OMB Control No. 2060

- 0003

Approval expires 4/30/2017



## United States Environmental Protection Agency

General Permit for New or Modified Minor Sources of Air Pollution in

Indian Country

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



## Request for Coverage under the General Air Quality Permit for New or Modified

True Minor Source Boilers in Indian Country

Last Modified: July 2 , 2014

Version 1. 0

This request for coverage under the General Air Quality Permit f or New or Modified True Minor Source Boilers applies to

the construction of new, true minor source boilers or the modification of existing, true minor source boilers in Indian

Country that burn only natural gas or low

- sulfur liquid fuels

. This source category

– True Minor Source Boilers

– includes

stationary sources with boilers, process heaters and emergency engines. This permit applies to stationary sources that

, after the proposed construction or modificat ion project, have a combined total maximum heat input capacity for boilers

,

process heaters , and emergency engines as described below based on the ozone attainment status

. A boiler means an

enclosed device using controlled flame combustion in which water i s heated to recover thermal energy in the form of

steam and/or hot water

.

You qualify to apply for coverage under this general permit if you meet all of the following criteria:

 You plan to construct a new

, true minor source boiler (s) OR you plan to modify an existing, true minor

source boiler (s) ;

 Your new or modified true minor source boiler s is located within Indian Country;

 You p lan to construct or modify a boiler , process heater, or emergency engine that, after construction or

modi fication, burns only gaseous fuels or low

- sulfur (containing no more than 15 parts per million ( ppm )

(0.0015 percent) sulfur) liquid fuels;

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

 Your boile r has a PTE less than the major source thresholds for hazardous air pollutants (HAPs) ;

 Your boiler ( or process heater )

, if burning only natural gas

, is located in an attainment, unclassifiable, or

attainment /unclassifiable area for ozone or a marginal, moderate, serious

, or severe nonattainment area for

ozone and will meet the following combined maximum ratings for all equipment , based on ozone

designation/attainment area status :

Types of Emission Unit Combined Allowed Maximum Rating of Emissions Unit s

Ozone Designation/Attainment Status

Attainment,

Unclassifiable or

Attainment /

Unclassifiable Nonattainment

Marginal, Moderate,

or Serious Severe

All boilers rated ≥ 10.0 million

British thermal units ( MMBtu ) / hour

( hr ) 160 MMBtu/hr 160 MMBtu/hr 100 MMBtu/hr

All small boilers and process

heaters rated < 10.0 MMBtu/hr 20 MMBtu/hr 20 MMBtu/hr 20 MMBtu/hr

All emergency generators (all fuels) 1500 horsepower

( hp ) 1500 hp 1000 hpOMB Control No. 2060

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Request for Coverage : Boilers Page 2 of 19

Version 1.0  Your boiler (or process heater)

, if burning gaseous and/or liquid fuels

, is located in an attainment,

unclassifiable, or attainment/unclassifiable area for ozone or a marginal, moderate, serious, or severe

nonattainment area for ozone and will meet the following combined maximum ratings for all equipment

, based on ozone designation/attainment area status :

Types of Emission Units Combined Maximum Rating of Emissions Units

Ozone Designation/Attainment Status

Attainment,

Unclassifiable or

Attainment /

Unclassifiable Nonattainment

Marginal,

Moderate, or

Serious Severe

All boilers rated ≥ 10.0 MMBtu/hr 120 MMBtu/hr 120 MMBtu/hr 100 MMBtu/hr

All small boilers and auxiliary

heaters rated < 10.0 MMBtu/hr 20 MMBtu/hr 20 MMBtu/hr 20 MMBtu/hr

All emergency generators (all fuels) 1500 hp 1500 hp 1000 hp

 Your boiler

, if located in an extreme ozone nonattainment area , will use only natural gas in boilers and

process heaters and meet the following combined ma ximum ratings for all equipment :

Types of Emission Units Combined Allowed Maximum

Rating of Emissions Units

All boilers rated ≥ 2.0 MMBtu/hr 100 MMBtu/hr

All small boilers and auxiliary

heaters rated < 2.0 MMBtu/hr 20 MMBtu/hr

All emergency generators (all fuels) 750

 Y o u de m o n s t r a t e t h a t yo u meet o n e o f t h e c r i t er i a l i s t ed i n Appe ndix A w i t h re s p e c t t o t h e p r o t e c t i o n o f an y

an d al l s p e ci es t ha t a re feder all y

- li s t ed a s e n d an gered o r t h re a t e n ed u n der t h e E n d an gered S p e ci es A c t (ESA)

o r o f habi t a t t ha t i s feder all y

- de s i g na t ed a s “c r i t ic a l hab i t a t ” u n der t h e E S A; and

 Y o u have f o ll o wed t h e s c ree nin g p r o c ess i n A pp e n d i x B t o de t e r m in e i f the construction, modification o r operation

of your new or modified true minor source of air pollutants ha s t h e p o t e n t ia l t o ca u se effe c t s t o hi s t o r i c p r o p er t i e s

(pursuant to the National Historic Preservation Act (NHPA))

, an d w h e t h er y o u n eed t o c o n t ac t the appropriate

state o r t r iba l re p r e s e n t a t i ve f o r f u r t h er in f o rm a t i o n

.

This General Air Quality Permit for Boiler s is not applicable to:

 Boiler s that burn solid fuels (e.g.

, wood, wood wastes, coal, solid waste, tires, etc.) ;

 B oiler s that burn any liquid fuels other than low

- sulfur (containing no more than 15 ppm (0.0015 percent )

sulfur) biodiesel or fuel oil ;

 B oiler s that burn any liquid fuels in boilers and process heaters and are located in an extreme ozone

nonattainment area ; or

 Boilers that are 100 MMBtu/ h r or larger.OMB Control No. 2060

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Approval expires 4/30/2017

Request for Coverage : Boilers Page 3 of 19

Version 1.0 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 Indian Country Minor NSR rule can be

found at 40 CFR 49.153.

