ENCLOSURE 1

FORM A - GENERAL INFORMATION

Parent Company Information

Parent Company

Street Address- Line 1

Street Address- Line 2

City

State

Zip code

Mailing Address (if different)- Line 1

Mailing Address (if different)- Line 2

City

State

Zip code

Number of Employees in Parent Company 

(circle one)

Dun and Bradstreet number

Facility Information

Please Number the Facilities  Facility ________ Facility ________ Facility _________

Facility ID

Facility Name

Address 1

Address 2

City

County

State

Zip code

Mailing Address (if different)- Line 1

Mailing Address (if different)- Line 2

City

State

Zip code

Number of employees at facility (circle one) 0-99 100-249 250-499 >500 0-99 100-249 250-499 >500 0-99 100-249 250-499 >500

What is your size classification for HAP 

emissions? (circle one)

Major Source Area Source (True) 

Not Sure Area Source (Synthetic)

Major Source Area Source (True) 

Not Sure Area Source (Synthetic)

Major Source Area Source (True) 

Not Sure Area Source (Synthetic)

Hours of operation for this facility (hr/yr)

Facility's primary NAICS or SIC code

Total Number of Periodic Kilns at this Facility

Total Number of Tunnel Kilns at this Facility

Contact Person for this ICR

Contact Phone Number ( ) _____________  __________________ ( ) _____________  __________________ ( ) _____________  __________________

Contact Email Address

INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

Please reprint the form to include additional facilities

0-99 100-249 250-499 >500

FORM A - Page 1 of 1
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM B - KILN INFORMATION

Facility ID Kiln ID(s) (a)

Reporting 

year (if 

not 2007) Type of Kiln (b)

If periodic, 

number of 

identical 

kilns on 

this line

Year 

Built

Stack 

Diamete

r (ft)

Major Product Types Fired in this Kiln 

(see instructions for list of products)

Annual 

Operatin

g Hours 

for Kiln

Does this kiln 

have an Air 

Pollution 

Control Device 

(APCD)? Yes 

or No

 Full 

Design 

Capacity 

(tph)

Permitted 

Capacity 

(tph) if 

applicable

Actual 

Capacity 

Utilizatio

n (%)

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

(a) Use the ID from your permit or assign using TK-1, 2, etc. for tunnel and PK-1, 2, etc. for periodic. Use same ID throughout this form.

(b) Enter one of these: Tunnel, Tunnel-low profile roller, Tunnel-inactive, Periodic-shuttle, Periodic-beehive

FACILITY and KILN IDs GENERAL INFORMATION KILN SIZE (c)

FORM B - Page 1 of 3
(c) Kiln size capacities should be in units of tons per hour (tph) of fired product

FORM B - Page 1 of 3
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM B - KILN INFORMATION (Continued)

Facility ID Kiln ID(s) Primary Fuel (d) Secondary Fuel (d)

Percent Use of 

Secondary Fuel 

(% of operating 

time) Back-up Fuel (d) Reason(s) back-up would be used (e.g., NG curtailment)

Total time back-up 

fuel was used 

during year (hr)

(d) Fuel Types: (Select one of the following) Natural Gas, Sawdust, Coal, Fuel Oil, Landfill / Biogas, Propane, Other, None

FACILITY and KILN IDs FUEL USAGE

FORM B - Page 2 of 3
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM B - KILN INFORMATION (Continued)

ADDITIONAL INFORMATION ON PERIODIC KILNS

Facility ID Kiln ID(s)

Do you vent 

this kiln to a 

sawdust 

dryer? 

Yes or No

Sawdust Dryer ID 

(Assign)

Total Number 

of kilns vented 

to this Dryer

Average percent 

of operating time 

this kiln vents to 

dryer

Average percent 

of flow sent to 

dryer

Kiln batch 

capacity 

(tons)

Average 

batch cycle 

time (hr)

Average 

number of batch 

cycles per year

Average time required 

to load unfired shapes 

into kiln (hr)

Average time required 

to unload fired shapes 

from kiln (hr)

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

FACILITY and KILN IDs FOR SAWDUST FIRED KILNS ONLY

FORM B - Page 3 of 3
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM C - APCD INFORMATION

Facility ID Kiln ID(s) (a) Control ID (b) Type (c) Reason Control was Installed (d)

Number of kilns 

vented to this 

control device

Year 

control 

device was 

installed

(a) Use the ID from your permit or assign using TK-1, 2, etc. for tunnel and PK-1, 2, etc. for periodic. Use same ID throughout this form.

(b) Assign based on ID used in Title V or using CD-1, 2, etc.

(c) Select One: Dry Limestone Adsorber (DLA), Dry Injection / Fabric Filter (DIFF), Dry Lime Scrubber (DLS), Wet Scrubber, Fabric Filter / Baghouse Only, Lime System 

(unsure if DIFF or DLS), Spray Dryer / Electrostatic Precipitator, Other.

