontium chromate, 

ethylene glycol dibutyl ether) rather than the general class of HAP (e.g., 

chromium compounds, glycol ethers).

 HAP Component in Liquid Stored

 Mass Fraction of HAP Component in Liquid (lb HAP/lb liquid)

 Emissions (lb/yr)

 Emission Estimation Method

 HAP Component in Liquid Stored

 Mass Fraction of HAP Component in Liquid (lb HAP/lb liquid)

 Emissions (lb/yr)

 Emission Estimation Method

 HAP Component in Liquid Stored

 Mass Fraction of HAP Component in Liquid (lb HAP/lb liquid)

 Emissions (lb/yr)

 Emission Estimation Method

 HAP Component in Liquid Stored

 Mass Fraction of HAP Component in Liquid (lb HAP/lb liquid)

 Emissions (lb/yr)

 Emission Estimation Method

 HAP Component in Liquid Stored

 Mass Fraction of HAP Component in Liquid (lb HAP/lb liquid)

 Emissions (lb/yr)

 Emission Estimation Method

3. Control Device Identification No. (must correspond to ID No. of one of 

the control devices for which a Form J was completed)
4. Type of Control Device

5. Capture Efficiency

6. How was capture efficiency determined?

 Testing (specify method)

 Manufacturer's Specifications

 Engineering Estimate

III. Work Practices

 Describe any work practices that you use to reduce emissions from this 

tank

IV. Comments

 Use this section to explain any of the above responses or to provide 

additional information
Tank 4 Tank 5 Tank 6 Tank 7 Tank 8


Tank 9 Tank 10


FORM H-1

WASTEWATER TREATMENT OPERATIONS

Use this form to report wastewater treatment operations that treat or use 

HAP-containing materials. If your facility does not have any wastewater 

treatment operations that treat or use HAP-contianing materials, then state 

that in the Comments section.

Tank/Process 1 Tank/Process 2 Tank/Process 3

I. Processing Tank/Operation Description and Location

1. Tank/Operation Identification No.

2. Location of Tank/Operation

Latitude and longitude must be reported in decimal degrees to six decimal 

places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in 

Washington, D.C. is 38.894907 latitude and -77.028625 longitude at the 

front door. You may use the Satellite function of Google Maps to identify 

latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees to at least six decimal places)

 Longitude (decimal degrees to at least six decimal places)

3. Dimensions of Building in Which Tank/Operation is Located

 Length (ft)

 Width (ft)

 Height (ft)

4. Purpose of this Tank/Operation

5. Average Daily Hours of Operation

 Average Days per Year of Operation

II. HAP Emissions and Controls
To avoid double counting, do not report the same HAP emissions under 

different CAS numbers or as different compounds. For example, do not 

report both "total chromium" and "hexavalent chromium" for a single 

chromium compound contained in a coating. The correct reporting method, 

particularly for chromium compounds, glycol ethers, and polycyclic organic 

matter, is to report the specific compound (e.g., strontium chromate, 

ethylene glycol dibutyl ether) rather than the general class of HAP (e.g., 

chromium compounds, glycol ethers).

1. HAP Emissions

 HAP Name

 CAS No.

 Emissions (lb/yr)

 Fugitive or Stack Emissions

 HAP Name

 CAS No.

 Emissions (lb/yr)

 Fugitive or Stack Emissions

 HAP Name

 CAS No.

 Emissions (lb/yr)

 Fugitive or Stack Emissions

 HAP Name

 CAS No.

 Emissions (lb/yr)

 Fugitive or Stack Emissions

 HAP Name

 CAS No.

 Emissions (lb/yr)

 Fugitive or Stack Emissions

2. Control Device Identification No. (must correspond to ID No. of one of 

the control devices for which a Form J was completed)

3. Type of Control Device

4. Capture Efficiency
5. How was capture efficiency determined?

 Testing (specify method)

 Manufacturer's Specifications

 Engineering Estimate

III. Work Practices

 Describe any work practices that you use to reduce emissions from this 

tank/operation

IV. Comments

 Use this section to explain any of the above responses or to provide 

additional information
Tank/Process 4 Tank/Process 5 Tank/Process 6 Tank/Process 7 Tank/Process 8


Tank/Process 9 Tank/Process 10


FORM I-1

STARTUPS AND SHUTDOWNS

 A. A description of each event, including identification of the 

emissions source or sources associated with the event.