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

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

area’s attainment status.

Information on any available voluntary consensus standards that can used as alternatives to the emissions measurement

standards in the General Air Qua lity Permit f or New or Modified True Minor Source Boilers can be found in: “ Voluntary

Consensus Standard Results for General Permits and Permits by Rule for the Indian Country Minor New Source Review

Program; 40 CFR Part 49, Subparts 156 (c) and 162,” f rom Robin Segall

, Acting Group Leader

, Measurement Technology

Group, to Laura McKelvey

, Community and Tribal Programs Group

, February 7, 2014

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

.

The reviewing authority retains discretion to deny coverage under a general permit and require a source

- specific permit

even if the above criteria are met.



### Instructions

Step 1: Complete all sections of the permit application. If you have questions, please contact the reviewing authority

.

Step 2: Submit a copy of this permit application to the reviewing authority and the tribe in the area where the source is

locating

. 

### After you submit the application to the Reviewing Authority :

 You may not commence construction until you receive notification of the final decision on your application for

coverage under this general permit.

 Your reviewing authority will act on your permit as expeditiously as possible, and will notify you in writing within

30 days from receipt of your application

, if more information is needed. Upon deeming the application complete,

and if any additional information requested by the reviewing authority is received within 15 days of the request,

the reviewing authority will follow the pro cedures outlined in 40 CFR 49.156(e) and your permit application will

be granted or denied no later than 90 days after the receipt of your coverage request.

 Your reviewing authority will send you a letter notifying you of the approval or denial of your re quest for

coverage under this general permit if the reviewing authority determines that your request for coverage under

this general permit has all the relevant information and is complete. Such a letter is a final permit action for

purposes of judicial re view only for the issue of whether your source qualifies for this general permit

Applicants are welcome to s end comments on the U.S. Environmental Protection Agency’s (EPA’s) need for th e

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 compl eted form to this address.OMB Control No. 2060

- 0003

Approval expires 4/30/2017



## United States Environmental Protection Agency

General Permit for New or Modified Minor Sources of Air Pollution in

Indian Country

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



## Request for Coverage under the General Air Quality Permit for New or Modified

True Minor Source Boilers in Indian Country

Last Modified: July 2 , 2014

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

General Air Quality Permit for True Minor Source Boilers or visit: http://www.epa.gov/air/tribal/tribalnsr.html

.

For assistance with this application please contact your reviewing authority.

For instructions on completing this application please see the document “Instructions f or Requesting

Coverage under the General Air Quality Permit f or New or Modified True Minor Source Boilers i n Indian

Country .”



### Section 1: Contact Information

1. Business Name : 2. Date :

3. Site Address : 4. County :

5. Name of Operator or Contact at Site (if different from

owner) : 6. Telep hone of Operator or Contact at Site (if different

from owner) :

7. Owner : 8. Telephone Number of Owner :

9. Mailing Address of Owner : 10. C orrespondence Address :

Company Name:

C/o:

Address:

11. A uthorized C ontact Person :

Name:

Title:

Phone: Email:

FAX:OMB Control No. 2060

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Request for Coverage : Boilers Page 5 of 19

Version 1.0 

### Section 2: Facility Information for Requesting Coverage under the General Air Quality Permit for

New or Modified True Minor Source Boilers

12. This application is for (check all that apply) :

A new boiler source (please describe the proposed new source ).

_______________________________________________________________________________________________

___________________________________________________________ ____________________________________

A m odification to an existing boiler source ( p lease describe the modification below )

. T he definition of

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

.

______ _________________________________________________________________________________________

___________________________________________________________ ____________________________________

13. North American Industry Classification System (NAICS) /Standard Ind ustrial Classification (SIC) Code and/or

description of the facility:

_______________________________________________________________________________________________

___________________________________________________________ ________________________________ ____

 11**** NAICS Agriculture, greenhouses

 2211** NAICS Electric Power Generation

 321*** NAICS Wood product manufacturing (except sawmills)

 311*** NAICS Food manufacturing

 327*** NAICS Nonmetallic mineral product manufacturing (ex cept Ready

- Mix Concrete )

 424*** NAICS Wholesale trade, nondurable goods

 611110 NAICS Elementary and Secondary Schools

 611210 NAICS Junior Colleges

 611310 NAICS Colleges, Universities, and Professional Schools

 62  NAICS Health care and social assistance

 721120 NAICS Casino Hotels

 813110 NAICS Religious organizations

 92** ** NAICS Public administration

 2***

- 3*** SIC Manufacturing

 5*** SIC Wholesale and Retail Trade

 7011 SIC Hotels and Motels

 82** SIC Educational Services

 Other

– please specify _____NAICS; _____SIC

14. Is your new or modified boiler located in an ozone nonattainment area? Information on the ozone

attainment status of the area where your boiler is /will be located can be found at:

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

.

Yes No

If yes, specify the classification of the ozone nonattainment area:

Marginal Moderate Serious Severe ExtremeOMB Control No. 2060

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Request for Coverage : Boilers Page 6 of 19

Version 1.0 15. Is the PTE

, of your new boiler or the emissions increase from your modified existing boiler equal to or above the

applicable minor NSR thresholds listed below for ANY of the listed pollutant s , both in tons per year (tpy) ?

Emissions from your boiler may be calculated using the PTE calculator available online at :

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

. Be sure to include all new, modified, and existing emission units

when determining PT E.

Pollutant Attainment Area Nonattainment Area

Carbon Monoxide (CO) 10 tpy 5 tpy

Particulate Matter (PM) 10 tpy 5 tpy

Particulate Matter (PM 10 ) 5 tpy 1 tpy

Particulate Matter (PM 2.5 ) 3 tpy 0.6 tpy

Sulfur Dioxide (SO 2 ) 10 tpy 5 tpy

Nitrogen Oxides (NO X ) 10 tpy 5 tpy

Volatile Organic

Compounds (VOC s ) 5 tpy 2 tpy

Yes No

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

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

question

.

