Instructions for Emissions Testing Template

1) Three different tabs are provided based on the type of test performed: 

Emissions source test results should be entered in the "Emissions_Data" tab

Wastewater sampling data should be entered in the "Wastewater_Data" tab

Cooling water system sampling data should be entered in the "CoolingWater_Data" tab

*** Fuel gas sampling data should be entered in Refinery Testing Supplement – Version 2 for Fuel Gas 

2) Data should be entered into the white cells only; blue cells are intended for calculations

3) A list of pollutants, their CAS No./Pollutant Code, and their pollutant category are provided in the "Pollutants" tab

4) Guidance for process data to report is provided below:

For fluid or thermal catalytic cracking units, “throughput/production” (in bbl/hr) is determined in terms of charged liqu

both fresh and recycle feed. Use coke burn-off rate (lb/hr) as the secondary process data element.

For fluid coking units, “throughput/production” (in bbl/hr) is determined in terms of charged liquid material. Use coke b

the secondary process data element.

For delayed coking units, “throughput/production” is determined in terms of charged liquid material over the course of 

(bbl/cycle) . Use coke production rate (lb dry coke/drum cycle) as the secondary process data element.

For catalytic reforming units, “throughput/production” is determined in terms of charged liquid material. For continuo

actual charge rate during the test (in bbl/hr); for cyclic and semi-regenerative reformers, provide cumulative charge qua

For fluid or thermal catalytic cracking units, “throughput/production” (in bbl/hr) is determined in terms of charged liqu

both fresh and recycle feed. Use coke burn-off rate (lb/hr) as the secondary process data element.

For fluid coking units, “throughput/production” (in bbl/hr) is determined in terms of charged liquid material. Use coke b

the secondary process data element.

For delayed coking units, “throughput/production” is determined in terms of charged liquid material over the course of 

(bbl/cycle) . Use coke production rate (lb dry coke/drum cycle) as the secondary process data element.

For catalytic reforming units, “throughput/production” is determined in terms of charged liquid material. For continuo

actual charge rate during the test (in bbl/hr); for cyclic and semi-regenerative reformers, provide cumulative charge qua

regeneration (MMbbl/charge cycle). Use coke burn-off rate (lb/hr) as the secondary process data element for the coke b

chording agent addition rate (lb/hr) for rejuvenation purge as the secondary process data element.

For catalytic hydrocracking units, “throughput/production” (in bbl/hr) is determined in terms of charged liquid materia

hydrogen). Use hydrogen addition rate coke production rate (scf/hr using 32°F (0°C) and 1 atmosphere as “standard co

secondary process data element.

For hydrogen production units, “throughput/production” (scf/hr using 32°F (0°C) and 1 atmosphere as “standard condit

quantity of purified hydrogen produced. No secondary process data are required. 

For asphalt blowing units, “throughput/production” is based on quantity of asphalt in blowing still (bbl/batch). Use blo

(scf/hr using 68°F (20°C) and 1 atmosphere as “standard conditions”) as the secondary process data.

For sulfur recovery units, “throughput/production” is based on quantity of elemental sulfur (for Claus units) or other su
 for Fuel Gas 

ed in the "Pollutants" tab

Form Approved 03/28/2011

OMB Control No. 2060-0657

Approval Expires 03/31/2014

ned in terms of charged liquid material, including 

d liquid material. Use coke burn-off rate (lb/hr) as 

d material over the course of a drum cycle 

quid material. For continuous reformers, provide 

ovide cumulative charge quantity since last 

ned in terms of charged liquid material, including 

d liquid material. Use coke burn-off rate (lb/hr) as 

d material over the course of a drum cycle 

quid material. For continuous reformers, provide 

ovide cumulative charge quantity since last 

s data element for the coke burn-off vent. Use 

ms of charged liquid material (i.e., excluding 

atmosphere as “standard conditions”) as the 

mosphere as “standard conditions”) is based on 

ing still (bbl/batch). Use blowing air inlet flow rate 

r (for Claus units) or other sulfur product produced 
Emissions Test Data

Instruction:

Enter APCD used 

during test. Enter 

more than 1 APCD 

if needed (e.g., 

ESP1/WS1)

Enter other source 

reduction measures 

used during emission 

test (e.g., low NOx 

burners or catalyst 

additives)

General source description, 

e.g., Fluid catalytic cracking 

unit; semiregenerative 

catalytic reforming unit; etc.