 B. What standard was exceeded;

 C. The duration of each event;

 D. The actions taken to minimize emissions during the event, 

including the use of any backup control systems;

 E. Estimates or measurements, if any, of emissions during the 

event. If you did not have the ability to quantify emissions during the 

event, please explain why.

2. Are there any types of startup or shutdown events that you have 

been able to eliminate; if so, how? Use additional space if 

necessary.

3. Please submit a copy of any plan you have been required to 

develop to address startup and shutdown events.

4. Please provide all performance test data collected during periods 

of startup and shutdown over the last 3 years. Indicate the test 

method used for each event.

5. Please provide all monitoring data, including control system 

parameter monitoring, collected during periods of startup or 

shutdown over the last 3 years.

Startup: the setting in operation of an affected source or portion of an affected source for any purpose.

Shutdown: the cessation of operation of an affected source or portion of an affected source for any purpose.

1. For each startup and shutdown event during the reporting year that resulted in excess HAP emissions AND that caused a NESHAP emission 

limit to be exceeded or caused a deviation of any requirement of the NESHAP, please provide the following information requested in A. through F. 

Using the definitions provided below, indicate whether the event was a startup or shutdown. 
6. Optional: Do you wish to recommend a standard that would apply

during startup or shutdown? If so, please describe the event to 

which the standard would apply; the recommended standard (this 

could be an emission limitation, work practice, or operational 

standard) that would apply during the period; the basis for the 

recommended standard; why and how the standard would minimize 

emissions during the event; and how would compliance be 

determined and/or monitored. Use additional space if necessary.
FORM J-1

AIR POLLUTION CONTROL

I. Electrostatic Precipitator (ESP)

 For each ESP: ESP 1 ESP 2 ESP 3

 Process line(s) (identification name/number)

 Equipment/process(es) controlled. Include identification number listed 

on Forms B - F.

Latitude and longitude must be reported in decimal degrees to six decimal 

places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in 

Washington, D.C. is 38.894907 latitude and -77.028625 longitude at the 

front door. You may use the Satellite function of Google Maps to identify 

latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees, six decimal places)

 Longitude (decimal degrees, six decimal places)

 Stack or vent height (units)

 Stack or vent diameter (units)

 Manufacturer and model

 Date of original installation

 Number of collection plates and configuration

 Gas flow rate to ESP (acfm @ °F)

 Inlet gas temperature (°F)

 Outlet gas temperature (°F)

 Inlet grain loading (gr/dscf)

 Outlet grain loading (gr/dscf)

 Average stack opacity (%)

 Pressure drop across ESP (in. H

2O gauge)

 Plate area (ft

2

)

 Vendor guarantee on ESP efficiency (attach copy)

 Method of plate cleaning and frequency

 Flow rate of plate wash water to ESP (gpm), if applicable

 Temperature of plate wash water to ESP (°F), if applicable

 Source of plate wash water used for cleaning, if applicable

 Concentration (mg/l) of dissolved and suspended solids in plate wash 

water, if applicable

 Conditioning agents used and amounts (in gpm or lbs/hr), if applicable

 Amount of wastewater generated (gpd), if applicable

 Amount of wastewater recycled (gpd), if applicable

 Amount of wastewater disposed of (gpd), if applicable
 Method of wastewater disposal, if applicable

 Quantity of solid waste collected (lbs/yr)

 Quantity of solid waste recycled (lbs/yr)

 Quantity of solid waste disposed of (lbs/yr)

 Method of solid waste disposal

 Nature and frequency of routine/preventive maintenance procedures

 Problems experienced with control device within the last five years; how 

were problems solved? For example, periods when the process was shut 

down or excess emissions resulted because of control device problems.