1 6

. If located in an attainment , unclassifiable, or attainment/unclassifiable area, is the PTE of your boiler less

than 250 tpy for PM, PM 10 , PM 2.5 , VOC s , NO X , CO, and SO 2 ? Be sure to include all existing, new, and

modified emission units.

Yes No

If you answered ‘No

, ’ your source does not qualify for the minor NSR program. Please contact your

reviewi ng authority to apply for a site

- specific permit. If you answered ‘Yes

, ’ continue on to the next

question.

1 7

. If located in a nonattainment area for any pollutant, is the PTE of your boiler for the particular

nonattainment pollutant less than the NSR ma jor source thresholds specified in the table below (based on

nonattainment classification)? The emissions from your boiler may be calculated using the PTE calculator

provided at http://www.epa.go v/air/tribal/tribalnsr.html

. Be sure to include all existing, new, and

modified emission units

.

Pollutant Nonattainment Classification NSR Major Source Threshold

Ozone Marginal 100 tpy of VOC or NO X

Moderate 100 tpy of VOC or NO X

Serious 50 tpy of VOC or NO XOMB Control No. 2060

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Request for Coverage : Boilers Page 7 of 19

Version 1.0 Pollutant Nonattainment Classification NSR Major Source Threshold

Severe 25 tpy of VOC or NO X

Extreme 10 tpy of VOC or NO X

PM 10 Moderate 100 tpy

Serious 70 tpy

CO Moderate 100 tpy

Serious 50 tpy

SO 2 , NO 2 , PM 2.5 No nonattainment classification 100 tpy

Yes No N/A

- Not located in any no nattainment area

If you answered ‘No

, ’ your source does not qualify for the minor NSR program. Please contact reviewing

authority to apply for a site

- specific permit. If you answered ‘Yes’ or ‘N/A

, ’ continue on to the next question.

1 8

. I s the PTE of your boiler below 10 tpy for a single HAP or 25 tpy for any combination of HAPs ? The

emissions from your boiler may be calculated using the PTE calculator provided at

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

. Be sure to include all existing, new, and modified

emission units.

Yes No

If you answered ‘No

, ’ your source does not qualify for the minor NSR program. Please contact your

reviewing authority to apply for a site

- specific permit. If you answered ‘Yes

, ’ continue on to the next

question.

19

. What will be the distance of the proposed boiler ( or heater) from the nearest property boundary (feet)?

___________ _______ What will be the distance of the proposed boiler ( or heater) from any adjacent residential or commercial

establishment or place of public assembly (feet) ?

__________________



### Section 3: Technical Information for Requesting Coverage under the General Air Quality Permit

for New or Modified True Minor Source Boilers

If needed, a dditional pages may be photocopied and added after this one. Use a unique ID# for each piece of

equipment.

2 0

. Boilers and Heaters

Unit

ID # Unit Description

(include whether new, modified or

existing) Fuel Type (s) Maximum

Rated Capacity

(MMBtu/ h r ) Manufacturer Date of

Construction

(mm/dd/yyyy)OMB Control No. 2060

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Request for Coverage : Boilers Page 8 of 19

Version 1.0 Unit

ID # Unit Description

(include whether new, modified or

existing) Fuel Type (s) Maximum

Rated Capacity

(MMBtu/ h r ) Manufacturer Date of

Construction

(mm/dd/yyyy)

2 1

. Emergency Engines

Unit

ID # Unit Description

(include whether new, modified or

existing) Fuel Type(s) Maximum

Rated

Capacity ( hp ) Manufactured

Date

(mm/dd/yyyy) Model

Year

2 2 . Volatile Liquid Storage Tanks

This section applies to storage tanks used to store liquid materials. Please provide the following information for

each s torage t ank.

Unit

ID # Type of

Liquid Capacity

(gallons) Vapor pressure

of L iquid ( psi ) Is the tank above

or underground? Date of I nstallation

(if existing)OMB Control No. 2060

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Request for Coverage : Boilers Page 9 of 19

Version 1.0 

### Section 4: Information on Compliance with Federal Statutes Necessary for Requesting Coverage

under the General Air Quality Permit for New or Modified True Minor Source Boilers

2 3 . Endangered Species Act

Have y o u de m o n s t r a t ed t h a t yo u meet o n e o f t h e c r i t er i a l i s t ed i n Appendix A w i t h re s p e c t t o t h e p r o t e c t i o n o f

an y an d al l s p e ci es t ha t a re feder all y

- li s t ed a s e n d an gered o r t h re a t e n ed u n der t h e E S A o r o f habi t a t t ha t i s

feder all y

- de s i g na t ed a s “c r i t ic a l hab i t a t ” u n der t h e E S A? If no, you cannot request coverage under this permit.

Yes No

If yes, then you need to provide the appropriate documentation to the EPA to qualify for coverage under this

permit. Please indicate under which c riterion in Appendix A you are satisfying th is requirement:

A B C D E

2 4 . Nation al Historic Preservation Act

Have y o u f o ll o wed t h e s c ree nin g p r o c ess i n A pp e n d i x B t o de t e r m in e i f the construction, modification or

operation of your new or modified true minor source of air pollutants ha s t h e p o t e n t ia l t o ca u se effe c t s t o hi s t o r i c

p r o p er t i e s (pursuant to the NHPA)

, an d w h e t h er y o u n eed t o c o n t ac t the appropriate state o r t r iba l

re p r e s e n t a t i ve f o r f u r t h er in f o rm a t i o n ? If no, you cannot request coverage under this permit.

Yes No

If yes, then provide the appropriate documentation to the EPA to qualify for coverage under this permit

.