Assign a 

unique ID 

for each test 

report Enter start date 

Field:

Facility ID 

Number

Unit ID 

Number APCD ID(s)

Combustion controls 

used to reduce air 

pollution (from 

combustion sources) General Description

Test Report 

ID

Test Date

(mm/dd/yyyy)

PA1A1030 1232 SCR/WGS Fluid Catalytic Cracking M OH 06/22/2011

CTM027 06/24/2011

M18 07/08/2011

Form Approved 03/28/2011

OMB Control No. 2060-0657

Approval Expires 03/31/2014
M29 06/23/2011

M0061 06/27/2011

M0010 07/08/2011

M0011 07/08/2011

M23 06/21/2011

M7E 06/24/2011

M6C 06/24/2011

M5/202 06/24/2011

M25A 07/08/2011

M26A 06/21/2011

M10 06/24/2011
Enter the feed input rate or production rate in units as specified in table for Que

of Part I (see instructions tab for details)

Process Throughput or Production Rate

Pollutant Name Pollutant CAS No. Pollutant Class Test Method

Run 1

Hourly 

Production 

Rate

(value)

Run 2

Hourly 

Production 

Rate

(value)

Run 3

Hourly 

Production 

Rate

(value)

Average

Hourly 

Production 

Rate

(value)

Mercury 7439-97-6 Metal HAP ASTM D6784- 2813.58757 2916.48079 2916.48079 2882.183051

Ammonia 7664-41-7 Other Compounds EPA CTM027 3021.027995 3021.027995 3021.027995 3021.027995

Ethane 74-84-0 Other Compounds EPA M 18 3413.702148 3389.332357 3358.299154 3387.11122

Methane 3413.702148 3389.332357 3358.299154 3387.11122

2,2,4-Trimethylpentane 540-84-1 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

Carbon Disulfide 75-15-0 Other Inorganic HAP 3413.702148 3389.332357 3358.299154 3387.11122

1,3-Butadiene 106-99-0 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

2-Propanone 3413.702148 3389.332357 3358.299154 3387.11122

Methyle Isobutyl Ketone 108-10-1 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

Methylene Chloride 75-09-2 3413.702148 3389.332357 3358.299154 3387.11122

Ethylene Dibromide 106-93-4 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

1,1,1-Trichloroethane 3413.702148 3389.332357 3358.299154 3387.11122

Trichloroethylene 79-01-6 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

Tetrachloroethylene 127-18-4 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

Benzene 71-43-2 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

Enter the pollutant information for each pollutant measured (see 

pollutant tab for list of possible pollutants)
Toluene 108-88-3 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

Ethylbenzene 100-41-4 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

p+m-Xylene 106-42-3 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

o-Xylene 95-47-6 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

Chlorobenzene 108-90-7 3413.702148 3389.332357 3358.299154 3387.11122

Cumene (isopropylbenzene)98-82-8 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

Hexane 110-54-3 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

Total Xylene 1330-20-7 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

Total Metals Metals 2813.587565 2916.480794 2916.480794 2882.183051

Hexavalent Chrome 18540-29-9 Metal HAP SW-846 M0061 3169.92513 3169.92513 3169.92513 3169.92513

Total SVOCs VOC SW-846 M0010 3413.702148 3389.332357 3358.299154 3387.11122

Formaldehyde 50-00-0 Volatile Organic HAPSW-846 M0011 3413.702148 3389.332357 3358.299154 3387.11122

Acetaldehyde 75-07-0 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

Acrolein 107-02-8 Volatile Organic HAP 3413.702148 3389.332357 3358.299154 3387.11122

Propionaldehyde 3413.702148 3389.332357 3358.299154 3387.11122

Dioxins Furans and PCBs Dioxins Furans and PCBs EPA M23 2810.86263 2810.86263 2813.587565 2811.770942

NOx NOX Criteria Pollutants EPA M7E 3021.027995 3021.027995 3021.027995 3021.027995

SO2 7446-09-5 Criteria Pollutants EPA 6C 3021.027995 3021.027995 3021.027995 3021.027995

Filterable Grains/DSCF Criteria Pollutants EPA M5/M202 3021.027995 3021.027995 3021.027995 3021.027995

Organic CPM Grains/DSCF Criteria Pollutants 3021.027995 3021.027995 3021.027995 3021.027995

Inorganic CPM Grains/DSCF Criteria Pollutants 3021.027995 3021.027995 3021.027995 3021.027995

Total PM Grains/DSCF Criteria Pollutants 3021.027995 3021.027995 3021.027995 3021.027995

Total Hydrocarbon (THC) THC Surrogate EPA M25A 3413.702148 3389.332357 3358.299154 3387.11122

Hydrogen chloride 7647-01-0 Other Inorganic HAPEPA M26A 2810.86263 2810.86263 2813.587565 2811.770942

Hydrogen fluoride 7664-39-3 Other Inorganic HAP 2810.86263 2810.86263 2813.587565 2811.770942

Chlorine 7782-50-5 Other Inorganic HAP 2810.86263 2810.86263 2813.587565 2811.770942

Hydrogen cyanide (& cyanide compounds) 74-90-8 Other Inorganic HAP 2810.86263 2810.86263 2813.587565 2811.770942

Carbon monoxide 630-08-0 Criteria Pollutants EPA M10 3021.027995 3021.027995 3021.027995 3021.027995
nits as specified in table for Question 16 

s tab for details)

Provide other processing rate data as specified in the instructions for the type of unit 

tested.

