EPA Form 7610-1 (Revised 6-2011)

United States Environmental Protection Agency OMB Nos. 2060-0258, 2060-0570, and 2060-NEW

Acid Rain, CAIR, and Transport Rule Programs Approval Expires 11/31/2012

Certificate of Representation

For more information, see instructions and 40 CFR 72.24, 96.113, 96.213, 96.313, 97.113, 97.213, 97.313, 97.416, 

97.516, 97.616, 97.716, or a comparable state regulation, as applicable.

This submission is: □ New □ Revised (revised submissions must be complete; see instructions)

 FACILITY (SOURCE)

 INFORMATION

STEP 1

Provide 

information for 

the facility

(source).

Facility (Source) Name State Plant Code

County Name

Latitude Longitude

STEP 2

Enter requested

information for 

the 

designated 

representative.

Name Title

Company Name

Mailing Address

Phone Number Fax Number

E-mail address

STEP 3

Enter requested

information for 

the

alternate 

designated 

representative.

Name Title

Company Name

Mailing Address

Phone Number Fax Number

E-mail address
EPA Form 7610-1 (Revised 6-2011)

Certificate of Representation

Page of 

UNIT INFORMATION

STEP 4: Complete a separate page 2 for each unit located at the facility identified in STEP 1 (i.e., for each boiler, simple cycle combustion turbine, or combined cycle 

combustion turbine) Do not list duct burners. Indicate each program to which the unit is subject, and enter all other unit-specific information. See instructions for more details. 

Applicable Program(s):  Acid Rain  CAIR NOX Annual  CAIR SO2  CAIR NOX Ozone Season 

 TRNOx Annual  TRNOx Ozone Season  TRSO2 Annual 

Unit ID# Unit Type

Source Category

Generator ID Number (Maximum 

8 characters)

Acid Rain Nameplate 

Capacity (MWe)

CAIR/Transport Rule

Nameplate Capacity (MWe)

NAICS Code

Date unit began (or will begin) serving any

generator producing electricity for sale (including 

test generation) (mm/dd/yyyy):

):

Check One:

 Yes 

 No 

Is this unit located in Indian Country?

Check One:

 Yes 

 No 

If this is the first time the unit has been identified on the Certificate of Representation for this 

facility, was the unit moved from another facility?

Check One:

 Yes 

 No 

Company Name:  Owner

 Operator

Company Name:  Owner

 Operator

Company Name:  Owner

 Operator

Company Name:  Owner

 Operator

Company Name:  Owner

 Operator
EPA Form 7610-1 (Revised 6-2011)

Certificate of Representation

Page of 

STEP 5: Read the appropriate certification statements, sign, and date.

Acid Rain Program 

I certify that I was selected as the designated representative or alternate designated representative (as applicable) by an 

agreement binding on the owners and operators of the affected source and each affected unit at the source (i.e., the source 

and each unit subject to the Acid Rain Program, as indicated in "Applicable Program(s)" in Step 4).

I certify that I have all necessary authority to carry out my duties and responsibilities under the Acid Rain Program on behalf 

of the owners and operators of the affected source and each affected unit at the source and that each such owner and 

operator shall be fully bound by my representations, actions, inactions, or submissions.

I certify that the owners and operators of the affected source and each affected unit at the source shall be bound by any

order issued to me by the Administrator, the permitting authority, or a court regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, an affected unit, or where a utility or 

industrial customer purchases power from an affected unit under a life-of-the-unit, firm power contractual arrangement, 

I certify that:

I have given a written notice of my selection as the designated representative or alternate designated 

representative (as applicable) and of the agreement by which I was selected to each owner and operator of 

the affected source and each affected unit at the source; and

Allowances, and proceeds of transactions involving allowances, will be deemed to be held or distributed in 

proportion to each holder's legal, equitable, leasehold, or contractual reservation or entitlement, except that, 

if such multiple holders have expressly provided for a different distribution of allowances, allowances and 

proceeds of transactions involving allowances will be deemed to be held or distributed in accordance with 

the contract.