### Section 5: Applicant’s Statement



### 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: _____________________________________OMB Control No. 2060

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Request for Coverage : Boilers Page 10 of 19

Version 1.0 

## A pp e n d i x A

- E n da n g e r ed S p ec i es A c t R e q ui r e m en t s

T h e p u r p os e o f t hi s appendix i s t o a s s i s t y o u i n c o m pl y in g w i t h t h e re q u i reme n t s of your request for coverage under

the General Air Quality Permit for True Minor Source Boilers in Indian Country

. I n o rder t o b e e l i g ibl e f o r c o ver a ge

u n d e r t hi s p erm i t, y o u must de m o n s t r a t e t h a t yo u meet o n e o f t h e c r i t er i a l i s t ed i n t h i s app e n d ix w i t h re s p e c t t o t h e

p r o t e c t i o n o f an y an d al l s p e ci es t ha t a re feder all y

- li s t ed a s e n d an gered o r t h re a t e n ed u n der t h e E S A o r o f habi t a t t ha t

i s feder all y

- de s i g na t ed a s “c r i t ic a l hab i t a t ” u n der t h e E S A.

T hi s appendix p r o v i des y o u in f o rm a t i o n o n t h e f o ll o w in g:

• Section 1.0: E S A Eli g ibil i t y C r i t er ia and

• Section 2.0: G u i d anc e f o r D e t erm inin g Whic h E S A C r i t er i a A ppli es

.



### 1.0 ESA Eli g i b ility Cr ite r ia

Y o u m u st c er t i fy i n y o u r request for coverage under the general permit t ha t yo u meet o n e o f t h e e li g i bi l i t y c r i t er i a li s t e d

b e l o w i n o rder t o b e e li g ibl e f o r c o ver a ge u n d er t h e general permit

. Y o u m u s t al s o s p e ci fy i n your request for coverage

t h e ba s i s f o r y ou r s e l e c t i o n o f t h e applic a b l e e li g ib i l i t y c r i t er i o n and provide documentation supporting the criterion

selected with your request for coverage under the general permit . If you do not meet any of these ESA eligibility

criteria, you will not be eligible for coverage under this permit and you must apply for a site

- specific permit.

No t e : ( 1 ) R eg a r d l e s s o f t h e c r i t er i o n s e l e c t ed, y o ur request for coverage m us t p r o v i de sufficient d o c u me n t a t i o n t o s u pp o rt y o u r

de t erm ina t io n t ha t yo u s a t i s fy t h e r e q u i reme n t s o f t h e pa r t ic u la r c r i t er i o n you have selected

. ( 2 ) Whil e c oo rd ina t i o n b e tw een yo u

an d t h e U

. S

. F i s h an d Wil d li fe S erv ic e (FWS) an d / o r t h e N a t i o na l M a r in e F i s h er i es S erv ic e ( NMFS; t o ge t h er, t h e “ S erv i c e s ” ) i s n o t

n e c es s a r il y re q u i red i n al l ca se s

, the EPA e nc o u r a ges y o u t o c o o rd ina t e w i t h t h e Services an d t o do s o e a r l y i n t h e plannin g p r o c e s s

p r i o r t o s u b m i tt in g you r request for coverage

.

Cr ite r ion A :

N o f eder all y

- li s t ed t h re a te n ed o r e n d an gered s p e ci es o r t h e i r des i g na t ed c r i t i c a l ha b i t a t ( s ) a re lik e l y t o o c c u r within

the action area. 1

Cr ite r ion B :

F eder all y

- li s t ed t h re a t e n ed o r e n d an gered s p e ci es o r t h e i r de s i g na t ed c r i t ica l habi t a t ( s ) a re lik e l y t o o c c u r within the

action area of your source an d the construction and operation of y o u r new minor source or construction and operation of

the modification to your existing minor source is n o t lik e l y t o a dverse l y a ff e ct li s t ed t h re a t e n ed o r e n d an gered s p e ci es

o r c r i t i c a l hab i t a t . T hi s de t erm ina t i o n m a y incl u de c o n s i der a t io n o f a n y air pollution c o n t r o l s or other changes to the

construction and/or operation of your new or modified source that yo u w il l a d o p t to e n s u re t ha t construction, modification

or operation of your new or modified source is n o t l ik e l y t o a dver s e l y a f fe c t li s t ed s p e ci es an d c r i t ic a l hab i t a t. To m ak e

t hi s c ert i f ic a t i o n

, y o u m u st incl u de t h e f o ll ow in g i n you r request for coverage : ( 1 ) identify any feder all y li s t ed s p e ci es

an d /o r d e s i g na t ed hab i t a t l o ca t ed within the action area of your source; ( 2 ) t h e d i s t a n c e b e tw een you r s i t e an d t h e

li s t ed s p e ci es o r des i g na t ed c r i t ica l h a b i t a t ( i n m il es ) ; and (3) any other information necessary ( e.g. , a map) to show that

1 Action area means all areas to be affected directly or indirectly by the Federal action and not merely the immediate area

involved in the action [50 CFR 402.02].OMB Control No. 2060

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Request for Coverage : Boilers Page 11 of 19

Version 1.0 the construction/ modification and operation of your new or modified source are not likely to cause any adverse effects to t he

listed threatened or endangered species or their critical habitat.

Cr ite r ion C :

C o o rd ina t i o n b et w een yo u an d t h e S erv ic e s ha s b een c o ncl u de d

. T h e c oo rd ina t i o n m us t ha ve a ddre s sed t h e effe c t s o f

y o u r new or modified true minor source’s construction/modification and operation o n fe d er all y

- li s t ed t h r e a t e n ed o r

e n d an gered s p e ci es an d feder all y

- d e s i g na t ed c r i t ica l hab i t a t

, an d m us t ha ve re s u l t ed i n a w r i t t en c o nc u rre nc e f ro m t h e

re l ev an t S erv ic e ( s) t h a t you r new or modified true minor source’s construction/modification and operation a re n o t

lik e l y t o a dver s e l y a ffe c t li s t ed s p e ci es o r c r i t i c a l ha b i t a t

. Y o u m us t incl u de c o pi es o f t h e c o rre s p o n de nc e b e tw een

y o u r s e l f an d t h e S e r v ic es with your request for coverage under the general permit

.

