FORM A-1

COMPANY INFORMATION

I. Parent Company / Legal Corporate Owner Information

1. Legal Parent Company / Legal Corporate Name Example Resins

2. Mailing Address 123 Example Resins Rd

3. City Anytown

4. State North Carolina 

5. Zip Code 28590

6. County Any County

501-750

7. Size of Company (approximate number of employees 

including all subsidiaries, branches, and related 

establishments owned):

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM A-2

FACILITY INFORMATION

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

1. Facility Name Example Resins Sometown

Facility Address

a. Street 123 Any Road Way

b. City Sometown

c. State Louisiana 

d. Zip Code 70767

e. County Any Parish

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

f. Latitude 35.72154

g. Longitude -79.17732

2. Number of employees attached to the PVC 

production facility:

175

III. Technical Contact

1. Name John Doe

2. Technical Contact Title Environmental Manager

3. Telephone 1-234-567-8910

4. Facsimile 1-234-567-8910

5. Email John.Doe@ExampleResins.com

IV. Other

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

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

potential HAP emissions to avoid classification 

as a major source?

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

emissions to avoid classification as a major 

source, provide the date on which the limit was 

taken (MM/DD/YYYY).

4. Does the facility manufacture other products 

in addition to PVC resin?

Yes

5. If Yes, list the other products manufactured 

at the facility.

Ethylene Dichloride, Vinyl Chloride Monomer

6. Are there any HAP emissions associated 

with any co-located facilities?

Yes

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM F-1

CONTROL DEVICES - ABSORBER

Instructions

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

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

1 Type of Equipment or Device Control Device

2 Equipment of Device ID C-1

3 Type of Absorber Packed bed

4 If other, provide a description:

5 Gas inlet flow rate (dscfm): 2300

6 Gas inlet temperature (°F): 170

7 Pressure drop (in H2O): 10

8 Liquid-to-gas ratio (gal/103

 acfm): 18

Inlet scrubbing liquor

9 Liquor used: Water

10 pH: 6.5

11 Percent solids: 7

12 Type of alkali added, if any: NaOH

13 Addition rate (lb/gal): 0.01

14 Wastewater generation rate (gal/min): 10

15 Year Equipment Installed: 1985

16 Equipment Currently Regulated Under (cite regulations): 40 CFR 61 Subpart F

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM F-2

CONTROL DEVICES - THERMAL OR CATALYTIC OXIDIZER

1 Control Device ID: C-2

2 Number of operating hours per year (hours/year): 8400

3 Is this emergency equipment? No

4 Type (Thermal Oxidizer or Catalytic Oxidizer) Thermal Oxidizer

5 Oxidizer Inlet Flow Rate (dscfm): 2300

6 Average percentage of total flow originating from the production facility: 10

7

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

measurement is not in chamber) 1800

8 Excess air (%): 25

9 Nominal residence time (s): 1.5

Heat recovery

10 Recuperative, percent heat recovery

11 Regenerative, percent heat recovery

12 Design Capacity (Heat Input) (MMBtu/hr): 5

13 Fuel Basis for Design Capacity: Fuel Gas

14 Heat Release Rate (Btu/scf): 792

15 Is the unit subject to NSPS? No

16 If yes, indicate the year:

Start-up Fuel/Material

17 Start-up fuel: Fuel Gas

18 Number of start-ups per year: 2

19 Typical length of time for start-up (hours): 16

20 Higher heating value (HHV): 792

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

21 Fuel 1: PVC Vent

22 Hours used per year: 8400

23 Higher heating value (HHV): 421

24 Fuel 2: EDC/VCM Vent

25 Hours used per year: 8400

26 Higher heating value (HHV): 1600

27 Fuel 3: Fuel Gas

28 Hours used per year: 8400

29 Higher heating value (HHV): 792

30 Fuel 4: Natural Gas

31 Hours used per year: 10

32 Higher heating value (HHV): 993

33 Fuel 5:

34 Hours used per year:

35 Higher heating value (HHV):

36 Year Equipment Installed: 1985

37 Equipment Currently Regulated Under (cite regulations): 40 CFR 61 Subpart F

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM F-3

CONTROL DEVICES - CONDENSERS

Instructions

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

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

1 Type of Equipment or Device

2 Equipment of Device ID

3 Type of Condenser

4 If other, provide a description:

5 Is the condenser refrigerated?

6 Describe the materials condensed:

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

8 Describe the fate of the condensate outlet stream:

9 Gas inlet flow rate (dscfm):

10 Gas inlet temperature (°F):

11 Gas outlet temperature (°F):

12 Liquid outlet for rate (gpm):

15 Year Equipment Installed:

16 Equipment Currently Regulated Under (cite regulations):

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM H

EQUIPMENT LEAKS

Instructions

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

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

Table 1. LDAR Program

Yes

Yes

No

No

$10,000

Table 2. Equipment Counts

In Source 

Category

Subtotal of Equipment Associated 

with Closed Vent System(s)