Clean Air Interstate Rule (CAIR) NOX Annual Trading Program

I certify that I was selected as the CAIR designated representative or alternate CAIR designated representative (as 

applicable), by an agreement binding on the owners and operators of the CAIR NOX source and each CAIR NOX unit at the 

source (i.e., the source and each unit subject to the CAIR NOX Annual Trading Program, as indicated in "Applicable 

Program(s)" in Step 4).

I certify that I have all necessary authority to carry out my duties and responsibilities under the CAIR NOX Annual Trading 

Program on behalf of the owners and operators of the CAIR NOX source and each CAIR NOX unit at the source and that each 

such owner and operator shall be fully bound by my representations, actions, inactions, or submissions.

I certify that the owners and operators of the CAIR NOX source and each CAIR NOX unit at the source shall be bound by any

order issued to me by the Administrator, the permitting authority, or a court regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a CAIR NOX unit, or where a utility

or industrial customer purchases power from a CAIR NOX unit under a life-of-the-unit, firm power contractual arrangement, 

I certify that:

I have given a written notice of my selection as the CAIR designated representative or alternate CAIR 

designated representative (as applicable) and of the agreement by which I was selected to each owner and 

operator of the CAIR NOX source and each CAIR NOX unit at the source; and

CAIR NOX allowances and proceeds of transactions involving CAIR NOX allowances will be deemed to be 

held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual reservation or 

entitlement, except that, if such multiple holders have expressly provided for a different distribution of CAIR 

NOX allowances by contract, CAIR NOX allowances and proceeds of transactions involving CAIR NOX

allowances will be deemed to be held or distributed in accordance with the contract.
EPA Form 7610-1 (Revised 6-2011)

Certificate of Representation

Page of 

Clean Air Interstate Rule (CAIR) SO2 Trading Program

I certify that I was selected as the CAIR designated representative or alternate CAIR designated representative (as 

applicable), by an agreement binding on the owners and operators of the CAIR SO2 source and each CAIR SO2 unit at the 

source (i.e., the source and each unit subject to the SO2 Trading Program, as indicated in "Applicable Program(s)" in Step 4).

I certify that I have all necessary authority to carry out my duties and responsibilities under the CAIR SO2 Trading Program, 

on behalf of the owners and operators of the CAIR SO2 source and each CAIR SO2 unit at the source and that each such 

owner and operator shall be fully bound by my representations, actions, inactions, or submissions.

I certify that the owners and operators of the CAIR SO2 source and each CAIR SO2 unit at the source shall be bound by any

order issued to me by the Administrator, the permitting authority, or a court regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a CAIR SO2 unit, or where a utility or 

industrial customer purchases power from a CAIR SO2 unit under a life-of-the-unit, firm power contractual arrangement, 

I certify that:

I have given a written notice of my selection as the CAIR designated representative or alternate CAIR 

designated representative (as applicable) and of the agreement by which I was selected to each owner and 

operator of the CAIR SO2 source and each CAIR SO2 unit at the source; and

CAIR SO2 allowances and proceeds of transactions involving CAIR SO2 allowances will be deemed to be held or 

distributed in proportion to each holder's legal, equitable, leasehold, or contractual reservation or entitlement, 

except that, if such multiple holders have expressly provided for a different distribution of CAIR SO2 allowances 

by contract, CAIR SO2 allowances and proceeds of transactions involving CAIR SO2 allowances will be deemed 

to be held or distributed in accordance with the contract.

Clean Air Interstate Rule (CAIR) NOX Ozone Season Trading Program

I certify that I was selected as the CAIR designated representative or alternate CAIR designated representative (as 

applicable), by an agreement binding on the owners and operators of the CAIR NOX Ozone Season source and each CAIR 

NOX Ozone Season unit at the source (i.e., the source and each unit subject to the CAIR NOX Ozone Season Trading 

Program, as indicated in "Applicable Program(s)" in Step 4).