Secondary Processing Rate Data Outlet - Run 1 Stack Gas Parameters

Hourly 

Production 

Rate

(units)

Production 

comment

Run 1

Hourly 

Production 

Rate

(value)

Run 2

Hourly 

Production 

Rate

(value)

Run 3

Hourly 

Production 

Rate

(value)

Average

Hourly 

Production 

Rate

(value)

Hourly 

Production 

Rate

(units)

Production 

comment

Run 1

Airflow Rate 

Outlet

(acfm)

Run 1

Airflow Rate 

Outlet

(scfm)

BBL/HR 561378 490698

BBL/HR 575210 499778

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139
BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 575890 50534

BBL/HR 580499 510841

BBL/HR 578289 505856

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 574759 501139

BBL/HR 553009 483977

BBL/HR 574656 499297

BBL/HR 574656 499297

BBL/HR 557670 485376

BBL/HR 557670 485376

BBL/HR 557670 485376

BBL/HR 557670 485376

BBL/HR 574759 501139

BBL/HR 523192 458049

BBL/HR 523192 458049

BBL/HR 523192 458049

BBL/HR 523192 458049

BBL/HR 574849 498918
 Gas Parameters Outlet - Run 2 Stack Gas Parameters

Run 1

Airflow Rate 

Outlet

(dscfm)

Run 1

Gas Moisture 

Outlet

(%)

Run 1

Gas Temp 

Outlet

(F)

Run 1

Gas Pressure 

Outlet

(in. Hg)

Run 1

Gas Oxygen 

Outlet

(%)

Run 2

Airflow Rate 

Outlet

(acfm)

Run 2

Airflow Rate 

Outlet

(scfm)

Run 2

Airflow Rate 

Outlet

(dscfm)

Run 2

Gas Moisture 

Outlet

(%)

381696 22.21 143 0.06 4 597016 520242 403982 22.35

393739 21.22 143.8 0.06 3.7 571745 496905 392288 21.05

393166 21.55 144.25 0.06 4 569865 502267 397151 20.93

393166 21.55 144.25 0.06 4 569865 502267 397151 20.93

393166 21.55 144.25 0.06 4 569865 502267 397151 20.93

393166 21.55 144.25 0.06 4 569865 502267 397151 20.93

393166 21.55 144.25 0.06 4 569865 502267 397151 20.93

393166 21.55 144.25 0.06 4 569865 502267 397151 20.93

393166 21.55 144.25 0.06 4 569865 502267 397151 20.93

393166 21.55 144.25 0.06 4 569865 502267 397151 20.93

393166 21.55 144.25 0.06 4 569865 502267 397151 20.93

393166 21.55 144.25 0.06 4 569865 502267 397151 20.93

393166 21.55 144.25 0.06 4 569865 502267 397151 20.93

393166 21.55 144.25 0.06 4 569865 502267 397151 20.93

393166 21.55 144.25 0.06 4 569865 502267 397151 20.93
393166 21.55 144.25 0.06

4 569865 502267 397151 20.93

393166 21.55 144.25 0.064 569865 502267 397151 20.93

393166 21.55 144.25 0.064 569865 502267 397151 20.93

393166 21.55 144.25 0.064 569865 502267 397151 20.93

393166 21.55 144.25 0.064 569865 502267 397151 20.93

393166 21.55 144.25 0.064 569865 502267 397151 20.93

393166 21.55 144.25 0.064 569865 502267 397151 20.93

393166 21.55 144.25 0.064 569865 502267 397151 20.93

387774 22.99 143.67 0.064 580723 507012 389088 23.26

397596 22.17 143 0.064 581378 511041 404320 20.88

396402 21.64 144.25 0.064 578894 506417 393383 22.32

393166 21.55 145 0.064 569865 502267 397151 20.93

393166 21.55 145 0.064 569865 502267 397151 20.93

393166 21.55 145 0.064 569865 502267 397151 20.93

393166 21.55 145 0.064 569865 502267 397151 20.93

380441 21.39 142.375 0.064 572951 500633 391445 21.81

393359 21.22 143.83 0.064 571745 496905 392288 21.05

393359 21.22 143.83 0.064 571745 496905 392288 21.05

389173 19.82 142.79 0.064 577671 502992 395094 21.45

389173 19.82 142.79 0.064 577671 502992 395094 21.45

389173 19.82 142.79 0.064 577671 502992 395094 21.45

389173 19.82 142.79 0.064 577671 502992 395094 21.45

393166 21.55 145 0.064 569865 502267 397151 20.93

359028 21.62 143.63 0.064 523192 458049 359028 21.53

359028 21.62 143.63 0.064 523192 458049 359028 21.53

359028 21.62 143.63 0.064 523192 458049 359028 21.53

359028 21.62 143.63 0.064 523192 458049 359028 21.53

393148 21.2 145 0.064 572379 502194 395729 21.2
Outlet - Run 3 Stack Gas Parameters

Run 2

Gas Temp 

Outlet

(F)

Run 2

Gas Pressure 

Outlet

(in. Hg)

Run 2

Gas Oxygen 

Outlet

(%)

