EPA Form No. 5900-341

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

United States Environmental Protection Agency

Air Quality Permit by Rule for New or Modified True Minor Sources of 

Air Pollution in Indian Country

http://www.epa.gov/air/tribal/tribalnsr.html

Notification of Coverage: Petroleum Dry Cleaning Facilities Page 1 of 10

Version 1.0

Notification of Coverage under the Air Quality Permit by Rule for New or Modified 

True Minor Source Petroleum Dry Cleaning Facilities in Indian Country

Last Modified: March 23, 2015

Version 1.0

This Notification of Coverage under the Air Quality Permit by Rule for New or Modified True Minor Source Petroleum 

Dry Cleaning Facilities in Indian Country applies to the construction of new, true minor source petroleum dry cleaning 

facilities or the modification of existing, true minor source petroleum dry cleaning facilities in Indian country. It applies 

only to facilities that use 5,600 gallons or less of petroleum solvents annually in National Ambient Air Quality Standard 

(NAAQS) ozone attainment, unclassifiable or attainment/unclassifiable areas, or 1,300 gallons or less of petroleum 

solvents annually in NAAQS ozone nonattainment areas. A petroleum dry cleaning facility consists of dry cleaning dryers, 

washers, filters, stills, settling tanks, and boilers.

You qualify to submit a Notification for Coverage under the Permit by Rule if you meet all of the 

following criteria:

 Your new or modified true minor source petroleum dry cleaning facility is located within Indian Country;

 Your facility has a potential to emit (PTE) less than the New Source Review (NSR) major source thresholds;

 If located in an ozone attainment, unclassifiable or attainment/unclassifiable area, after the proposed 

construction or modification project, the projected total usage of petroleum solvents at your facility will not 

exceed 5,600 gallons per year based on a 12-month rolling total; 

 If located in an ozone nonattainment area, after the proposed construction or modification project, the 

projected total usage of petroleum solvents at your facility will not exceed 1,300 gallons per year based on a 

12-month rolling total; 

 You do not use fuels other than natural gas, propane, and butane in the fuel combustion units at your 

facility; 

 The maximum heat input capacity of each fuel combustion unit is less than 10 MMBtu/hour;

 The total heat input capacity of the fuel combustion units at your facility is equal to or less than 30 

MMBtu/hour;

 The capacity of any volatile organic liquid storage tank at your facility does not exceed 19,812 gallons;

 You demonstrate, and obtain confirmation from the U.S. Environmental Protection Agency (EPA), that you

have followed the screening process the EPA has provided with respect to the protection of speciesthat are

federally-listed as threatened or endangered under the Endangered Species Act (ESA) or of habitat that is

federally-designated as “critical habitat” under the ESA; and

 You demonstrate, and obtain written confirmation from the EPA, that you followed the screening process to 

address any effects to historic properties eligible for protection under the National Historic Preservation Act 

(NHPA).

The reviewing authority retains discretion to terminate your coverage under the Permit by Rule and require a sourcespecific permit even if the above criteria are met. Reasons the reviewing authority may terminate a permitted source’s 

coverage under the Permit by Rule include:
EPA Form No. 5900-341

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Notification of Coverage: Petroleum Dry Cleaning Facilities Page 2 of 10

Version 1.0

1. The permittee is not in compliance with the provisions of the Permit by Rule; 

2. The reviewing authority determines that the emissions resulting from the construction or modification of the 

permitted source significantly contribute to NAAQS violations, which are not adequately addressed by the 

requirements in the Permit by Rule;

3. The reviewing authority has reason to believe that the permittee obtained coverage under the Permit by Rule by 

fraud or misrepresentation; or

4. The permittee failed to disclose a material fact required by the Notification of Coverage or the regulations 

applicable to the permitted source of which the applicant had or should have had knowledge at the time the 

permittee submitted the Notification of Coverage.

More Information

Information on the definition of a “modification” and “PTE” can be found at 40 CFR 49.152(d) and in the “Instructions” 

document. Additional information on the applicability of the Federal Indian Country Minor NSR Rule can be found at 40 

CFR 49.153.