I certify that I have all necessary authority to carry out my duties and responsibilities under the CAIR NOX Ozone Season 

Trading Program on behalf of the owners and operators of the CAIR NOX Ozone Season source and each CAIR NOX Ozone 

Season unit at the source and that each such owner and operator shall be fully bound by my representations, actions, 

inactions, or submissions.

I certify that the owners and operators of the CAIR NOX Ozone Season source and each CAIR NOX Ozone Season unit shall 

be bound by any order issued to me by the Administrator, the permitting authority, or a court regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a CAIR NOX Ozone Season unit, or 

where a utility or industrial customer purchases power from a CAIR NOX Ozone Season unit under a life-of-the-unit, firm 

power contractual arrangement, I certify that:

I have given a written notice of my selection as the CAIR designated representative or alternate CAIR 

designated representative (as applicable) and of the agreement by which I was selected to each owner and 

operator of the CAIR NOX Ozone Season source and each CAIR NOX Ozone Season unit; and

CAIR NOX Ozone Season allowances and proceeds of transactions involving CAIR NOX Ozone Season 

allowances will be deemed to be held or distributed in proportion to each holder's legal, equitable, leasehold, 

or contractual reservation or entitlement, except that, if such multiple holders have expressly provided for a 

different distribution of CAIR NOX Ozone Season allowances by contract, CAIR NOX Ozone Season 

allowances and proceeds of transactions involving CAIR NOX Ozone Season allowances will be deemed to 

be held or distributed in accordance with the contract.
EPA Form 7610-1 (Revised 6-2011)

Certificate of Representation

Page of 

Transport Rule NOx Annual

I certify that I was selected as the designated representative or alternate designated representative, as applicable, by an 

agreement binding on the owners and operators of the source and each TR NOX Annual unit at the source.

I certify that I have all the necessary authority to carry out my duties and responsibilities under the TR NOX Annual 

Trading Program on behalf of the owners and operators of the source and of each TR NOX Annual unit at the source 

and that each such owner and operator shall be fully bound by my representations, actions, inactions, or submissions 

and by any order issued to me by the Administrator regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a TR NOX Annual unit, or 

where a utility or industrial customer purchases power from a TR NOX Annual unit under a life-of-the-unit, firm power 

contractual arrangement, I certify that: 

I have given a written notice of my selection as the ‘designated representative’ or ‘alternate designated 

representative’, as applicable, and of the agreement by which I was selected to each owner and operator of the 

source and of each TR NOX Annual unit at the source.

TR NOX Annual allowances and proceeds of transactions involving TR NOX Annual allowances will be deemed 

to be held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual reservation or 

entitlement, except that, if such multiple holders have expressly provided for a different distribution of TR NOX 

Annual allowances by contract, TR NOX Annual allowances and proceeds of transactions involving TR NOX 

Annual allowances will be deemed to be held or distributed in accordance with the contract.

Transport Rule NOx Ozone Season

I certify that I was selected as the designated representative or alternate designated representative, as applicable, by an 

agreement binding on the owners and operators of the source and each TR NOX Ozone Season unit at the source.

I certify that I have all the necessary authority to carry out my duties and responsibilities under the TR NOX Ozone 

Season Trading Program on behalf of the owners and operators of the source and of each TR NOX Ozone Season unit 

at the source and that each such owner and operator shall be fully bound by my representations, actions, inactions, or 

submissions and by any order issued to me by the Administrator regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a TR NOX Ozone Season unit, 

or where a utility or industrial customer purchases power from a TR NOX Ozone Season unit under a life-of-the-unit, 

firm power contractual arrangement, I certify that: 

I have given a written notice of my selection as the ‘designated representative’ or ‘alternate designated 

representative’, as applicable, and of the agreement by which I was selected to each owner and operator of the 

source and of each TR NOX Ozone Season unit at the source. 