Run 3

Airflow Rate 

Outlet

(acfm)

Run 3

Airflow Rate 

Outlet

(scfm)

Run 3

Airflow Rate 

Outlet

(dscfm)

Run 3

Gas Moisture 

Outlet

(%)

Run 3

Gas Temp 

Outlet

(F)

Run 3

Gas Pressure 

Outlet

(in. Hg)

143 0.06 4 576091 503710 393090 21.96 143.8 0.06

143.7 0.06 3.7 574995 500040 403108 19.38 143.3 0.06

142.9 0.06 4 574052 501315 394952 21.22 142.7 0.06

142.9 0.06 4 574052 501315 394952 21.22 142.7 0.06

142.9 0.06 4 574052 501315 394952 21.22 142.7 0.06

142.9 0.06 4 574052 501315 394952 21.22 142.7 0.06

142.9 0.06 4 574052 501315 394952 21.22 142.7 0.06

142.9 0.06 4 574052 501315 394952 21.22 142.7 0.06

142.9 0.06 4 574052 501315 394952 21.22 142.7 0.06

142.9 0.06 4 574052 501315 394952 21.22 142.7 0.06

142.9 0.06 4 574052 501315 394952 21.22 142.7 0.06

142.9 0.06 4 574052 501315 394952 21.22 142.7 0.06

142.9 0.06 4 574052 501315 394952 21.22 142.7 0.06

142.9 0.06 4 574052 501315 394952 21.22 142.7 0.06

142.9 0.06 4 574052 501315 394952 21.22 142.7 0.06
142.9 0.06

4 574052 501315 394952 21.22 142.7 0.06

142.9 0.064 574052 501315 394952 21.22 142.7 0.06

142.9 0.064 574052 501315 394952 21.22 142.7 0.06

142.9 0.064 574052 501315 394952 21.22 142.7 0.06

142.9 0.064 574052 501315 394952 21.22 142.7 0.06

142.9 0.064 574052 501315 394952 21.22 142.7 0.06

142.9 0.064 574052 501315 394952 21.22 142.7 0.06

142.9 0.064 574052 501315 394952 21.22 142.7 0.06

143.75 0.064 569831 486644 379581 22 145.042 0.06

143.208 0.064 580503 510562 402041 21.26 143.33 0.06

142.95 0.064 562211 490745 382523 22.05 142.66 0.06

138.46 0.064 574052 501315 394952 21.22 144 0.06

138.46 0.064 574052 501315 394952 21.22 144 0.06

138.46 0.064 574052 501315 394952 21.22 144 0.06

138.46 0.064 574052 501315 394952 21.22 144 0.06

143.33 0.064 576091 503710 393090 21.96 143.667 0.06

143.67 0.064 574565 499666 402806 19.38 143.29 0.06

143.67 0.064 574565 499666 402806 19.38 143.29 0.06

142.54 0.064 586685 511159 400914 21.57 142.16 0.06

142.54 0.064 586685 511159 400914 21.57 142.16 0.06

142.54 0.064 586685 511159 400914 21.57 142.16 0.06

142.54 0.064 586685 511159 400914 21.57 142.16 0.06

143.9 0.064 574052 501315 394952 21.22 144 0.06

143.54 0.064 573478 500679 391148 21.88 143.83 0.06

143.54 0.064 573478 500679 391148 21.88 143.83 0.06

143.54 0.064 573478 500679 391148 21.88 143.83 0.06

143.54 0.064 573478 500679 391148 21.88 143.83 0.06

143.9 0.064 575130 501059 394334 21.3 144 0.06
Outlet - Average Stack Gas Parameters Outlet - Run 1 Emissions Data

Run 3

Gas Oxygen 

Outlet

(%)

Average

Airflow Rate 

Outlet

(acfm)

Average

Airflow Rate 

Outlet

(scfm)

Average

Airflow Rate 

Outlet

(dscfm)

Average

Gas Moisture 

Outlet

(%)

Average

Gas Temp 

Outlet

(F)

Average Gas 

Pressure Outlet

(in. Hg)

Average

Gas Oxygen 

Outlet

(%)

Run 1 Outlet

concentration

4 578161.6667 504883.3333 392922.667 22.17333333 143.2666667 0.06 4 0.0011

3.82 573983.3333 498907.6667 396378.333 20.55 143.6 0.06 3.74 [<2.2]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 5400

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 2000

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 1230

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.7]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 40.1
4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 2230

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 572892 501573.6667 395089.667 21.23333333 143.2833333 0.06 4 [<0.1]

4 575481.3333 348063.3333 385481 22.75 144.154 0.06 4 0.1946

4 580793.3333 510814.6667 401319 21.43666667 143.1793333 0.06 4 0.00035

4 573131.3333 501006 390769.333 22.00333333 143.2866667 0.06 4 0.000182

4 572892 501573.6667 395089.667 21.23333333 142.4866667 0.06 4 0.0072

4 572892 501573.6667 395089.667 21.23333333 142.4866667 0.06 4 0.00168

4 572892 501573.6667 395089.667 21.23333333 142.4866667 0.06 4 [<0.4]