(d) Select One: Comply with MACT, become Synthetic Minor, SO2 Control, Particulate / Opacity Control, Other.

FACILITY AND KILN IDs GENERAL INFORMATION

FORM C - Page 1 of 5
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM C - APCD INFORMATION (Continued)

FACILITY AND KILN IDs

Facility ID Kiln ID(s) (a) Reagent Type

Reagent 

feedrate (value)

 Units/ 

time

Total fan 

hp

Total hp for 

other motors

Water usage 

(gpd)

Added cooling 

air, acfm Other utility requirements Units/time

DESIGN AND OPERATING PARAMETERS

FORM C - Page 2 of 5
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM C - APCD INFORMATION (Continued)

FACILITY AND KILN IDs

Facility ID Kiln ID(s) (a)

Number 

of bags

Bags- Length 

(ft)

Bags- Width 

(ft)

Bags- Diam. 

(ft)

Bag- material of 

construction

Avg. 

Life of 

bags 

(yrs) Cleaning method

Air-to-cloth 

ratio (d)

Cost of full 

set of bags

Avg. 

compressed 

air 

requirements, 

acfm

(d) The air-to-cloth ratio is the ratio of the design exhaust flow (acfm) to the total surface area of the bags (ft2). 

BAGHOUSE/FABRIC FILTER (Stand-alone or as Part of DLS/DIFF system)

FORM C - Page 3 of 5
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM C - APCD INFORMATION (Continued)

FACILITY AND KILN IDs

Facility ID Kiln ID(s) (a)

Is reagent 

recirculated or 

one-pass? (Enter 

one)

If 

recirculated, 

average ratio 

of 

recirculated 

to fresh 

reagent

Number 

of 

cascade

s

Do you use 

reconditionin

g 

drum/peeler

? Yes or No

What is the 

rate at which 

limestone is 

removed from 

the system as 

waste?

If complying with 

the MACT, do you 

monitor pressure 

drop or use an 

alternative? (e)

If complying with the 

MACT, how do you 

verify sufficient 

limestone in 

hopper? (f) Explain Other or Alternative

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

(e) If complying with the MACT, select one: Pressure Drop or Use an Alternative.

DIFF or DLS DLA

FORM C - Page 4 of 5
(f) Select One: Daily Climb to Hopper, Remote Visual Inspection, Fill / Discharge Records, Other.

FORM C - Page 4 of 5
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM C - APCD INFORMATION (Continued)

FACILITY AND KILN IDs WET SCRUBBER OTHER CONTROL (please identify parameters and units monitored to verify control is functioning 

properly)

Facility ID Kiln ID(s) (a)

Type of scrubber 

(e.g., venturi)

Liquid flow 

rate (gpm)

Pressure drop 

across scrubber 

(inches of 

water)

Design or 

Monitoring 

Parameter

Units / 

Time

Design or 

Monitoring 

Parameter Units / Time

Design or 

Monitoring 

Parameter

Units / 

Time

FORM C - Page 5 of 5
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM D - TEST DATA

GENERAL INFORMATION TEST INFORMATION

FAC ID Control ID Kiln/ Stack ID Test Date Report Date Type of Test - Circle One HF HCl PM

HAP 

Metals Other

Uncontrolled (or inlet to control) 

Controlled 

Both

Uncontrolled (or inlet to control) 

Controlled 

Both

Uncontrolled (or inlet to control) 

Controlled 

Both

Uncontrolled (or inlet to control) 

Controlled 

Both

Uncontrolled (or inlet to control) 

Controlled 

Both

Uncontrolled (or inlet to control) 

Controlled 

Both

Uncontrolled (or inlet to control) 

Controlled 

Both

Uncontrolled (or inlet to control) 

Controlled 

Both

Uncontrolled (or inlet to control) 

Controlled 

Both

Uncontrolled (or inlet to control) 

Controlled 

Both

POLLUTANTS TESTED (Please put X in box to indicate pollutant 

was tested)

FORM D - Page 1 of 2
Note: Please provide copies of full test reports to minimize the need for future information requests. Field notes and raw reading sections can be omitted. However, please include all 

other sections of the reports, including sample calculations, laboratory data, run-by-run emission data, and a description of any deviations from test methods or other anomalies that 

occurred with the process or control device operations during the test. Please also provide information on the following for each test: production rate in units of fired product (tph); 

APCD parameters monitored and monitored values; and any anecdotal information you believe would potentially be helpful to us. 