 List all monitoring methods used, including parameters and frequency

 Describe any plans to replace or upgrade ESP
FORM J-2

AIR POLLUTION CONTROL

II. Scrubber

 For each scrubber: Scrubber 1 Scrubber 2 Scrubber 3

 Process line(s) (identification name/number)

 Equipment/process(es) controlled. Include identification number 

listed on Forms B - F.

Latitude and longitude must be reported in decimal degrees to six 

decimal places. For example, EPA Headquarters at 1200 

Pennsylvania Ave, NW in Washington, D.C. is 38.894907 latitude and -

77.028625 longitude at the front door. You may use the Satellite 

function of Google Maps to identify latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees, six decimal places)

 Longitude (decimal degrees, six decimal places)

 Stack or vent height (units)

 Stack or vent diameter (units)

 Manufacturer and model

 Date of original installation

 Type (e.g., venturi, orifice)

 Gas flow rate to scrubber (acfm @ °F)

 Inlet gas temperature (°F)

 Outlet gas temperature (°F)

 Inlet grain loading (gr/dscf)

 Outlet grain loading (gr/dscf)

 Average stack opacity (%)

 Water flow rate to scrubber (gpm)

 Percent of scrubber water from recycled wastewater

 Source of scrubbing water and type of pretreatment. Substance(s) 

added as part of pretreatment and amount used (gpm or lbs/hr)

 HAP composition of wastewater (mg/L)

 Concentration (mg/L) of dissolved and suspended solids in 

scrubbing water
 Scrubbing water temperature (°F)

 Liquid/gas ratio (gal/103 acfm)

 Pressure drop across scrubber (in. H2O gauge)

 Amount of wastewater generated (gpd)

 Amount of wastewater recycled (gpd)

 Amount of wastewater disposed of (gpd)

 Method of wastewater disposal

 Quantity of solid waste collected (lbs/yr)

 Quantity of solid waste recycled (lbs/yr)

 Quantity of solid waste disposed of (lbs/yr)

 Method of solid waste disposal

 Vendor guarantee on scrubber efficiency (attach copy)

 Nature and frequency of preventive maintenance procedures

 Problems experienced with control device within the last five years; 

how were problems solved? For example, periods when the process 

was shut down or excess emissions resulted because of control 

device problems.

 List all monitoring methods used, including parameters and 

frequency

 Plans to replace or upgrade scrubber
FORM J-3

AIR POLLUTION CONTROL

III. Mechanical Collector (Cyclone)

 For each mechanical collector: Mechanical Collector 1 Mechanical Collector 2 Mechanical Collector 3

 Process line(s) (identification name/number)

 Equipment/process(es) controlled. Include identification number 

listed on Forms B - F.

Latitude and longitude must be reported in decimal degrees to six 

decimal places. For example, EPA Headquarters at 1200 

Pennsylvania Ave, NW in Washington, D.C. is 38.894907 latitude 

and -77.028625 longitude at the front door. You may use the 

Satellite function of Google Maps to identify latitude/longitude 

information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees, six decimal places)

 Longitude (decimal degrees, six decimal places)

 Stack or vent height (units)

 Stack or vent diameter (units)

 Manufacturer and model

 Date of original installation

 Type of mechanical collector 

 Gas flow rate to collector (acfm @ °F)

 Inlet gas temperature (°F)

 Outlet gas temperature (°F)

 Inlet grain loading (gr/dscf)

 Outlet grain loading (gr/dscf)

 Average stack opacity (%)

 Overall pressure drop (in. H2O gauge)

 Vendor guarantee on mechanical collector efficiency (attach 

copy)

 Quantity of solid waste collected (lbs/yr)

 Quantity of solid waste recycled (lbs/yr)

 Quantity of solid waste disposed of (lbs/yr)

 Method of solid waste disposal
 Nature and frequency of preventive maintenance procedures

 Problems experienced with control device within the last five 

years; how were problems solved? For example, periods when the 

process was shut down or excess emissions resulted because of 

control device problems.