4 572892 501573.6667 395089.667 21.23333333 142.4866667 0.06 4 0

4 567350.3333 496106.6667 388325.333 21.72 143.124 0.06 4 0.0012

4 573655.3333 498622.6667 396151 20.55 143.5966667 0.06 4 4.99

4 573655.3333 498622.6667 396151 20.55 143.5966667 0.06 4 4.41

4 574008.6667 499842.3333 395060.333 20.94666667 142.4966667 0.06 4 0.0205

4 574008.6667 499842.3333 395060.333 20.94666667 142.4966667 0.06 4 0.0004

4 574008.6667 499842.3333 395060.333 20.94666667 142.4966667 0.06 4 0.0182

4 574008.6667 499842.3333 395060.333 20.94666667 142.4966667 0.06 4 0.0391

4 572892 501573.6667 395089.667 21.23333333 144.3 0.06 4 0.53

4 539954 472259 369734.667 21.67666667 143.6666667 0.06 4 [<60ug]

4 539954 472259 369734.667 21.67666667 143.6666667 0.06 4 [<110ug]

4 539954 472259 369734.667 21.67666667 143.6666667 0.06 4 [<130ug]

4 539954 472259 369734.667 21.67666667 143.6666667 0.06 4 [<3ug]

4 574119.3965 500723.6667 394403.667 21.23333333 144.3 0.06 4 13.1
Enter 

BDL, 

DDL, or 

ADL

Enter 

BDL, 

DDL, or 

ADL

- Run 1 Emissions Data Outlet - Run 2 Emissions Data Outlet - Run 3 Emissions Data

Run 1 Outlet 

concentration units

Run 1 

Outlet 

Detect 

Flag

Run 1 Outlet

(lb/hr)

Run 2 Outlet

concentration

Run 2 Outlet 

concentration 

units

Run 2 

Outlet 

Detect 

Flag

Run 2 Outlet

(lb/hr)

Run 3 Outlet

concentration

mg/dscm ADL 0.001575 8.99E-05 mg/dscm ADL 0.000136 0.00026683

mg/dscm BDL 0 [<2.2] mg/dscm BDL 0 [<2.2]

ppbv ADL 12.61611605 5400 ppbv ADL 12.64451332 5400

ppbv ADL 2.492486685 2000 ppbv ADL 2.498096955 2000

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

ppbv DDL 0 918 ppbv DDL 3.866647601 [<0.1]

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

ppbv ADL 9.571894753 0 ppbv ADL 0 687

ppbv BDL 0 [<0.7] ppbv BDL 0 [<0.7]

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

ppbv ADL 0.287072154 33.5 ppbv ADL 0.240363182 27
ppbv ADL 18.39522769 [<0.1] ppbv ADL 0 0

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

ppbv BDL 0 [<0.1] ppbv BDL 0 [<0.1]

mg/dscm ADL 0.2827 0.1146 mg/dscm ADL 0.1669 0.06746

mg/dscm ADL 0.000521 [<0.03] mg/dscm ADL 0 [<0.03]

mg/dscm ADL 0.000000058 [<1] mg/dscm ADL 0 [<1]

mg/dscm ADL 0.010707 0.00784 mg/dscm ADL 0.011669 0.00668

mg/dscm ADL 0.002471 0.0028 mg/dscm ADL 0.004168 0.00223

mg/dscm BDL 0 [<0.4] mg/dscm BDL 0 [<0.4]

mg/dscm 0 0 mg/dscm 0 0

TEQ@7%02 Ng/M3 total ADL 0.0009 TEQ@7%02 Ng/M3 total ADL 0.0012

ppm ADL 13.9987 4.78 ppm ADL 13.3731 3.59

ppm ADL 17.228162 6.88 ppm ADL 26.8053 9.27

grain/dscf ADL 68.4922 0.0244 grain/dscf ADL 82.5758 0.0276

grain/dscf ADL 1.3354 0.0004 grain/dscf ADL 1.3109 0.0004

grain/dscf ADL 60.7603 0.0033 grain/dscf ADL 11.143 0.0078

grain/dscf ADL 130.5879 0.0281 grain/dscf ADL 95.0297 7.5559E-06

ppm ADL 1.238 0.17 ppm ADL 0.39717 0.13

mg/dscm DDL 0 0.88108 mg/dscm DDL 1.293851 0.71047

mg/dscm BDL 0 [<110ug] mg/dscm BDL 0 [<110ug]

mg/dscm BDL 0 [<130ug] mg/dscm BDL 0 [<130ug]

mg/dscm BDL 0 [<3ug] mg/dscm BDL 0 [<3ug]

ppm ADL 22.39 14.9 ppm ADL 25.64 13.3
Enter 

BDL, 

DDL, or 

ADL

Note any sample 

collection method 

deviations

- Run 3 Emissions Data Outlet - Average Emissions Data Comments

Run 3 Outlet 

concentration 

units

Run 3 

Outlet 

Detect 

Flag

Run 3 Outlet

(lb/hr)