FORM D - Page 1 of 2
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM D - TEST DATA (Continued)

FAC ID Control ID

Kiln/ Stack 

ID Reasons for Test

APCD Parameters Monitored 

During Test

Production 

rate of fired 

product 

during test 

(tph) Notes

GENERAL INFORMATION ADDITIONAL INFORMATION

FORM D - Page 2 of 2
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM E - MONITORING AND OTHER COSTS

Facility ID

Unit Costs for January 2008

Parameter Cost

Electricity cost, $/kwh

Reagent:

Reagent Cost, $/ton

Waste Reagent disposal cost, $/ton

Water treatment costs, $/gal

Activity Required by Activity

Estimated 

Hours Frequency

Staff Level - Select One: 

Operator, Maintenance, Engineer, 

Manager

Develop a start-up, shutdown, and malfunction plan Develop plan and educate staff 

Develop and implement an operating, maintenance, and 

monitoring plan Develop plan and educate staff 

Bag replacement Replace single bag

Bag replacement Replace all bags

Maintain free-flowing lime (Describe action in next box and 

then add estimated hours, frequency, and staff level)

Meet requirement to "maintain adequate amount of limestone 

in hopper." (Describe action taken in next box, then add 

estimated hours, frequency, and staff level). If different 

approaches are taken at different plants, please add rows 

and provide information on each approach

Control Device: 

Compliance demonstration activity (describe and estimate 

hours, frequency, and staff level)

Compliance demonstration activity (describe and estimate 

hours, frequency, and staff level)

Compliance demonstration activity (describe and estimate 

hours, frequency, and staff level)

Standard Activities- Baghouse/DIFF/DLS

Standard Activities- DLA (limestone)

Standard Activities- Wet Scrubber or Other Control

FORM E - Page 1 of 2
Activity Required by Activity

Estimated 

Hours Frequency

Staff Level - Select One: 

Operator, Maintenance, Engineer, 

Manager

Please also provide separately an itemized list of site/preparation costs not included in the estimate (e.g., costs for drilling ports in stack, costs for installing permanent access to 

sampling ports, etc.)

FORM E - Page 1 of 2
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM E - MONITORING AND OTHER COSTS (Continued)

Facility ID

Activity Required by Activity

Estimated 

Hours Frequency

Staff Level - Select One: 

Operator, Maintenance, Engineer, 

Manager

Daily Maintenance (list activity(ies) in next column)

Weekly Maintenance (list activity(ies) in next column)

Monthly Maintenance (list activity(ies) in next column)

Semi-Annual Maintenance (list activity(ies) in next column)

Yearly Maintenance (list activity(ies) in next column)

Other Frequency Maintenance (specify frequency and list 

activity(ies) in next column)

Stack Test Costs for the Previous 3 Years

Stack Test Year

Test Methods (please list all test methods 

conducted during stack test)

Uncontrolled 

(include 

uncontrolled 

stack or APCD 

inlet)? 

Controlled? 

Both? Select 

One Cost ($)

Notes (Include Any site/preparation 

costs not included in estimate)

Please also provide separately an itemized list of site/preparation costs not included in the estimate (e.g., costs for drilling ports in stack, costs for installing permanent access to 

sampling ports, etc.)

Standard Activities- All Controls

FORM E - Page 2 of 2
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM F - ECONOMICS IMPACT INFORMATION

Product Selling Price Labor Rates as of January 2008

Facility ID Product Type

Average Selling Price 

per Ton ($)

Reporting Year for 

Selling Price (if not 

2007)

Operator wage rate, 

$/hr

Maintenance wage rate, 

$/hr

Engineer wage rate, 

$/hr

Managerial/Supervisory 

wage rate, $/hr

FORM F - Page 1 of 1
INFORMATION COLLECTION REQUEST FOR THE BRICK AND STRUCTURAL CLAY PRODUCTS MANUFACTURING INDUSTRY

FORM G - ADDITIONAL QUESTIONS

Response

1.

Please provide a copy of the cost estimate for your selected 

control device and explain any differences between the 

estimated and final installed costs. Costs should include costs 

for ancillary equipment, such as reconditioning drums, water 

treatment systems, etc

2.

Do you currently do any work or operating practices (i.e., other 

than the use of an air pollution control device) that would have 

an impact on HF, HCl, or PM emissions from your kilns? If yes, 

please explain.

3.

Do you have any data available on the fluorine or chlorine 

contents of your raw materials? If yes, please explain the types 

of information you have, the test method used to determine 

these contents, the frequency in which you test your raw 

materials, and any other information you feel is relevant to this 

discussion.

4.

If you answered YES to #3, please include copies of your raw 

material testing for either: the past two months OR the past 10 

tests, whichever is more. Please indicate which you are 

submitted in the response section to this question.

5.

If you operate periodic kilns, please provide a time-temperature 

profile for each typical batch cycle. The profiles should show 

the duration of each temperature phase of the cycle from the 

time the kiln is fired to the time when the fired shapes can be 

removed from the kiln. (See instructions for example profile.) 

Also provide the additional information requested on Form B.

6.

If you operate periodic kilns, do you have any information 

regarding technological and/or economic limitations to testing 

those kilns?

7. Please provide a copy of a process flow diagram for your 

facility, if available.

Question 

FORM G - Page 1 of 1