 List all monitoring methods used, including parameters and 

frequency

 Plans to replace or upgrade mechanical collector

 Comments
FORM J-4

AIR POLLUTION CONTROL

IV. Fabric/Cartridge Filter 

NOTE: Do not complete this form for particulate filters on 

paint spray booths. Spray booth filters should be reported on 

Form B-1, Section II, Particulate Filters.

 For each fabric/cartridge filter (some of these questions apply 

only to fabric filters and not to cartridge filters; complete as 

appropriate for your situation): Fabric Filter 1 Fabric Filter 2 Fabric Filter 3

 Process line(s) (identification name/number)

 Equipment/process(es) controlled. Include identification 

number listed on Forms B - F.

Latitude and longitude must be reported in decimal degrees to six 

decimal places. For example, EPA Headquarters at 1200 

Pennsylvania Ave, NW in Washington, D.C. is 38.894907 latitude 

and -77.028625 longitude at the front door. You may use the 

Satellite function of Google Maps to identify latitude/longitude 

information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees, six decimal places)

 Longitude (decimal degrees, six decimal places)

 Stack or vent height (units)

 Stack or vent diameter (units)

 Manufacturer and model

 Date of original installation

 Number of compartments

 Number of bags/cartridges per compartment

 Filter material and coatings applied (if any)

 Fabric weight (oz/yd

2

)

 Filter surface area (ft2)

 Gas flow rate to filter (acfm @ °F)

 Inlet gas temperature (°F)

 Outlet gas temperature (°F)
 Inlet grain loading (gr/dscf)

 Outlet grain loading (gr/dscf)

 Average stack opacity (%)

 Overall pressure drop (in. H2O gauge)

 Method of bag cleaning

 Frequency of bag cleaning

 Vendor guarantee on fabric filter/cartridge efficiency (attach 

copy)

 Quantity of solid waste collected (lbs/yr)

 Quantity of solid waste recycled (lbs/yr)

 Quantity of solid waste disposed of (lbs/yr)

 Method of solid waste disposal

 Nature and frequency of preventive maintenance procedures

 Problems experienced with control device within the last five 

years; how were problems solved? For example, periods when the 

process was shut down or excess emissions resulted because of 

control device problems.

 List all monitoring methods used, including parameters and 

frequency

 Plans to replace or upgrade fabric filter

 Comments
FORM J-5

AIR POLLUTION CONTROL

V. Thermal Incinerator

 For each thermal incinerator Thermal Incinerator 1 Thermal Incinerator 2 Thermal Incinerator 3

 Process line(s) (identification name/number)

 Equipment/process(es) controlled. Include identification 

number listed on Forms B - F.

 Incinerator type

Latitude and longitude must be reported in decimal degrees to six 

decimal places. For example, EPA Headquarters at 1200 

Pennsylvania Ave, NW in Washington, D.C. is 38.894907 latitude 

and -77.028625 longitude at the front door. You may use the 

Satellite function of Google Maps to identify latitude/longitude 

information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees, six decimal places)

 Longitude (decimal degrees, six decimal places)

 Stack or vent height (units)

 Stack or vent diameter (units)

 Manufacturer and model

 Date of original installation

 Fuel type: gas or oil

 Fuel consumption rate (BTU/hr)

 Inlet gas flow rate (acfm @ °F)

 Inlet gas temperature (°F)

 Chemical composition of combustibles in inlet gas

 Combustion chamber gas temperature (°F)

 Outlet gas temperature (°F)

 Inlet grain loading (gr/dscf)

 Outlet grain loading (gr/dscf)

 Average stack opacity (%)

 Excess air (%)

 Residence time (sec) at temperature (°F)

 Percent heat recovery

 Vendor guarantee on incinerator efficiency (attach copy)

 Nature and frequency of preventive maintenance procedures
 Problems experienced with control device within the last five 

years; how were problems solved? For example, periods when the 

process was shut down or excess emissions resulted because of 

control device problems.