Information on the ozone attainment status of the area where your facility is located can be found at: 

http://www.epa.gov/airquality/greenbook/. You may also contact your reviewing authority for information on the 

area’s attainment status.

Sources eligible for the Air Quality Permit by Rule for New or Modified True Minor Source Petroleum Dry Cleaning 

Facilities may also be subject to federal standards under 40 CFR 60 Subpart JJJ, Standards of Performance for Petroleum 

Dry Cleaners. The conditions applicable to sources seeking coverage under this Permit by Rule are intended to be 

generally consistent with the requirements in Subpart JJJ. However, compliance with the applicable requirements in 

Subpart JJJ is required independent of the conditions in the Permit by Rule, and not all requirements applicable under 

Subpart JJJ are necessarily included in the Permit by Rule. The Background Document for the Permit by Rule identifies 

the specific requirements in Subpart JJJ that are intended to be included in the Permit by Rule. In addition, information 

regarding the major federal regulations affecting petroleum dry cleaners is available here: 

http://www.epa.gov/dfe/pubs/garment/frapc/petrfact.htm. 

Instructions

Step 1: Notify your reviewing authority, including providing appropriate documentation, that you (1) meet one of the

criteria listed in the EPA’s screening process for the protection of any and all species that are federally-listed as

threatened or endangered under the ESA or of habitat that is federally-designated as “critical habitat” under the ESA; 

and (2) satisfy the EPA’s screening process for the NHPA. You must obtain written confirmation from the EPA that the 

threatened and endangered species and historic property screening procedures have been satisfied prior to submitting 

your Notification of Coverage under the Permit by Rule.

Step 2: After receiving notification that you have successfully met the requirements of Step 1, complete all sections of 

the Notification of Coverage under the Permit by Rule (i.e., pages 4 – 10). If you have questions, please contact the 

reviewing authority.

Step 3: Certify that your existing or proposed facility is/will be in compliance with the applicable requirements as stated 

in 40 CFR 49.163 and submit a copy of this notification to the reviewing authority and to the tribe in the area where the 

source is locating. Submittal of this notification form also satisfies the requirement that minor sources in Indian country 

register with the EPA.
EPA Form No. 5900-341

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Notification of Coverage: Petroleum Dry Cleaning Facilities Page 3 of 10

Version 1.0

After you submit the Notification of Coverage under the Permit by Rule to the reviewing authority:

 You may commence construction of your new source or modification of your existing source under the Permit by 

Rule.

 Your reviewing authority may request additional information from you in order to verify you are eligible for the 

Permit by Rule. 

Applicants are welcome to send comments on the EPA’s need for the information in this application, 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.
EPA Form No. 5900-341

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Notification of Coverage: Petroleum Dry Cleaning Facilities Page 4 of 10

Version 1.0

Notification of Coverage under the Air Quality Permit by Rule for New or Modified 

True Minor Source Petroleum Dry Cleaning Facilities in Indian Country

Last Modified: March 23, 2015

Version 1.0

Prior to construction or modification, complete this application and submit it to your reviewing authority.

A list of reviewing authorities, their area of coverage, and contact information can be found in Attachment D to the Air 

Quality Permit by Rule for New or Modified True Minor Source Petroleum Dry Cleaning Facilities in Indian Country or 

visit: http://www.epa.gov/air/tribal/tribalnsr.html.

For assistance with this notification please contact your reviewing authority. 

For instructions on completing this notification please see the document “Instructions for Notification of Coverage 

under the Air Quality Permit by Rule for New or Modified True Minor Source Petroleum Dry Cleaning Facilities in

Indian Country.”

Section 1: Contact Information

1. Business Name: 2. Date:

3. Site Address: 4. County:

5. Name of Operator at Site (if different from owner): 6. Phone of Operator or Contact at Site (if different from 

owner):

7. Owner: 8. Telephone Number of Owner:

9. Owner’s Mailing Address: 10.Send all correspondence regarding this application to:

Company Name:

c/o:

Address: 

11. Authorized contact regarding this permit application:

Name:

Title:

Phone: 

Email:

FAX:
EPA Form No. 5900-341

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Notification of Coverage: Petroleum Dry Cleaning Facilities Page 5 of 10

Version 1.0

Section 2: Facility and Technical Information for the Notification of Coverage under the Air Quality 

Permit by Rule for New or Modified True Minor Source Petroleum Dry Cleaning Facilities in 

Indian Country

12. This notification is for:

A new petroleum dry cleaning facility (please describe the proposed new source).

