CALIFORNIA AIR RESOURCES BOARD 

### SIP COMPLETENESS CHECKLIST (Electronic Format) *** TO BE COMPLETED BY DISTRICT AND RETURNED TO ARB *** All rules submitted to the EPA as State Implementation Plan (SIP) revisions must be supported by certain information an d documentation for the rule packages to be deemed complete for review by the EPA. Rules will not be evaluated for approvability by the EPA unless the submittal packages are complete. To assist you in determining that all necessary materials are included in rules packages sent to the ARB for submittal to the EPA, please fill out the following form and include it with the rule package you send ARB. See the ARB's Guidelines on the Implementation of the 40 CFR 51, Appendix V , for a more detailed explanation than is provided here. Adopted rules and rule amendments should be checked against U.S. EPA's Guidance Document for Correcting Common VOC & Other Rule Deficiencies(Little Blue Book, August 21, 2001) to ensure that they contain no elements which will res ult in disapproval by EPA. District: Great Basin Unified Air Pollution Control District Rule No: 216* (Adopted 10/15/79), 405, 307 & 502

. Note: The District has two rules that are numbered 216. One was adopted on 3/10/76 an d the other on 10/15/79. The July 7, 2005 revision was made to Rule 216 that was adopted on 10/15/79. Rule Title: 216

-New Source Review Requirements for Determining Impact on Air Quality Secondary Sources; 405

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Exceptions; 307

-Conserv ation Management Practices Plan Fees; 502

-Conservation Management Practices Date Adopted or Amended: July 7, 2005 ADMINISTRATIVE MATERIALS Note: All documents should be in electronic format. Items that have signatures, initials, or s tamps may be scanned. Not Attached Attached N/A COMPLETE COPY OF THE RULE: Provide an unmarked copy of the entire rule as adopted or amended by your District Board. UNDERLINE AND STRIKEOUT COPY OF THE RULE : If an amended rule, provide a complete copy of the rule indicating in underline and strikeout format all language which has been added, deleted, or changed since the rule was last adopted or amended. COMPLETE COPY OF THE REFERENCED RULE(S): For any rule which includes language specifically referencing another rule, a copy of that other rule must also be submitted, unless it has already been submitted to EPA as part of a previous SIP submittal. PUBLIC NOTICE EVIDENCE: Include a copy of the local newspaper clipping certification(s), stating the date of publication, which must b e at least 30 days before the hearing. As an alternative, include a copy of the actual published notice of the public hearing as it appeared in the local newspaper(s). In this case, however, enough of the newspaper page must be included to show the date o f publication. The notice must specifically identify by title and number each rule adopted or amended. RESOLUTION/MINUTE ORDER: Provide the Board Clerk certified resolution or minute order. This d ocument must include certification that the hearing was held in accordance with the information in the public notice. It must also list the rules that were adopted or amended, the date of the public hearing, and a statement of compliance with California H ealth and Safety Code Sections 40725

-40728 (Administrative Procedures Act).5/1/2002 PUBLIC COMMENTS AND RESPONSES: Submit copies of written public comments made during the notice period and at the public he aring. Also submit any written responses prepared by the District staff or presented to the District Board at the public hearing. A summary of the public comments and responses is adequate. If there were no comments made during the notice period or at t he hearing, please indicate N/A to the left.CALIFORNIA AIR RESOURCES BOARD 

### SIP COMPLETENESS CHECKLIST (Electronic Format)

TECHNICAL MATERIALS

Not Attached Attached N/A RULE EVALUATION FORM: See instructions for completing the Rule Evaluation Form and the accompanying sample form. NON

- EPA TEST METHODS: Attach all test methods that are referenced in your rule that do not appear in 40 CF R 51, 60, 61, 63, or have not been previously submitted to EPA. EPA methods used in other media such as SW846 for solid waste are not automatically approved for air pollution applications. Submittal of test methods that are not EPA

- approved should includ e the information and follow the procedure described in Region 9’s “Test Method Review & Evaluation Process.” MODELING SUPPORT: Provide if appropriate. In general, modeling support is not required for VOC and NOx rules to determine their impacts on ozone levels. Modeling is required where a rule is a relaxation that affects large sources ( > 100 TPY) in an attainment area for SO2, directly emitted PM10, CO, or NOx (for NO2 purposes). In cases where EPA is concerned with the impact on air quality of rule revisions which relax limits or cause a shift in emission patterns in a nonattainment area, a reference back to the approved SIP will be sufficient provided the approved SIP accounts for the relaxati on and provided the approved SIP used the current EPA modeling guidelines. If current EPA modeling guidelines were not used, then new modeling may be required. ECONOMIC AND TECHNICAL JUSTIFICATION F OR DEVIATIONS FROM EPA POLICIES : The District staff report or other information included with the submittal should discuss all potential relaxations or deviations from RACT, RACM, BACT, BACM, enforceability, attainment, RFP, or other relevant EPA requirem ents. This includes, for example, demonstrating that exemptions or emission limits less stringent than the presumptive RACT (e.g., a CTG) meet EPA’s 5 percent policy, and demonstrating that all source categories exempted from a RACM/BACM rule are de minim us according to EPA’s RACM/BACM policy. ADDITIONAL MATERIALS : Provide District staff reports and any other supporting information concerning development of the rule or rule changes. This informatio n should explain the basis for all limits and thresholds contained in the rule.