Cr ite r ion D :

Co n s u l t a t i o n b et w een another F eder a l A ge n c y an d t h e F W S an d /o r t h e N M F S u n d e r s e c t i o n 7 o f t h e E S A ha s b een

c o ncl u de d

. T h e c o n s u l t a t i o n m us t ha ve a ddres s ed t h e effe c t s o f your minor source’s construction/modification and

operation o n feder all y

- li s t ed t h re a t e n ed o r e n d an ge r ed s p e ci es an d feder ally

- des i g na t ed c r i t ic a l hab i t a t

. T h e re s u l t o f

t hi s c o n s u l t a t i o n m us t b e e i t h er:

1. A bi o l o g ica l o pini o n t h a t c o ncl u des t ha t t h e a c t i o n i n q u e s t i o n ( t akin g i n t o acc ou n t t h e effe c t s o f y ou r

s ource’s construction/modification and operation) i s n o t lik e l y t o j e o pa rd i z e t h e c o n t in u ed ex i s t e nc e o f

li s t ed s p e ci e s

, o r to result in t h e des t r u c t i o n o r a dverse m o d i f ica t i o n o f c r i t i ca l hab i t a t ; o r

2. Written c o nc u rre nc e f ro m t h e appl i cabl e S erv ic e ( s ) w i t h a f in d in g t h a t t h e source’s

construction/modification and operation a re n o t lik e l y t o a dver s e ly a ffe c t feder all y

- li s t ed s p e ci es o r

fed e r all y

- des i g na t ed habi t a t

.

Y o u m u st incl u de c o pi es o f t h e c o rre s p o n de nc e b e tw een you rse l f an d t h e S erv ic es i n y o u r request for coverage under

the general permit

.

Cr ite r ion E :

Y ou r c o n s t r u c t i o n/modification and operation ac t i v i t i es a re a u t h o r i z ed t h r ou g h t h e i ssu anc e o f an incidental take

p erm i t u n der s e c t i o n 10 o f t h e E S A

, an d t hi s a u t h o r i z a t i o n a ddres s e s t h e effe c t s o f t h e source o n feder all y

- li s t ed s p e ci es

an d feder all y

- des i g na t ed c r i t i ca l hab i t a t

. Y o u m u st incl u de c o pi es o f t h e incidental take permit and associated

documentation and c o rre s p o n de nc e b e tw e e n y o u r s e l f an d t h e S erv i c es with your request for coverage under the

general permit

.

You must comply with any applicable terms, conditions, or other requirements developed in the process of meeting

one of the eligibility criteria (A

- E) in this section to remain eligible for coverage under this permit. Documentation of

these requirements must be kept as part of your permit application and shall be maintained by the pe r mittee for the

duration of time the affected emissions unit(s) is (are) covered under the permit.



### 2.0 De t e r mini n g W hich Cr ite r ion A pp lies

To qualify for this permit, yo u need to m e et o n e o f t h e five c r i t er i a l i s t ed a b o ve . Y o u m u st f o ll o w t h e p r o c ed u res i n

S t e p s 1 t h r ou gh 4 below t o de t erm in e t h e E S A c r i t er i o n, if any, u n der w hic h y o u r project i s e li g ibl e f o r p e r m i t

c o ver a ge.OMB Control No. 2060

- 0003

Approval expires 4/30/2017

Request for Coverage : Boilers Page 12 of 19

Version 1.0 2.1 Step 1

De t erm in e i f L i s t ed T h re a t e n ed o r En d an gered S p e ci es o r t h e i r D e s i g na t ed C r i t ica l Ha b i t a t ( s ) a re L ik e l y t o O cc u r within

the Action Area of your Minor Source.

Y o u m u s t de t erm in e, t o t h e b e s t o f y o u r kn o w l edge, w h e t h er s p e ci es federally li s t ed a s e i t h er t h re a t e n ed o r

e n d an ge r ed, o r t h e i r c r i t ic a l hab i t a t ( s ), a re l o ca t ed within the action area of your minor source. 2 T o m ak e t hi s

de t erm ina t i o n

, y o u s h ou l d f i r st de t erm in e i f li s t ed s p e ci es an d /o r c r i t ica l hab i t a t a re ex p e c t ed t o ex i s t i n you r c ou n t y o r

t o w n s hip or nearby counties or townships to determine if species/habitat in those areas could potentially be affected

by the construction/modification or operation of your new or modified source

. T h e l o ca l o ff ic es o f t h e F W S

, N M F S

, an d

S t a t e o r T r ib a l H er i t a ge C e n t ers o f t en m ain t a i n li s t s o f feder all y li s t ed e n d an gered o r t h re a t e n ed s p e ci es o n t h e i r

i n t er n et si t es. Fo r F W S t erre s t r ia l a n d aq u a t i c s p e ci es in f o rm a t i o n

, y o u c a n u se the F W S o n

- lin e m app i n g t oo l

, t h e

I n f o rm a t i o n

, P lannin g, a n d Co n su l t a t i o n S y st em, l o ca t ed a t h t t p : // www

. f w s

. g o v / ipac /

.

No t e : T o de t erm in e t h e f i e l d o ff ic e t ha t c o rres p o n ds t o y ou r p r o je c t s i t e, v i s i t

h t t p : // www

. f w s

. g o v / e n d an gered / reg i o n s / in de x

. h t ml an d h t t p : // www

. n mf s

. n o a a

. g o v/ ( un der t h e l eft t ab f o r “ R eg i o n s ” )

.