(Subset of count in source category)

50 13

5 0

20 0

4 0

100 25

10 0

1 0

10 0

75 15

5 0

100 10

10 0

10 2

80 21

In heavy liquid service

In gas, vapor, and light liquid service

Connectors

In heavy liquid service

In gas, vapor, and light liquid service

Agitators

In liquid service

In gas and vapor service

Pressure Relief Devices

Open ended valves and lines

Sampling connection systems

Compressors

Instrumentation systems

Valves

In heavy liquid service

In light liquid service

Pumps

40 CFR Part 61, Subpart V

Other Federal LDAR Regulation

Specify: 

State LDAR Regulation

Specify:

Provide the total cost to your facility for conducting the LDAR 

program at this process unit in 2013:

Equipment

In heavy liquid service

In gas, vapor, and light liquid service

Is there an equipment leak detection and repair (LDAR) 

program for all equipment at your facility included in the 

source category?

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

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

40 CFR Part 63, Subpart UU

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM K-1

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

Instructions

1. Complete this form for 2013 only.

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

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

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

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

Table 1.

VCM Storage Bullets

25

50

65

Table 2.

Vapor Pressure Total Emissions

(in H2O) Minimum Maximum Average (pounds)

Vinyl chloride 1391 99 100 99.1 0

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

(select HAP)

VCM Storage Bullet - pressure vessel

Feedstock storage

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

Source Process Equipment ID (if applicable):

Equipment Description:

If not provided in the equipment description above, 

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

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

external roof. 

Select the purpose of the equipment:

If Yes, How Are The Emissions Controlled? Displaced vapor during filling is routed to VCM recovery system.

Concentration (ppmvd @ 3% O2)

How is the HAP Concentration Determined? Equipment is VCM storage - all material stored is HAP.

Are HAP Emissions Controlled? Yes

Individual HAP Present

Source Equipment Type:

Number of turnovers:

Equipment volume (m3):

Notes

Storage Temperature (°F)

Page 1 of 1

DRAFT PVC Section 114 Survey Part 2

06/23/2009
FORM L

STARTUP, SHUTDOWN, AND MALFUNCTION

Instructions

1. Complete this form for 2013 only.

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

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

Yes

Startup Shutdown

32 24

For a malfunction:

Yes Yes

No No

40 CFR Part 61 Subpart F 40 CFR Part 61 Subpart F

Control equipment (thermal oxidizer and scrubber) 

is brought online before startup begins.

Control equipment (thermal oxidizer and scrubber) 

is kept online until plant is completely shutdown.

Vinyl chloride (pounds) 0.02 0.02

Hydrochloric acid (pounds) 0.05 0.05

Methylene chloride 

(Dichloromethane) (pounds) 0.01 0.01

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

(select HAP) (pounds)

Total Emissions During Startup, Shutdown, 

or Malfunction Event

Were all of the emissions control devices 

operating for the entire duration of the startup, 

shutdown, or malfunction event?

Startup, Shutdown or Malfunction?

If startup or shutdown, what was the 

duration (hours):

Provide a short description of 

the malfunction and the 

circumstances:

If No, which control devices were not operating 

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

Were permitted emissions limits exceeded?

Provide a description of the 

procedures used to alert the 

owner/operator that the 

malfunction occurred. If the malfunction resulted in 

a release of emissions, 

describe any indicators used 

to signal and/or measure the 

release.

Is there a written startup, shutdown and/or 

malfunction plan for the process unit?

Provide a description of the systems and 

equipment in place that function to notify 

operators that a malfunction is occurring .

Pressure monitors on reactors with high, high-high alarms. All PRDs are "backed" by rupture disks - vapor space between is monitored for pressure and 

alarms when > atmospheric detected. Thermal oxidizer bypass has a flow detector which alarms to operator whenever flow is detected in the bypass. 