TR NOX Ozone Season allowances and proceeds of transactions involving TR NOX Ozone Season allowances 

will be deemed to be held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual 

reservation or entitlement, except that, if such multiple holders have expressly provided for a different 

distribution of TR NOX Ozone Season allowances by contract, TR NOX Ozone Season allowances and 

proceeds of transactions involving TR NOX Ozone Season allowances will be deemed to be held or distributed 

in accordance with the contract.
EPA Form 7610-1 (Revised 6-2011)

Certificate of Representation

Page of 

Transport Rule SO2 Annual Group 1

I certify that I was selected as the designated representative or alternate designated representative, as applicable, by an 

agreement binding on the owners and operators of the source and each TR SO2 Group 1 unit at the source.

I certify that I have all the necessary authority to carry out my duties and responsibilities under the TR SO2 Group 1 

Trading Program on behalf of the owners and operators of the source and of each TR SO2 Group 1 unit at the source 

and that each such owner and operator shall be fully bound by my representations, actions, inactions, or submissions 

and by any order issued to me by the Administrator regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a TR SO2 Group 1 unit, or 

where a utility or industrial customer purchases power from a TR SO2 Group 1 unit under a life-of-the-unit, firm power 

contractual arrangement, I certify that: 

I have given a written notice of my selection as the ‘designated representative’ or ‘alternate designated 

representative’, as applicable, and of the agreement by which I was selected to each owner and operator of the 

source and of each TR SO2 Group 1 unit at the source. 

TR SO2 Group 1 allowances and proceeds of transactions involving TR SO2 Group 1 allowances will be 

deemed to be held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual 

reservation or entitlement, except that, if such multiple holders have expressly provided for a different 

distribution of TR SO2 Group 1 allowances by contract, TR SO2 Group 1 allowances and proceeds of 

transactions involving TR SO2 Group 1 allowances will be deemed to be held or distributed in accordance with 

the contract.

Transport Rule SO2 Annual Group 2

I certify that I was selected as the designated representative or alternate designated representative, as applicable, by an 

agreement binding on the owners and operators of the source and each TR SO2 Group 2 unit at the source.

I certify that I have all the necessary authority to carry out my duties and responsibilities under the TR SO2 Group 2 

Trading Program on behalf of the owners and operators of the source and of each TR SO2 Group 2 unit at the source 

and that each such owner and operator shall be fully bound by my representations, actions, inactions, or submissions 

and by any order issued to me by the Administrator regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a TR SO2 Group 2 unit, or 

where a utility or industrial customer purchases power from a TR SO2 Group 2 unit under a life-of-the-unit, firm power 

contractual arrangement, I certify that: 

I have given a written notice of my selection as the ‘designated representative’ or ‘alternate designated 

representative’, as applicable, and of the agreement by which I was selected to each owner and operator of the 

source and of each TR SO2 Group 2 unit at the source.

TR SO2 Group 2 allowances and proceeds of transactions involving TR SO2 Group 2 allowances will be 

deemed to be held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual 

reservation or entitlement, except that, if such multiple holders have expressly provided for a different 

distribution of TR SO2 Group 2 allowances by contract, TR SO2 Group 2 allowances and proceeds of 

transactions involving TR SO2 Group 2 allowances will be deemed to be held or distributed in accordance with 

the contract.
EPA Form 7610-1 (Revised 6-2011)

Certificate of Representation

Page of 

General

I am authorized to make this submission on behalf of the owners and operators of the source or units for which the submission

is made. I certify under penalty of law that I have personally examined, and am familiar with, the statements and information 

submitted in this document and all its attachments. Based on my inquiry of those individuals with primary responsibility for

obtaining the information, I certify that the statements and information are to the best of my knowledge and belief true, accurate, 

and complete. I am aware that there are significant penalties for submitting false statements and information or omitting 

required statements and information, including the possibility of fine or imprisonment.