I n m o st ca se s

, s p e ci es an d /o r c r i t ica l hab i t a t li s t s all o w yo u t o de t erm in e i f an y s u c h s p e ci es o r habi t a t ex i s t s i n

y o u r c o u n t y o r t o w n s h i p

. Yo u ca n al so f in d c r i t i ca l hab i t a t des i g na t i o n s an d a sso ci a t ed re q u i reme n t s a t 50 CF R

P a r t s 17 an d 22 6 (see h t t p : // www

. acc e s s

. g p o .g o v )

. You may also use the FWS Critical Habitat Portal (see

http://criticalhabitat.fws.gov/crithab/ ).

• I f the r e ar e li s ted sp e cies a n d

/or c r itic a l h ab it a t in your coun t y or t o w n s hi p (or nearby areas in which

species/habitat could potentially be affected by the construction/modification of your new or

modified source)

, y o u s h ou l d c o n t ac t you r l o c a l F W S

, N MFS

, o r S t a t e o r T r iba l H er i t a ge C e n t er t o de t erm in e

i f t h e l i s t ed sp e ci es a re kn o w n t o ex i st within the action area of y o u r minor source an d i f any designated

c r i t i c a l ha b i t a t a re a s o ver la p the action area of y o u r minor source

.

o I f you r l o ca l F W S

, N M F S

, o r S t a t e o r T r iba l H er i t a ge C e n t er in d ica t es t h a t t h ese s p e ci es an d /o r c r i t ica l

hab i t a t c ou l d ex i s t within the action area of y o u r minor source

, y o u m us t do one of the following :

 Co n d u c t v i su a l in s p e c t i o n s. T hi s me t h o d m a y be pa r t ic u la r l y su i t abl e f o r s i t es t h a t a re s m all er in

s i z e o r l o ca t ed i n n o n

- na t u r a l s e tt in gs s u c h a s hi g hly u r bani z ed a re a s o r in d u s t r ia l pa r k s w h ere

t h ere i s l i t t l e o r n o na t u r a l hab i t a t

.

 Co n d u c t a f o rm a l bi o l o g i ca l su rv e y

. I n so me ca s e s

, pa r t ic u la r l y f o r la rger s i t es, b i o l o g ica l s u rv e y s

m a y b e a n app r o p r ia t e w a y t o a s s e s s w h e t h er s p e ci es a re l o ca t ed within the action area of y o u r

minor source an d w h e t h er t h ere a re lik e l y t o b e a dverse effe c t s t o s u c h s p e ci e s

. Bi o l o g ica l su rv e y s

a r e fre q u e n t ly p erf o rmed b y e n v i r o n me n t a l c o n s u l t in g f i rms. A b i o l o g ica l su rv e y m a y i n s o me

ca s e s b e u se f u l t o c o n d u c t in c o n j u nc t i o n w i t h S t e p s 2, 3, or 4 o f t h e s e in s t r u c t i o n s.

 Fo ll o w t h e in s t r u c t i o n s i n S t e p s 2

– 4 b e l o w

, a s ap p licabl e. No t e t h a t m an y b u t n o t al l m e a s u r e s

i m p os ed t o p r o t e c t li s t ed s p e ci es u n der t h ese s t e p s w il l al s o p r o t e c t c r i t ica l ha bi t a t

. T h u s

, to mee t

2 For definitions of terms that you might encounter when hearing or reading about the endangered species program, go to:

http://www.fws.gov/midwest/endangered/glossary/index.html and http://www.fws.gov/northeast/nyfo/es/actionarea.htm

.OMB Control No. 2060

- 0003

Approval expires 4/30/2017

Request for Coverage : Boilers Page 13 of 19

Version 1.0 t h e e li g i bi l i t y re q u i reme n t s o f t hi s permit the me a su r es needed t o p r o t e c t c r i t ic a l hab i t a t may be

se pa r a t e fr o m t h os e needed t o p r o t e c t li s t ed s p e ci e s

.

• I f t h e r e ar e n o li s ted sp e cies in y our coun t y or t o w n s hip (or nearby areas in which species/habitat could

potentially be affected by the construction/modification of your new or modified source) a nd no c r itic a l

h a b it a t ar

e a s in your a ct

i on ar e a

, y o u m a y select cr i t e r i o n A as the ESA criterion for which your project is

eligible in your request for coverage under the general permit

. Y o u m u st al so p r o v i de a des c r ip t i o n o f t h e

ba s i s f o r t h e c r i t er i o n s e l e c t ed o n y ou r request for coverage f o rm an d p r o v i de d o c u me n t a t i o n su pp o r t in g t h e

c r i t er i o n selected.



### 2.2 Step 2

D e t erm in e i f t h e Co n s t r u c t i o n/Modification or Operation of Your New or Modified Minor Source is L ik e l y t o

A d ver s e l y A f f e c t L i s t ed T h re a t e n ed o r En d an gered S p e ci es o r D e s i g na t ed C r i t ica l H a b i t a t

I f i n S t ep 1 y o u de t erm in e

, ba s ed o n c o mm u nica t i o n w i th yo u r l o ca l F WS

, N M F S

, o r S t a t e o r T r iba l H er i t a ge C e n t er, o r

o t h erwise, t ha t l i s t ed s p e ci es an d /o r c r i t i c a l habi t a t c ou l d ex i s t within the action area of your new or modified minor

source

, y o u m u s t n ext a s se s s w h e t h er the construction/modification or operation of your new or modified minor source is

lik e l y t o a dver s e l y a ffe c t li s t ed t h re a t e n ed o r e n d an gered s p e ci es o r d e s i g na t ed c r i t ica l h a b i t a t.

P o t e n t ia l a dver s e effe c t s fr o m construction/ modification and operation activities incl u de direct and indirect effects and

could include, but are not limited to, the following:

• Ha b i t a t Disturbance

. Surface disturbance activities such as e x ca v a t i o n

, s i t e deve l o p me n t, gr a d in g, and associated

light and noise m a y a dverse l y a ffe c t li s t ed s p e ci es o r t h e i r habi t a t

.

 Operation of the Source. Source operations could result in additional traffic, noise and light that could affect

species or habitat.