Applicable standard or regulation:

Describe what actions, if any, were taken to 

minimize emissions to the atmosphere:

Page 1 of 1

DRAFT PVC Section 114 Survey Part 1

06/23/2009
FORM P

PROCESS VENT EMISSIONS TESTING DATA

Instructions

1. Copy this worksheet as necessary for pollutants/compounds sampled on different dates.

2. For multiple control devices, users may copy this worksheet within this workbook.

Control Equipment ID:

Indicate whether the inlet to the control device is from the PVC process only ("dedicated") or from the PVC 

process and another process unit (non-PVC) ("combined"):

Parameter

Test Date (mm/dd/yy)

Required Operating Parameters During Test

Total Heat Input (MMBtu/hr)

Fuel 1

Feed Rate

HHV

Fuel 2

Feed Rate

HHV

Fuel 3

Feed Rate

HHV

Flow Rate

Temperature

Moisture

O2

CO2

Number of PVC resin grades being produced during sampling

Number of PVC resin grades being produced (as percentage of all resin grades produced by facility)

Testing Data

Compound

Benzene

Chloroethane

Chloroform

Chloroprene

1,1-Dichloroethane

1,2-Dichloroethane

n-Hexane

Methylene chloride

Toluene

1,1,1-Trichloroethane

1,1,2-Trichloroethane
Vinylidene chloride

Acetophenone

Bis(2-ethylhexyl) phthalate (DEHP)

1,4-Dichlorobenzene

2,4-Dinitrophenol

Hexachlorobutadiene

Hydroquinone

Naphthalene

Phenol

1,2,4-Trichlorobenzene

Acetaldehyde

1,3-Butadiene

Chlorobenzene

Chloromethane

Cumene

Ethylbenzene

Ethylene glycol

Formaldehyde

Methanol

1,1,2,2-Tetrachloroethane

2,2,4-Trimethylpentane

Vinyl acetate

Vinyl bromide

Xylenes (isomers and mixtures)

Vinyl chloride

Methane (CH4)
C-2

Combined

CAS Number Run #1 Run #2 Run #3 Units

Enter the CAS number for 

each pollutant/compound. 

Do not include dashes.

Select appropriate unit from list.

4/1/2014 4/1/2014 4/1/2014

19.6 17.1 15.9 MMBTU/hr

Natural Gas Natural Gas Natural Gas

19.6 17.1 15.9 MMBTU/hr

337 337 337 BTU/scf

MMBTU/hr

BTU/scf

MMBTU/hr

BTU/scf

8790.1 8867.3 8930.8 dscfm

451 447 457 deg F

15.1 14.9 14.5 %

6.7 5.9 7.05 %

8.7 8.9 8.7 %

1 1 1

20 20 20 %

CAS Number

71432 0.02 0.02 0.02 ppmvd @ 3% O2

75003 0.005 0.005 0.005 ppmvd @ 3% O2

67663 0.05502 0.00429 0.55921 ppmvd @ 3% O2

126998 0.47091 0.84152 0.48407 ppmvd @ 3% O2

75343 0.34632 0.22430 0.63035 ppmvd @ 3% O2

107062 0.23618 0.10824 0.31487 ppmvd @ 3% O2

110543 0.61394 0.00318 0.04897 ppmvd @ 3% O2

75092 0.28723 0.77804 0.74157 ppmvd @ 3% O2

108883 0.08046 0.05573 0.30012 ppmvd @ 3% O2

71556 0.16892 0.95882 0.95167 ppmvd @ 3% O2

79005 0.32749 0.35141 0.42412 ppmvd @ 3% O2

Enter numerical value only.