 List all monitoring methods used, including parameters and 

frequency

 Plans to replace or upgrade thermal incinerator
FORM J-6

AIR POLLUTION CONTROL

VI. Condenser

 For each condenser: Condenser 1 Condenser 2 Condenser 3

 Process line(s) (identification name/number)

 Equipment/process(es) controlled. Include identification number 

listed on Forms B - F.

Latitude and longitude must be reported in decimal degrees to six 

decimal places. For example, EPA Headquarters at 1200 

Pennsylvania Ave, NW in Washington, D.C. is 38.894907 latitude 

and -77.028625 longitude at the front door. You may use the 

Satellite function of Google Maps to identify latitude/longitude 

information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees, six decimal places)

 Longitude (decimal degrees, six decimal places)

 Stack or vent height (units)

 Stack or vent diameter (units)

 Manufacturer and model

 Date of original installation

 Gas flow rate to condenser (acfm @ °F)

 Inlet gas temperature (°F)

Organic compounds in inlet gas stream

 Name of organic compound

 Volume fraction

 Name of organic compond

 Volume fraction

 Name of organic compound

 Volume fraction

 Name of organic compound

 Volume fraction

 Name of organic compound

 Volume fraction

 Vendor guarantee on condenser efficiency (attach copy)

 Nature and frequency of preventive maintenance procedures
 Problems experienced with control device within the last five 

years; how were problems solved? For example, periods when the 

process was shut down or excess emissions resulted because of 

control device problems.

 List all monitoring methods used, including parameters and 

frequency

 Plans to replace or upgrade condenser
FORM J-7

AIR POLLUTION CONTROL

VII. Carbon Adsorber

 For each carbon adsorber: Carbon Adsorber 1 Carbon Adsorber 2 Carbon Adsorber 3

 Process line(s) (identification name/number)

 Equipment/process(es) controlled. Include identification number 

listed on Forms B - F.

Latitude and longitude must be reported in decimal degrees to six 

decimal places. For example, EPA Headquarters at 1200 

Pennsylvania Ave, NW in Washington, D.C. is 38.894907 latitude 

and -77.028625 longitude at the front door. You may use the 

Satellite function of Google Maps to identify latitude/longitude 

information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees, six decimal places)

 Longitude (decimal degrees, six decimal places)

 Stack or vent height (units)

 Stack or vent diameter (units)

 Manufacturer and model

 Date of original installation

 Gas flow rate to condenser (acfm @ °F)

 Inlet gas temperature (°F)

Organic compounds in inlet gas stream

 Name of organic compound

 Volume fraction

 Name of organic compond

 Volume fraction

 Name of organic compound

 Volume fraction

 Name of organic compound

 Volume fraction

 Name of organic compound

 Volume fraction

 Number of carbon beds

 Vendor guarantee on adsorber efficiency (attach copy)

 Nature and frequency of preventive maintenance procedures
 Problems experienced with control device within the last five 

years; how were problems solved? For example, periods when the 

process was shut down or excess emissions resulted because of 

control device problems.

 List all monitoring methods used, including parameters and 

frequency

 Plans to replace or upgrade adsorber
FORM J-8

AIR POLLUTION CONTROL

VIII. High Velocity Air Filter (HVAF)

 For each HVAF: HVAF 1 HVAF 2 HVAF 3

 Process line(s) (identification name/number)

 Equipment/process(es) controlled. Include identification number 

listed on Forms B - F.

Latitude and longitude must be reported in decimal degrees to six 

decimal places. For example, EPA Headquarters at 1200 

Pennsylvania Ave, NW in Washington, D.C. is 38.894907 latitude 

and -77.028625 longitude at the front door. You may use the 

Satellite function of Google Maps to identify latitude/longitude 

information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees, six decimal places)

 Longitude (decimal degrees, six decimal places)

 Stack or vent height (units)

 Stack or vent diameter (units)

 Manufacturer and model

 Date of original installation

 Inlet gas flow rate (acfm @ °F)

 Inlet gas temperature (°F)

 Outlet gas temperature (°F)

 Inlet grain loading (gr/dscf)

 Outlet grain loading (gr/dscf)