 Water

- Related Impacts. Changes in water usage or water discharges may affect listed species or their habitat.

 Air Emission Impacts. Increases in emission of certain pollutants may in certain cases affect vegetation growth

patterns which can affect listed species or their habita t.

T h e s c o p e o f e ffe c t s t o c o n s i der w il l v a ry w i t h e a c h site and project

. I f yo u a re ha v in g d i ff ic u l t y de t erm inin g w h et h er

y o u r p r o je c t i s lik e l y t o a dver s e l y a ffe c t li s t ed s p e ci es o r c r i t ical habi t a t

, o r o n e o f t h e S e r v ic es ha s al re a dy r ai sed

c o nc er n s t o y o u

, y o u s h o u l d c o n t act t h e app r o p r i a t e o ff ic e o f t h e F W S

, N MF S o r N a t u r a l H er i t a ge C e n t er f o r

a s s i st anc e.

• I f a d v e rs e e

ff e cts to li s ted th r e a tened or en da n g e r ed sp ecies or their c r itic a l h ab it a t ar

e not l i kel y

, t h e n y o u

m a y s e l e c t cr i t e r i o n B as the ESA criterion for which your project is eligible in request for coverage under the general

permit

. Y o u m u st p r o v i de t h e f o ll o w in g s p e ci f i c in f o rm a t i o n with your request for coverage f o r m :

1 . The feder all y li s t ed s p e ci es an d /o r d e s i g na t ed hab i t a t a re l o ca t ed within the action area of your minor

source ;

2 . T h e d i s t anc e b et w een you r s i t e an d t h e li s t ed s p e ci e s o r des i g na t ed c r i t ica l h a b i t a t ( i n m il es ); and

3 . Any other information necessary to show that the air emissions from your source are not likely to cause any

adverse effects to the listed threatened or endangered species or their critical habitat.OMB Control No. 2060

- 0003

Approval expires 4/30/2017

Request for Coverage : Boilers Page 14 of 19

Version 1.0 • If adverse e

f f ects to li s t e d th r e a tened or en da n g e r

ed sp ecies or t h eir c r

iti c a l h ab it a t ar

e like l y

, y o u m us t

f o ll o w S t ep 3 b e l o w

.



### 2.3 Step 3

D e t erm in e i f M e a s u r e s C a n B e I m pl eme n t ed t o A v o i d A d ver s e E f f e c t s

I f yo u m ak e a p re li m ina ry de t erm ina t i o n i n S t ep 2 t ha t a dver s e effe c t s fr o m the construction/modification or operation

of your new or modified minor source are lik e l y to o c c u r

, y o u ca n s t i l l re c e i ve c o ver a g e u n der e li g ibili t y cr i t er i o n B o f

t h is permit i f app r o p r ia t e me a su res a re u n der t ak en t o a v o i d o r e li m ina t e t h e lik e l ih oo d o f a dve r se ef f e c t s p r i o r t o

applying for c o v er a g e under the permit

.

T h ese me a su r es m a y in v o l ve re la t i ve l y s i m pl e chan ges t o c o n s t r u c t i o n ac t i v i t i es s u c h a s re

- r ou t in g construction t o

b y pa s s a n a rea w h ere s p e ci es a re l o ca t ed, re l o ca t in g source activities

, o r m o d i f y in g t h e “ f oo t p r in t ” o f t h e site

. I f y o u a re

u nabl e t o determine w hic h m e a su r e s t o i m pl eme n t t o a v o i d t h e lik e lih oo d o f a dver s e eff e c t s, y o u m u s t c oo rd ina t e with,

o r e n t er in t o c o n su l t a t i o n w i t h

, t h e F W S an d /o r N M F S

, i n w hic h c a se y o u w ou l d n o t b e e li g ibl e f o r c o ver a ge u n der

e li g ibi l i t y c r i t er i o n B

, b u t m a y in s t e a d b e e li g ibl e f o r c o ver a ge u n der e li g ibili t y cr i t er io n C, D

, o r E ( de s c r ib ed i n m o re

de t ai l i n S t ep 4 ).

• I f y ou ar e ab l e to im p le m ent appr o pr i a te me as u r

es to av oid the likelihood of adv e rs e e f f e ct s

, t h en y o u m a y

s e l e c t cr i t e r i o n B as the criterion for which your project is eligible in notifying of coverage under the general permit

.

T h e me a s u r e s y o u a d o p t t o a v o i d o r e li m ina t e a dver s e e ffe c t s m u st b e i m pl eme n t ed f o r t h e d u r a t i o n o f t h e

c o n s t r u c t i o n/modification and operation of your new or modified minor source an d y o u r c o v er a ge u n der t h is

permit

. Yo u m us t al so p r o v i de a d e s c r ip t i o n o f t h e ba s i s f o r t h e c r i t er i o n s e l e c t ed, an d t h e f o ll o w in g s p e ci f i c

in f o rm a t i o n o n y o u r request for coverage f o r m : ( 1 ) the feder all y li s t ed s p e ci es an d /o r d e s i g na t ed hab i t a t that

a re l o ca t ed within the action area of your minor source ; ( 2 ) t h e d i s t anc e b et w een you r source an d t h e li s t ed

s p e ci e s o r des i g na t ed c r i t ica l h a b i t a t ( i n m il es ); and (3) what steps were or will be taken to avoid the likelihood

of adverse effects

• I f y ou c a n n ot determine w hich me as u r es to im p l em ent to a v

oid the l i kelih oo d of ad v e rs e e

ff e ct s

, y o u m u s t

f o ll o w t h e p r o c ed u r e s i n S t ep 4

.