Average Outlet

concentration

Average Outlet 

concentration units

Count 

Outlet NonDetect RunsAverage Outlet

(lb/hr) Sampling comments

mg/dscm ADL 0.000417 0.000485577 mg/dscm 0 0.000709333

mg/dscm BDL 0 3 0

ppbv ADL 12.62054683 0 12.62705874

ppbv ADL 2.493362047 0 2.494648562

ppbv BDL 0 3 0

ppbv DDL 0 0 1.288882534

ppbv BDL 0 3 0

ppbv ADL 5.348131015 0 4.973341922

ppbv BDL 0 3 0

ppbv BDL 0 3 0

ppbv BDL 0 3 0

ppbv BDL 0 3 0

ppbv BDL 0 3 0

ppbv BDL 0 3 0

ppbv ADL 0.193358361 0 0.240264566
ppbv ADL

0

0 6.131742564

ppbv BDL0

3

0

ppbv BDL0

3

0

ppbv BDL0

3

0

ppbv BDL0

3

0

ppbv BDL0

3

0

ppbv BDL0

3

0

ppbv BDL0

3

0

mg/dscm ADL 0.095930 0.181843333

mg/dscm ADL0

0 0.000173667

mg/dscm ADL0

0 1.93333E-08

mg/dscm ADL 0.0098760 0.010750667

mg/dscm ADL 0.0032920 0.003310333

mg/dscm BDL

0

3

0

mg/dscm

00

TEQ@7%02 

Ng/M3 total ADL0

ppm ADL 10.3130880 12.56162933

ppm ADL 37.08540 27.03962067

grain/dscf ADL 94.86660 81.9782

grain/dscf ADL 1.30780 1.318033333

grain/dscf ADL 26.80960 32.9043

grain/dscf ADL 122.9840 116.2005333

ppm ADL 0.646380 0.760516667

mg/dscm DDL 1.040920 0.778257

mg/dscm BDL

0

3

0

mg/dscm BDL

0

3

0

mg/dscm BDL

0

3

0

ppm ADL 22.830 23.62
Note any analytical 

deviations 

Note any QA issues, 

such as unusal blanks

Analytical comments QA Comments Other comments

Well-Mixed Assessment 

Criteria or Description Value

Meets definition of EBU

Meets characteristics in Table 1

Meets specifications in Table 2

Calculated mixing time

Forms used to calculate mixing time

Waste Water Sampling Data

Instruction:

General source description, e.g., 

submerged aeration activated sludge unit; 

UNOX system; etc.

Assign a 

unique ID 

for each test 

report

Field:

Facility ID 

Number

Unit ID 

Number General Description

Test Report 

ID

PA1A1030 1232 WGS Recirc Agglo Filter

Quench 

Form Approved 03/28/2011

OMB Control No. 2060-0657

Approval Expires 03/31/2014

F_bio Determination

Compound F_bio

First-order 

biorate, k1 

(L/gMLVSS-hr)

Benzene Only Spike

Benzene

Multi-compound Spike

Benzene

Toluene

Xylene

Naphthalene

Enter start date 

Test Date

(mm/dd/yyyy) Pollutant Name Pollutant CAS No. Pollutant Class Test Method

06/24/2011 Total Dissolved Solids ATSM D5907

Total Suspended Solids ATSM D5907

06/24/2011 Total Dissolved Solids ATSM D5907

Total Suspended Solids ATSM D5907

Enter the pollutant information for each pollutant measured (see 

pollutant tab for list of possible pollutants)

Enter the wastewater flow rate and other parameters of the wastewater of unit tested.

Process Throughput or Production Rate

Average 

wastewater 

flow rate 

during test 

(m3/s)

Wastewater 

pH

Wastewater 

temperature 

(deg, F)

Volatile suspended 

solids in biological 

treatment unit 

(g/L)

Total 

horsepower to 

surface 

aerators 

(HP)

Total air flow 

rate to diffused 

aerators (scfm 

at 68°F)

0.018 N/A N/A N/A N/A N/A

0.018 N/A N/A N/A N/A N/A

0.048 N/A N/A N/A N/A N/A

0.048 N/A N/A N/A N/A N/A

f unit tested.

Influent Sample Results Within Biological Treatment Unit Results 

Other 

information or 

comment

Concentration 

Value

Concentration 

units 

(μg/L or mg/L) Concentration Value

Concentration units 

(μg/L or mg/L)

2560 Mg/L N/A N/A

6376 Mg/L N/A N/A

1400 Mg/L N/A N/A

32170 Mg/L N/A N/A

Note any sample 

collection method 

deviations

Note any analytical 

deviations 

Note any QA issues, 

such as unusal blanks

Effluent Sample Results Comments

Concentration 

Value

Concentration 

units 

(μg/L or mg/L) Sampling comments Analytical comments QA Comments

N/A N/A

N/A N/A

N/A N/A

N/A N/A

Other comments

Sampling is conducted 

Cooling Water System Test Data

Instruction:

If sampling separate 

return lines for a single 

cooling tower, assign a 

unique ID for each 

return line

General source description, e.g., 

cooling tower for X,Y,Z units; 

east heat exchange return line 

(serving unit XX) to cooling 

tower 1; etc.