_______________________________________________________________________________________________

_______________________________________________________________________________________________

Modification of an existing petroleum dry cleaning facility. Please describe the modification below. The definition 

of “modification” can be found at 40 CFR 49.152(d), and in the “Instructions” document available for completing 

this notification form.

_______________________________________________________________________________________________

_______________________________________________________________________________________________

13. North American Industry Classification System/Standard Industrial Classification Code and/or description of the 

facility:

_______________________________________________________________________________________________

_______________________________________________________________________________________________

14. Will your new or modified facility be located in a serious, severe, or extreme ozone nonattainment area? 

Information on the ozone attainment status of the area where your facility is or will be located can be 

found at: http://www.epa.gov/airquality/greenbook/.

Yes No

If you answered ‘Yes,’ specify the classification of the ozone nonattainment area:

Marginal Moderate Serious Severe Extreme

15. Will the PTE of your new facility, or the increase in potential emissions from your modified existing facility, be 

equal to or above the applicable minor NSR thresholds listed below for ANY of the listed pollutants, both in tons 

per year (tpy)? Emissions from your facility may be calculated using the PTE calculator available online at:

http://www.epa.gov/air/tribal/tribalnsr.html. Be sure to include all new or modified emission units at your facility.

Pollutant Attainment Area Nonattainment Area

Carbon Monoxide (CO) 10 tpy 5 tpy

Particulate Matter (PM) 10 tpy 5 tpy

Particulate Matter 

(PM10) 5 tpy 1 tpy

Particulate Matter 

(PM2.5) 3 tpy 0.6 tpy

Sulfur Dioxide (SO2) 10 tpy 5 tpy

Nitrogen Oxides (NOX) 10 tpy 5 tpy
EPA Form No. 5900-341

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Notification of Coverage: Petroleum Dry Cleaning Facilities Page 6 of 10

Version 1.0

Pollutant Attainment Area Nonattainment Area

Volatile Organic 

Compounds (VOC) 5 tpy 2 tpy

Yes No

If you answered ‘No,’ your source is exempt from the minor NSR program. Please contact your reviewing authority 

to confirm that your facility will not need a permit. If you answered ‘Yes,’ continue on to the next question.

16. If located in an attainment, attainment/unclassifiable or unclassifiable area, will the PTE of your facility be 

less than 250 tpy for PM, PM10, PM2.5, VOC, NOX, CO, and SO2? Be sure to include all existing, new, and 

modified emission units at your facility.

Yes No

If you answered ‘No,’ your source does not qualify for the Permit by Rule. Please contact your reviewing 

authority to apply for a site-specific permit. If you answered ‘Yes,’ continue on to the next question.

17. If located in a nonattainment area, will the PTE of your facility for the particular nonattainment pollutant 

be less than the NSR major source thresholds below for ALL pollutants? Be sure to include all existing, 

new, and modified emission units at your facility.

Pollutant Nonattainment Classification NSR Major Source Threshold

Ozone Marginal 100 tpy of VOC or NOX

Moderate 100 tpy of VOC or NOX

Serious 50 tpy of VOC or NOX

Severe 25 tpy of VOC or NOX

Extreme 10 tpy of VOC or NOX

PM10 Moderate 100 tpy

Serious 70 tpy

CO Moderate 100 tpy

Serious 50 tpy

SO2, NO2, PM2.5 No nonattainment classification 100 tpy

Yes No N/A - Not located in any nonattainment area

If you answered ‘No,’ your source does not qualify for the Permit by Rule. Please contact your reviewing 

authority to apply for a site-specific permit. If you answered ‘Yes’ or ‘N/A,’ continue on to the next question.
EPA Form No. 5900-341

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Notification of Coverage: Petroleum Dry Cleaning Facilities Page 7 of 10

Version 1.0

18. Is your annual solvent usage less than the thresholds required under 40 CFR 49.163?

Yes No

If no, your source does not qualify for a Permit by Rule under 40 CFR 49.163 and you must obtain a site-specific 

permit from your reviewing authority.