Signature (Designated Representative) Date

Signature (Alternate Designated Representative) Date
1

Instructions for the Certificate of Representation

Note: The Certificate of Representation information can be submitted online through the 

CAMD Business System (CBS) at https://camd.epa.gov/cbs/index.cfm. You must have a user 

ID and password. If you need a user ID and password, call Karen Van Sickle at (202) 343-9220 or 

Kirk Nabors at (202) 343-9171 or Paula Branch at (202) 343-9168. If you have questions about 

CBS, contact Laurel DeSantis at desantis.laurel@epa.gov or (202) 343-9191, or Alex Salpeter at 

salpeter.alex@epa.gov or (202) 343-9157.

Any reference in these instructions to the Designated Representative means the Acid Rain 

Designated Representative, the CAIR Designated Representative, and/or Transport Rule 

Designated Representative, as applicable. Any reference to the Alternate Designated 

Representative means the Alternate Acid Rain Designated Representative, the Alternate CAIR 

Designated Representative, and/or the Alternate Transport Rule Designated Representative, as 

applicable. As reflected in this form, the Acid Rain Designated Representative, the CAIR 

Designated Representative, and the Transport Rule Designated Representative for a facility

(source) must be the same individual, and the Alternate Acid Rain Designated Representative, the 

Alternate CAIR Designated Representative, and the Alternate Transport Rule Designated 

Representative for a facility (source) must be the same individual.

Please type or print. Submit a separate page 2 for each unit subject to the Acid Rain Program, a 

CAIR Trading Program, or a Transport Rule Program at the facility (source), and indicate the page 

order and total number of pages (e.g., 1 of 4, 2 of 4, etc.) in the boxes in the upper right hand corner 

of page 2. A Certificate of Representation amending an earlier submission supersedes the 

earlier submission in its entirety and must therefore always be complete. Submit one 

Certificate of Representation form with original signature(s). NO FIELDS SHOULD BE LEFT 

BLANK. For assistance, contact Laurel DeSantis at desantis.laurel@epa.gov or (202) 343-9191.

STEP 1 

(i) A Plant Code is a 4 or 5 digit number assigned by the Department of Energy=s (DOE) Energy

Information Administration (EIA) to facilities that generate electricity. For older facilities, "Plant 

Code" is synonymous with "ORISPL" and "Facility" codes. If the facility generates electricity but no 

Plant Code has been assigned, or if there is uncertainty regarding what the Plant Code is, contact 

EIA at (202) 586-1029. For facilities that do not produce electricity, use the facility identifier 

assigned by EPA (beginning with "88"). If the facility does not produce electricity and has not been 

assigned a facility identifier, contact Laurel DeSantis at desantis.laurel@epa.gov or (202) 343-9191.

(ii) Enter the latitude and longitude representing the location of the facility in degree decimal 

format.

Note that coordinates MUST be submitted in decimal degree format; in this format minutes and 

seconds are represented as a decimal fraction of one degree. Therefore, coordinates 

containing degrees, minutes, and seconds must first be converted using the formula: 

decimal degrees = degrees + (minutes / 60) + (seconds / 3600)
2

Example: 

39 degrees, 15 minutes, 25 seconds = 39 + (15 / 60) + (25 / 3600) = 39.2569 degrees

STEPS 2 & 3

The Designated Representative and the Alternate Designated Representative must be individuals 

(i.e., natural persons) and cannot be a company. Enter the company name and address of the 

representative as it should appear on all correspondence. If an email address is provided, most 

correspondence will be emailed. Although not required, EPA strongly encourages owners and 

operators to designate an Alternate Designated Representative to act on behalf of the 

Designated Representative.

STEP 4

(i) Complete one page for each unit subject to the Acid Rain Program, a CAIR Trading Program, 

or a Transport Rule Program, and indicate the program(s) to which the unit is subject. Identify

each unit at the facility by providing the appropriate unit identification number, consistent with the 

identifiers used in previously submitted Certificates of Representation (if applicable) and with 

submissions made to DOE and/or EIA. Do not list duct burners. For new units without identification 

numbers, owners and operators must assign identifiers consistent with EIA and DOE requirements. 