Assign a 

unique ID 

for each test 

report Enter start date 

Field:

Facility ID 

Number

Cooling Tower 

(HE System) ID Return Line ID General Description

Test Report 

ID

Test Date

(mm/dd/yyyy)

Form Approved 03/28/2011

OMB Control No. 2060-0657

Approval Expires 03/31/2014

Enter the appropriate flow rate (in gallons per minute, gpm) from 

measurement data, company records, or engineering analyses during the 

testing period 

Cooling Tower 

Recirculation 

Rate

(gpm)

Cooling Tower 

Water Make-up 

Rate 

(gpm)

Return Line Flow 

Rate (if sampling 

separate return 

line to a singe 

cooling tower)

(gpm)

Flow rate 

comment Pollutant Name Pollutant CAS No. Pollutant Class

Enter the pollutant information for each pollutant measured (see 

pollutant tab for list of possible pollutants)

Note any sample 

collection method 

deviations

Note any analytical 

deviations 

Note any QA issues, 

such as unusal blanks

Stripping Air Concentration Liquid Concentration Comments

Measured Air 

Concentration

(ppmv, dry basis) Test Method 

Liquid 

Concentration

(ppmw)

Test Method 

(enter "backcalculated" if not 

directly 

measured) Sampling comments Analytical comments QA Comments

Other comments

Substance CAS Number

1 Carbon monoxide 630-08-0

2 Particulate matter (PM) ≤ 10 μm PM10-PRI

3 Filterable PM ≤ 10 μm PM10-FIL

4 PM ≤ 2.5 μm PM25-PRI

5 Filterable PM ≤ 2.5 μm PM25-FIL

6 Condensable PM PM-CON

7 Nitrogen dioxide 10102-44-0

8 Nitrogen oxides NOX

9 Sulfur dioxide 7446-09-5

10 Volatile organic compounds VOC

11 Ethylene 74-85-1

12 Acetylene 74-86-2

13 Propane 74-98-6

14 Propylene 115-07-1

15 Propadiene 463-49-0

16 n-Butane 106-97-8

17 Isobutane 75-28-5

18 1-Butene 106-98-9

19 2-Butene 107-01-7

20 Isobutene 115-11-7

21 1,2-Butadiene 590-19-2

22 n-pentane 109-66-0

23 2-Methylbutane 78-78-4

24 Cyclopentane 287-92-3

25 1,2-Pentadiene 591-95-7

26 1-cis-3-Pentadiene 1574-41-0

27 1-trans-3-Pentadiene 2004-70-8

28 1,4-Pentadiene 591-93-5

29 2,3-Pentadiene 591-96-8

30 3-Methyl-1,2-butadiene 598-25-4

31 2-Methyl-1,3-butadiene 78-79-5

32 Cyclopentadiene 542-92-7

33 Cyclohexane 110-82-7

34 Methylcylcohexane 108-87-2

35 Heptane (and isomers) 142-82-5

36 Octane (and isomers) 111-65-9

37 Methyl ethyl ketone 78-93-3

38 Trimethylbenzene(s) 25551-13-7

39 Acetaldehyde 75-07-0

40 Acrolein 107-02-8

41 Analine 62-53-3

42 Benzene 71-43-2

43 Bromomethane 74-83-9
44 1,3-Butadiene 106-99-0

45 Chloroethane 75-00-3

46 Chloroform 67-66-3

47 Chloromethane 74-87-3

48 Cumene 98-82-8

49 1,2-Dibromoethane 106-93-4

50 1,4-Dichlorobenzene 106-46-7

51 1,1-Dichloroethane 75-34-3

52 1,2-Dichloroethane 107-06-2

53 1,1-Dichloroethylene 75-35-4

54 1,2-Dichloropropane 78-87-5

55 1,3-Dichloropropene 542-75-6

56 Diethanolamine 111-42-2

57 Ethylbenzene 100-41-4

58 Formaldehyde 50-00-0

59 Hexachloroethane 67-72-1

60 n-Hexane 110-54-3

61 Methanol 67-56-1

62 Methyl isobutyl ketone 108-10-1

63 Methyl tert-butyl ether 1634-04-4

64 Styrene 100-42-5

65 1,1,2,2-Tetrachloroethane 79-34-5

66 Tetrachloroethylene 127-18-4

67 Toluene 108-88-3

68 1,1,2-Trichloroethane 79-00-5

69 Trichloroethylene 79-01-6

70 Triethylamine 121-44-8

71 2,2,4-Trimethylpentane 540-84-1

72 Vinyl bromide 593-60-2

73 Vinyl chloride 75-01-4

74 o-Xylene 95-47-6

75 m-Xylene 108-38-3

76 p-Xylene 106-42-3

77 Xylenes (total) 1330-20-7

78 Acenaphthene 83-32-9

79 Acenaphthylene 208-96-8

80 Anthracene 120-12-7