19. Is the maximum heat input capacity of each fuel combustion unit less than 10 MMBtu/hour and the total combined 

heat input capacity of all fuel combustion units less than 30 MMBtu/hour?

Yes No

If you answered ‘No,’ your source does not qualify for the Permit by Rule under 40 CFR 49.163 and you must 

obtain a site-specific permit from your reviewing authority.

20. Do you agree to comply with all requirements of the Permit by Rule as stated in 40 CFR 49.163?

Yes No

If you answered ‘No,’ your source does not qualify for the Permit by Rule under 40 CFR 49.163 and you must 

obtain a site-specific permit from your reviewing authority.

21. Emission Units

Information regarding the existing and planned emission units at your facility is required by 40 CFR 49.154 

and 49.160. Please provide the information in the following table for each emission unit at the site that is 

or will be owned, leased or operated by the applicant. Examples of potential emission units include 

combustion units, volatile liquid storage tanks, and petroleum dry cleaning dryers. 

For each emission unit, include supporting documentation for the PTE of each unit with your notification of 

coverage. In addition, for existing units, include the most recent actual annual emissions. See 40 CFR 

49.154(a)(2). (For more information on how to calculate actual emissions, go to: 

http://www.epa.gov/air/tribal/tribalnsrcalculators.html.) As needed, please include any other relevant 

information with your notification. 
EPA Form No. 5900-341

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Notification of Coverage: Petroleum Dry Cleaning Facilities Page 8 of 10

Version 1.0

List of Existing and Planned Emission Units (attach additional copies of this table as necessary):

Unit ID#

Description of Equipment and/or 

Process

Materials or Fuel 

(attach material safety 

data sheets for each 

volatile liquid or 

coating)

Maximum

Capacity or 

Production Rate

Description of 

Pollution Control 

Equipment

Operating 

Schedule

Existing, New 

or Modified 

(including 

installation 

for existing)
EPA Form No. 5900-341

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Notification of Coverage: Petroleum Dry Cleaning Facilities Page 9 of 10

Version 1.0

Section 3: Information on Completing Screening Processes that Have Been Satisfied Prior to 

Submitting a Notification of Coverage under the Air Quality Permit by Rule for New or Modified 

True Minor Source Petroleum Dry Cleaning Facilities in Indian Country

22. Threatened or Endangered Species

Have you obtained confirmation from the EPA that you have satisfactorily completed the screening process 

for the protection of any and all species that are federally-listed as threatened or endangered under the ESA

or of habitat that is federally-designated as “critical habitat” under the ESA? If you answer ‘No,’ you cannot 

gain coverage under the Permit by Rule.

Yes No

23. Historic Properties

Have you obtained confirmation from the EPA that you have satisfactorily completed the screening process

to determine if the construction, modification or operation of your new or modified true minor source of air 

pollutants has the potential to cause effectsto historic properties (pursuant to the NHPA)? If you answer

‘No,’ you cannot gain coverage under the Permit by Rule.

Yes No

Section 4: Additional Information about this Air Quality Permit by Rule for New or Modified True 

Minor Source Petroleum Dry Cleaning Facilities in Indian Country

This section provides information on the sizes of sources in terms of emissions that are eligible for the Permit by Rule. 

The emission limitations and standards in this permit are generally expected to ensure that source-wide emissions are 

below the rates shown in the following table:

Pollutant of 

Concern

Ozone 

Nonattainment 

Areas

Ozone Attainment, 

Unclassifiable or 

Attainment/Unclassifiable

Areas

VOC 7 tpy 25 tpy
EPA Form No. 5900-341

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Notification of Coverage: Petroleum Dry Cleaning Facilities Page 10 of 10

Version 1.0

Applicant’s Statement (to be signed by the applicant)

I certify that this document and all attachments were prepared under my direction or supervision according to a system 

designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my 

inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the 

information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.

Name: _____________________________Name: ____________________________Date:__________

(Signature) (Print or Type)

Title: _____________________________________