Each submission to EPA that includes the unit identification number(s) (e.g., monitoring plans and

quarterly reports) should reference those unit identification numbers in exactly the same way that 

they are referenced on the Certificate of Representation. Do not identify units that are not subject to 

the above-listed programs but are part of a common monitoring configuration with a unit that is 

subject to any of these programs. To identify units in a common monitoring configuration that are 

not subject to any of these programs, call the CAMD Hotline at (202) 343-9620, and leave a 

message under the “Continuous Emissions Monitoring” submenu.

(ii) Identify the type of unit using one of the following abbreviations:

Boilers Boilers Turbines

AF Arch-fired boiler OB Other boiler CC Combined cycle

BFB Bubbling fluidized bed 

boiler

PFB Pressurized 

fluidized bed boiler

CT Combustion turbine

C Cyclone boiler S Stoker OT Other turbine

CB Cell burner boiler T Tangentially-fired 

boiler

Others

CFB Circulating fluidized 

bed boiler

WBF Wet bottom wallfired boilerICE Internal combustion

engine

DB Dry bottom wall-fired 

boiler

WBT Wet bottom turbofired boilerKLN Cement kiln

DTF Dry bottom turbo-fired 

boiler

WVF Wet bottom 

vertically-fired boiler

PRH Refinery process 

heater

DVF Dry bottom verticallyfired boiler

If there is uncertainty about how a unit should be characterized, contact Robert Miller at 

miller.robertl@epa.gov or (202) 343-9077.
3

(iii) Indicate the source category description that most accurately describes the purpose for which

the unit is operated by entering one of the following terms. If none of these descriptions applies to 

your unit, contact Robert Miller at miller.robertl@epa.gov or (202) 343-9077.

Automotive Stampings Industrial Boiler Petroleum Refinery

Bulk Industrial Chemical Industrial Turbine Portland Cement Plant

Cement Manufacturing Institutional Pulp and Paper Mill

Cogeneration Iron and Steel Small Power Producer

Electric Utility Municipal Waste Combustor Theme Park

(iv) Provide the primary North American Industrial Classification System (NAICS) code that most 

accurately describes the business type for which the unit is operated. If unknown, go to 

http://www.census.gov for guidance on how to determine the proper NAICS code for the unit.

(v) Enter the date the unit began (or will begin) serving any generator producing electricity for sale, 

including test generation. Enter this date and check the "actual" box for any unit that has begun to 

serve a generator producing electricity for sale as of the date of submission of this form. (This 

information should be provided even if the unit does not currently serve a generator producing 

electricity for sale.) For any unit that will begin, but has not begun as of the date of submission of 

this form, to serve a generator producing electricity for sale, estimate the future date on which the 

unit will begin to produce electricity for sale and check the "projected" box. When the actual date is 

established, revise the form accordingly by entering the actual date and checking the "actual" box. 

Enter "NA" if the unit has not ever served, is not currently serving, and is not projected to serve, a 

generator that producing electricity for sale. You are strongly encouraged to use the CAMD 

Business System to update information regarding when a unit begins serving a generator 

producing electricity for sale. 

If you have questions regarding this portion of the form, contact Robert Miller at 

miller.robertl@epa.gov or (202) 343-9077.

(vi) For a unit subject to the Acid Rain Program, a CAIR Trading Program, or a Transport Rule 

Program, that, as of the date of submission of this form, serves one or more generators (whether or 

not the generator produces electricity for sale), indicate the generator ID number and the nameplate 

capacity (in MWe) of each generator served by the unit. A unit serves a generator if it produces, or 

is able to produce, steam, gas, or other heated medium for generating electricity at that generator. 

For combined cycle units, report separately the nameplate capacities of the generators associated 

with the combustion turbine and the steam turbine. Please ensure that the generator ID numbers 

entered are consistent with those reported to the EIA. 