81 Benzo(a)anthracene 56-55-3

82 Benzo(a)pyrene 50-32-8

83 Benzo(b)fluoranthene 205-99-2

84 Benzo(e)pyrene 192-97-2

85 Benzo(g,h,i)perylene 191-24-2

86 Benzo(k)fluoranthene 207-08-9

87 Biphenyl 92-52-4
88 Bis(2-ethyl hexyl)phthalate 117-81-7

89 2-Chloronaphthalene 91-58-7

90 m-Cresol 108-39-4

91 o-Cresol 95-48-7

92 p-Cresol 106-44-5

93 Cresols (total) 1319-77-3

94 Chrysene 218-01-9

95 Dibenz(a,h)anthracene 53-70-3

96 di-n-Butyl phthalate 84-74-2

97 Diethyl-phthalate 84-66-2

98 7,12-Dimethylbenz(a) anthracene 57-97-6

99 Fluoranthene 206-44-0

100 Fluorene 86-73-7

101 Indeno(1,2,3-cd) pyrene 193-39-5

102 3-Methylchloranthrene 56-49-5

103 2-Methylnaphthalene 91-57-6

104 Chrysene 218-01-9

105 Naphthalene 91-20-3

106 Perylene 198-55-0

107 Phenanthrene 85-01-8

108 Phenol 108-95-2

109 Pyrene 129-00-0

110 Dioxin: 4D 2378 1746-01-6

111 Dioxin: 5D 12378 40321-76-4

112 Dioxin: 6D 123478 39227-28-6

113 Dioxin: 6D 123678 57653-85-7

114 Dioxin: 6D 123789 19408-74-3

115 Dioxin: 7D 1234678 35822-46-9

116 Dioxin: 8D 3268-87-9

117 Dibenzofurans 132-64-9

118 Furan: 4F 2378 51207-31-9

119 Furan: 5F 12378 57117-41-6

120 Furan: 5F 23478 57117-31-4

121 Furan: 6F 123478 70648-26-9

122 Furan: 6F 123678 57117-44-9

123 Furan: 6F 123789 72918-21-9

124 Furan: 6F 234678 60851-34-5

125 Furan: 7F 1234678 67562-39-4

126 Furan: 7F 1234789 55673-89-7

127 Furan: 8F 39001-02-0

128 Polychlorinated biphenyls (total) 1336-36-3

129 Antimony 7440-36-0

130 Arsenic 7440-38-2

131 Beryllium 7440-41-7
132 Cadmium 7440-43-9

133 Chromium (hexavalent) 18540-29-9

134 Chromium (total) 7440-47-3

135 Cobalt 7440-48-4

136 Lead 7439-92-1

137 Manganese 7439-96-5

138 Mercury 7439-97-6

139 Nickel 7440-02-0

140 Selenium 7782-49-2

141 Carbon disulfide 75-15-0

142 Carbonyl sulfide 463-58-1

143 Chlorine 7782-50-5

144 Hydrogen chloride 7647-01-0

145 Hydrogen cyanide (& cyanide compounds) 74-90-8

146 Hydrogen fluoride 7664-39-3

147 Phosphorus 7723-14-0

148 Ammonia 7664-41-7

149 Ethane 74-84-0

150 Hydrogen sulfide 7783-06-4

151 Barium 7440-39-3

152 Copper 7440-50-8

153 Molybdenum 7439-98-7

154 Vanadium 7440-62-2

155 Zinc 7440-66-6

156 Higher Heating Value (HHV) HHV

157 Total Hydrocarbon (THC) THC

158 Total Reduced Sulfur (TRS) TRS

159 Sulfide Sulfide

160 5-day Biological Oxygen Demand BOD5

161 Chemical Oxygen Demand COD
Pollutant Class

Criteria Pollutants

Criteria Pollutants

Criteria Pollutants

Criteria Pollutants

Criteria Pollutants

Criteria Pollutants

Criteria Pollutants

Criteria Pollutants

Criteria Pollutants

Criteria Pollutants

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

VOC

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Form Approved 03/28/2011

OMB Control No. 2060-0657

Approval Expires 03/31/2014
Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP
Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Semi-Volatile/Non-Volatile Organic HAP

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Dioxins Furans and PCBs

Metal HAP

Metal HAP

Metal HAP
Metal HAP

Metal HAP

Metal HAP

Metal HAP

Metal HAP

Metal HAP

Metal HAP

Metal HAP

Metal HAP

Other Inorganic HAP

Other Inorganic HAP

Other Inorganic HAP

Other Inorganic HAP

Other Inorganic HAP

Other Inorganic HAP

Other Inorganic HAP

Other Compounds

Other Compounds

Other Compounds

Other Compounds

Other Compounds

Other Compounds

Other Compounds

Other Compounds

Surrogate

Surrogate

Surrogate

Surrogate

Surrogate

Surrogate