 Average stack opacity (%)

 Water spray pressure (psig), if applicable

 Water spray rate (gpm), if applicable

 Filter face velocity (acfm/ft2)

 Maximum pressure drop across mat (in. H2O gauge)

 Vendor guarantee on HVAF efficiency (attach copy)

 Method and frequency of filter mad advancement

 Amount of wastewater generated (gpd)

 Amount of wastewater recycled (gpd)
 Amount of wastewater disposed of (gpd)

 Method of wastewater disposal

 Quantity of solid waste collected (lbs/yr)

 Quantity of solid waste recycled (lbs/yr)

 Quantity of solid waste disposed of (lbs/yr)

 Method of solid waste disposal

 Nature and frequency of preventive maintenance procedures

 Problems experienced with control device within the last five 

years; how were problems solved? For example, periods when the 

process was shut down or excess emissions resulted because of 

control device problems.

 List all monitoring methods used, including parameters and 

frequency

 Plans to replace or upgrade HVAF
FORM J-9

AIR POLLUTION CONTROL

IX. Mist Eliminator

 For each mist eliminator: Mist Eliminator 1 Mist Eliminator 2 Mist Eliminator 3

 Process line(s) (identification name/number)

 Equipment/process(es) controlled. Include identification number 

listed on Forms B - F.

Latitude and longitude must be reported in decimal degrees to six 

decimal places. For example, EPA Headquarters at 1200 

Pennsylvania Ave, NW in Washington, D.C. is 38.894907 latitude 

and -77.028625 longitude at the front door. You may use the 

Satellite function of Google Maps to identify latitude/longitude 

information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees, six decimal places)

 Longitude (decimal degrees, six decimal places)

 Stack or vent height (units)

 Stack or vent diameter (units)

 Manufacturer and model

 Date of original installation

 Type of mist eliminator

 Gas flow rate to mist eliminator (acfm @ °F)

 Inlet gas temperature (°F)

 Outlet gas temperature (°F)

 Inlet grain loading (gr/dscf)

 Outlet grain loading (gr/dscf)

 Average stack opacity (%)

 Velocity in mist eliminator (ft/sec)

 Pressure drop (in. H2O gauge)

 For chevron blade mist eliminators:

 Spacing between blades (in.)

 Washing frequency of blades

 For mesh pad mist eliminators:

 Number of pads or elements
 Thickness of pad (in.) or element dimensions

 Density of pad, (lb/ft3)

 Washing frequency of pad

 Vendor guarantee on mist eliminator efficiency (attach copy)

 Amount of wastewater generated (gpd)

 Amount of wastewater recycled (gpd)

 Amount of wastewater disposed of (gpd)

 Method of wastewater disposal

 Quantity of solid waste collected (lbs/yr)

 Quantity of solid waste recycled (lbs/yr)

 Quantity of solid waste disposed of (lbs/yr)

 Method of solid waste disposal

 Nature and frequency of preventive maintenance procedures

 Problems experienced with control device within the last five 

years; how were problems solved? For example, periods when the 

process was shut down or excess emissions resulted because of 

control device problems.

 List all monitoring methods used, including parameters and 

frequency

 Plans to replace or upgrade mist eliminator 
FORM J-10

AIR POLLUTION CONTROL

XI. Other 

 For each other air pollution control devide (APCD): Other APCD 1 Other APCD 2 Other APCD 3

 Process line(s) (identification name/number)

 Equipment/process(es) controlled. Include identification number 

listed on Forms B - F.

Latitude and longitude must be reported in decimal degrees to six 

decimal places. For example, EPA Headquarters at 1200 

Pennsylvania Ave, NW in Washington, D.C. is 38.894907 latitude and 

-77.028625 longitude at the front door. You may use the Satellite 

function of Google Maps to identify latitude/longitude information at 

http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php

 Latitude (decimal degrees, six decimal places)

 Longitude (decimal degrees, six decimal places)

 Stack or vent height (units)

 Stack or vent diameter (units)

 Description

 Vendor guarantee on control efficiency

 List all monitoring methods used, including parameters and 

frequency

 Problems experienced with control device within the last five years; 

how were problems solved? For example, periods when the process 

was shut down or excess emissions resulted because of control 

device problems.
FORM K-1 

COST

Complete this form as completely as possible using readily available 

information for each air pollution control device for which you completed 

Form J.