The definitions of "nameplate capacity" under the Acid Rain Program and under the CAIR/Transport 

Rule Programs differ slightly. Therefore, for a unit subject to the Acid Rain Program and any

CAIR/Transport Rule Program, the nameplate capacity for the same generator under the Acid Rain 

Program and under the CAIR/Transport Rule Program may differ in certain limited circumstances. 

Specifically, for a unit subject to the Acid Rain Program, the nameplate capacity of a generator, if 

listed in the National Allowance Database ("NADB"), is not affected by physical changes to the 

generator after initial installation that result in an increase in the maximum electrical generating 

output that the generator is capable of producing. Otherwise, for a unit subject to the Acid Rain 

Program or a CAIR/Transport Rule Program, the nameplate capacity of a generator is affected by

physical changes to the generator after initial installation that result in an increase in the maximum 

electrical generating output that the generator is capable of producing. In such a case, the higher 

maximum electrical generating output number in MWe should be reported in the nameplate capacity

column. Enter "NA" if, as of the date of submission of this form, the unit does not serve a generator.

See the definition of "nameplate capacity" at 40 CFR 72.2, 96.102, 97.102, 96.202, 97.202, 96.302, 

97.302, 97.402, 97.502, 97.602, and 97.702, as applicable. The NADB is located at the CAMD 
4

website at http://www.epa.gov/airmarkets/trading/allocations.html. If you have questions regarding 

nameplate capacity, contact Robert Miller at miller.robertl@epa.gov or (202) 343-9077; if you have 

questions regarding the NADB, contact Craig Hillock at hillock.craig@epa.gov or (202) 343-9105.

(vii) Enter the company name of each owner and operator in the "Company Name" field. Indicate 

whether the company is the owner, operator, or both. For new units, if the operator of a unit has not 

yet been chosen, indicate that the owner is both the owner and operator and submit a revised form 

when the operator has been selected within 30 days of the effective date of the selection. EPA must 

be notified of changes to owners and operators within 30 days of the effective date of the change. 

You are strongly encouraged to use the CAMD Business System to provide updated 

information on owners and operators.

(viii) Indicate whether or not the unit is located in Indian Country. For more information see the 

definition of “Indian Country” at 40 CFR 97.402, 97.502, 97.602 and 97.702. 

(ix) When identifying a unit at a facility for the first time, indicate whether or not the unit was moved 

from another facility. If the answer is “yes”, the EPA will contact the owners/operator for more 

information. 

STEP 5 

Read the appropriate certification statements, sign, and date. 

Mail this form to:

For regular/certified mail: For overnight mail:

U.S. Environmental Protection Agency U.S. Environmental Protection Agency

Clean Air Markets Division (6204J) Clean Air Markets Division (6204J)

Attention: Designated Representative Attention: Designated Representative

1200 Pennsylvania Avenue, NW 1310 L Street, NW

Washington, DC 20460 Second Floor

Washington, DC 20005

(202) 343-9191

Submit this form prior to making any other submissions under the Acid Rain Program, CAIR 

Programs, or Transport Rule Programs. Submit a revised Certificate of Representation when any

information in the existing Certificate of Representation changes. You are strongly encouraged to 

use the CAMD Business System to provide updated information.

Paperwork Burden Estimate

The public reporting and record keeping burden for this collection of information is estimated to 

average 15 hours per response annually. Burden means the total time, effort, or financial resources 

expended by persons to generate, maintain, retain, or disclose or provide information to or for a 

Federal agency. This includes the time needed to review instructions; develop, acquire, install, and 

utilize technology and systems for the purposes of collecting, validating, and verifying information, 

processing and maintaining information, and disclosing and providing information; adjust the existing 

ways to comply with any previously applicable instructions and requirements; train personnel to be 

able to respond to a collection of information; search data sources; complete and review the 

collection of information; and transmit or otherwise disclose the information. An agency may not 

conduct or sponsor, and a person is not required to respond to, a collection of information unless it 

displays a currently valid OMB control number. 
5

Send comments on the Agency's need for this 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 form to this 

address.