Enter numerical value only.
75354 0.31693 0.34155 0.02419 ppmvd @ 3% O2

98862 0.46181 0.89753 0.21937 ppmvd @ 3% O2

117817 0.73100 0.84955 0.84679 ppmvd @ 3% O2

106467 0.76541 0.38040 0.60674 ppmvd @ 3% O2

51285 0.02045 0.12233 0.15984 ppmvd @ 3% O2

87683 0.44470 0.85413 0.92067 ppmvd @ 3% O2

123319 0.03777 0.56408 0.40106 ppmvd @ 3% O2

91203 0.78022 0.00196 0.80266 ppmvd @ 3% O2

108952 0.26708 0.18864 0.19807 ppmvd @ 3% O2

120821 0.40474 0.39410 0.81911 ppmvd @ 3% O2

75070 0.95814 0.35858 0.46405 ppmvd @ 3% O2

106990 0.09809 0.74534 0.87695 ppmvd @ 3% O2

108907 0.09093 0.29692 0.92321 ppmvd @ 3% O2

74873 0.56775 0.35855 0.13606 ppmvd @ 3% O2

98828 0.67384 0.28638 0.23619 ppmvd @ 3% O2

100414 0.23047 0.93697 0.09574 ppmvd @ 3% O2

107211 0.65432 0.42177 0.24037 ppmvd @ 3% O2

50000 0.89907 0.94252 0.35415 ppmvd @ 3% O2

67561 0.16015 0.99542 0.78944 ppmvd @ 3% O2

79345 0.18766 0.64299 0.27044 ppmvd @ 3% O2

540841 0.94718 0.64250 0.78853 ppmvd @ 3% O2

108054 0.59784 0.89953 0.09221 ppmvd @ 3% O2

593602 0.36167 0.72758 0.28526 ppmvd @ 3% O2

1330207 0.98577 0.41794 0.58376 ppmvd @ 3% O2

75014 0.03283 0.84356 0.75999 ppbvd @ 3% O2

74828 1.22400 0.99840 1.11340 ppmvd @ 3% O2
Run # 1 Detection Run # 2 Detection Run # 3 Detection

Identify the status of measured 

values relative to the detection 

levels

Identify the status of measured 

values relative to the detection 

levels

Identify the status of measured 

values relative to the detection 

levels

BDL BDL DLL

BDL BDL BDL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL
ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL

ADL ADL ADL
Analysis Method Used Note(s)

Where applicable, select the analysis method 

used.

For all pollutants/compounds, provide any other information 

supporting information you think is necessary about this test 

report. 

SW-846 Method 8260B Reporting average concentration; runs #1 and #2 are BDL.

SW-846 Method 8260B All 3 runs are BDL.

SW-846 Method 8260B

SW-846 Method 8260B

SW-846 Method 8260B

SW-846 Method 8260B

SW-846 Method 8260B

SW-846 Method 8260B

SW-846 Method 8260B

SW-846 Method 8260B

SW-846 Method 8260B
SW-846 Method 8260B

SW-846 Method 8270D

SW-846 Method 8270D

SW-846 Method 8270D

SW-846 Method 8270D

SW-846 Method 8270D

SW-846 Method 8270D

SW-846 Method 8270D

SW-846 Method 8270D

SW-846 Method 8270D

US EPA Method 18

US EPA Method 18

US EPA Method 18

US EPA Method 18

US EPA Method 18

US EPA Method 18

US EPA Method 18

US EPA Method 18

US EPA Method 18

US EPA Method 18

US EPA Method 18

US EPA Method 18

US EPA Method 18

US EPA Method 18

US EPA Method 18

US EPA Method 18
FORM Q

TOTAL HYDROCARBON 30-DAY MONITORING

Instructions

1. For multiple control devices, users may copy this worksheet within this workbook.

2. Add additional rows as necessary to provide 30 days of monitoring data.

Control Equipment ID:

Date and Time THC Reading CH4 Reading O2 level in exhaust gas

MM/DD/YYYY HH:MM (ppmvd as propane @ 3% O2) (ppmvd @ 3% O2) (% by volume, dry)

04/01/2014 15:00 27.4 1.56 8

04/01/2014 15:15 30.2 1.24 10

04/01/2014 15:30 40.5 1.33 5

04/01/2014 15:45 20.6 1.78 6

04/01/2014 16:00 20.3 1.15 8

04/01/2014 16:15 28.9 1.14 9

04/01/2014 16:30 35.1 1.67 10

04/01/2014 16:45 30.2 1.63 8

04/01/2014 17:00 32.7 1.64 6

04/01/2014 17:15 25.4 1.27 5

04/01/2014 17:30 29.4 1.23 10

Indicate whether the inlet to the control device is from the PVC process only ("dedicated") or from the 

PVC process and another process unit (non-PVC) ("combined"):














C-2

Combined

Moisture in exhaust 

gas

PVC Type PVC Grade Control Device 

Temperature

(% by volume) (e.g., suspension, 

dispersion/emulsion, bulk, etc.) (e.g., GP, HMW, LMW, etc.) (degF)

17 Suspension HMW 469

18 Suspension HMW 473

12 Suspension HMW 461

16 Suspension HMW 494

13 Suspension HMW 455

10 Suspension HMW 480

11 Suspension HMW 452

13 Suspension HMW 450

20 Suspension HMW 459

13 Suspension HMW 470

17 Suspension HMW 488














Control Device 

Operations Indicator

THC Monitoring 

Operations Indicator 

(note periods of start-up, 

Shutdown, malfunctions, or 

normal operation) 

(note periods of abnormal 

operations) 

Normal Normal

Normal Normal

Normal Normal

Normal Normal

Normal Normal

Normal Normal

Normal Normal

Normal Normal

Normal Normal

Normal Normal

Normal Normal