I. Air Pollution Control Device (APCD)

 For each APCD: APCD 1 APCD 2 APCD 3

 APCD ID

 Process Line ID

II. Capital Costs

 Base year

 APCD equipment purchase cost and what was included

 List the cost for each piece of auxiliary equipment for each APCD not 

included above

 Installation cost

 Land purchase cost

 Total capital cost

 Method of financing APCD

 Retrofit installation

 Field erected or modular

III. Annual Operating Costs

 Base year

 Maintenance materials and replacement parts (specify costs by item)

 Raw materials costs

 Labor

 ($/yr) for each labor class

 (hr/hr) for each labor class

 Utilities (breakdown for each utility)

 Waste treatment and/or disposal

 Savings associated with heat recovery and wastewater and/or solid 

waste returned to process from APCD (or sold to another user)

 Indirect costs

 Other (specify)

 Total annual operating cost
Form A-2 Form B-1

Yes Open Face

No Enclosed, but not a permanent total enclosure

Permanent total enclosure

Other (specify in comments)

Cross draft (side exhaust)

Down draft (floor exhaust)

1-Stage pad/panel

1-Stage bag

2-Stage pad/panel

2-Stage bag

1-Stage pad/panel and 1-stage bag

3-Stage pad/panel

1-Stage pad/panel and 2-stage bag

2-Stage pad/panel and 1-stage bag

Waterwash

Other (specify in comments)

None

Electrostatic precipitator

Scrubber

Mechanical collector

Fabric filter (other than spray booth filters)

Thermal incinerator

Thermal incinerator with concentrator

High velocity air filter

Mist eliminator

Carbon Adsorber

Biofilter

Condenser

Other (specify in comments)

Form C-1

Primer

Topcoat

Chemical milling maskant

Ablative coating

Adhesion promoter

Adhesive bonding primer, cured at 250°F or below

Adhesive bonding primer, cured above 250°F

Commercial interior adhesive

Cyanoacrylate adhesive

Fuel tank adhesive

Nonstructural adhesive

Rocket motor bonding adhesive

Rubber-based adhesive

Structural autoclavable adhesive

Structural nonautoclavable adhesive

Antichafe coating

Bearing coating

Caulking and smoothing compound

Chemical agent resistent coating

Clear coating

Commercial exterior aerodynamic structure primer

Compatible substrate primer

Corrosion prevention compound

Cryogenic flexible primer

Cryoprotective coating

Dry lubricative material

Electric or radiation-effect coating

Electrostatic discharge or electromagnetic interference coating

Elevated temperature Skydol-resistent commercial primer

Epoxy polyamide topcoat

Fire-resistant interior coating

Flexible primer

Missile or single use aircraft flight test coating

Flight test coating (all others)

Fuel tank coating

High temperature coating

Insulation covering

Intermediate release coating

Lacquer

Bonding maskant

Critical use and line sealer maskant

Seal coat maskant

Metallized epoxy coating

Mold release
Optical anti-reflective coating

Part marking coating

Pretreatment coating

Rain erosion-resistant coating

Rocket motor nozzle coating

Scale inhibitor

Screen print ink

Extrudable/rollable/brushable sealant

Sprayable sealant

Silicone insulation material

Solid film lubricant

Specialized function coating

Temporary protective coating

Thermal control coating

Wet fastener installation coating

Wing coating

Ablative coating

Other (specify in comments)

Spray applied

Other than spray applied
Form G-1 Form H-1

EPA TANKS Fugitive

Other (specify in comments) Stack

Form J-5

Direct Flame

Recupertive

Regenerative

Catalytic - Monolithic Fixed Bed

Catalytic - Packed Fixed Bed

Catalytic - Fluidized Bed