### 2.4 Step 4

D e t erm in e i f t h e Eli g i b il i t y R e q u i reme n t s o f C r i t er i o n C

, D

, o r E C a n B e M et

I f i n S t ep 3 y o u cann o t a s c er t ai n w hi c h me a su res t o i m pl eme n t t o a v o i d t h e lik e lih oo d o f a dver s e e f fe c t s

, y o u m u s t

c o n t a c t t h e F W S an d /o r N M F S

. Yo u m a y s t il l b e e li g ibl e f o r c o ver a ge under this permit i f a n y lik e l y a dver s e ef f e c t s c an b e

a ddre s sed t h r o u gh mee t in g c r i t er i o n C

, D

, o r E

.

• Cr ite r ion C : Y o u ha ve c o o rd ina t ed w i t h either of t h e S erv ic es an d ha ve a ddre s s ed t h e effe c t s o f the

construction/modification and operation of your new or modified minor source o n fe d er all y

- li s t ed t h re a t e n ed

o r e n d an gered s p e ci es an d feder all y

- d e s i g na t ed c r i t ica l hab i t a t

, w hic h res u l t ed i n a w r i t t e n c o nc u rre nc e f r o m

t h e re l ev an t S erv ic e ( s ) t ha t the construction/modification or operation of your new or modified minor source

is n o t lik e ly t o a dverse l y a f fe c t li s t ed s p e ci es o r c r i t ica l hab i t a t

.

I f yo u ha ve m et t h e re q u i reme n t s o f c r i t er i o n C

, then y o u m a y s e l e c t criterion C as the criterion for which your

project is eligible for request for coverage under the general permit

. As part of your request for coverage

,OMB Control No. 2060

- 0003

Approval expires 4/30/2017

Request for Coverage : Boilers Page 15 of 19

Version 1.0 y o u m u st p r o v i de a d e s c r ip t i o n o f t h e ba s i s f o r t h e c r i t er i o n s e l e c t ed with y ou r request for coverage f o r m an d

m us t incl u de c o p i es o f t h e c o rr e s p o n de n c e b e tw een yo u an d t h e applicabl e S erv ic e.

• Cr ite r ion D : Fo rm a l o r in f o rm a l E S A se c t i o n 7 c o n s u l t a t i o n i s p erf o rmed w i t h t h e F W S an d / o r N M F S an d t ha t

c o n su l t a t i o n a ddre ss e s t h e effe c t s o f the construction/modification or operation of y o u r minor source o n

feder all y

- li s t e d an d t h re a t e n ed s p e ci e s an d des i g na t ed c r i t ica l h a b i t a t

. I n o rder t o b e e li g ibl e f o r c o ver a ge

u n der t hi s p erm i t

, c o n s u l t a t i o n m us t re su l t i n a “n o je o pa rdy and no destruction/adverse modification

o pini o n ” o r a w r i tt en c o nc u rre nc e by t h e S erv ic e ( s ) o n a f in d in g t h a t the construction/modification or

operation of your new or modified minor source a re n o t lik e l y t o a dver s e l y a ffe c t li s t ed s p e ci es o r c r i t i c a l

ha b i t a t. ( F o r m o re in f o rm a t i o n o n c o n s u l t a t io n

, see 5 0 C F R Part 40 2 )

. I f y o u re c e i ve a “ je o pa r d y or

destruction/adverse modification o pi n i o n

, ” y o u m a y c o n t in u e t o w o rk w i th t h e F W S an d /o r N M F S an d y o u r

p erm i tt i n g a u t h o r i t y t o m o d i fy y o u r p r o je c t so t ha t i t w il l n o t je o pa rd i z e li s t ed s p e ci es o r result in the

destruction or adverse modification of de s i g na t ed c r i t ica l h a bi t a t

.

No t e t ha t m os t c o n su l t a t io n s a re acc o m pli s h ed in f o rm a lly. Wh en c o n d u c t in g in f o rm a l E S A s e c t i o n 7

c o n s u l t a t i o n a s a n o n

- feder a l re p re s e n t a t i ve, y o u m u st f o ll o w t h e p r o c ed u res fo u n d i n 50 C F R P a rt 402 o f

t h e E S A re g u la t i o n s. Yo u m u s t also n o t i fy F W S an d /o r N MF S o f y o u r in t e n t i o n an d a greeme n t t o c o n d u c t

c o n su l t a t i o n a s a n o n

- feder a l re p re s e n t a t i ve.

Your request for coverage under the general permit is not a federal action that triggers ESA section 7. However,

co n s u l t a t i o n m a y o cc u r i n t h e c o n t e x t o f an o t h er feder a l ac t i o n for the same project ( e

. g

., w h ere E S A s e c t i o n 7

c o n s u l t a t i o n w a s p erf o rmed f o r i s su anc e o f a w e t lan ds d redge an d f il l p erm i t f o r t h e p r o je c t or for some other

federal permit or permission )

. A s n o t ed ab o v e

, o p era t o r s m a y

, i f t he y w i s h

, i n i t i a te c o n s u l t a t i o n w i t h t h e S e r v i c es

a t S t e p 3

.

Wh e t h er E S A se c t i o n 7 c o n su l t a t i o n m us t b e p erf o rmed w i t h t h e F W S

, N MF S, o r b o t h S erv ic es d e p e n d s o n t h e

li s t ed s p e ci es t h a t m a y b e a ffe c t ed b y t h e construction/operational ac t i v i t y

. I n ge n er al

, N MF S ha s j u r i s d ic t i o n

o ver m a r in e, e s t u a r in e, an d ana dr o m o u s fish s p e ci e s

. O p er a t o rs s h o u l d al s o b e a w a re t h a t w h i l e f o rm a l s e c t i o n

7 c o n s u l t a t i o n p r o v i des p r ot e c t i o n fr o m inci de n t a l t akin gs liab i l i t y

, in f o r m a l c o n s u l t a t i o n d o es n o t

.

I f yo u ha ve m et t h e re q u i reme n t s o f c r i t er i o n D

, y o u m a y se l e c t c r i t e r i o n D as the criterion for which your

project is eligible in notifying of coverage under the general permit

. As part of your request for coverage , y o u

m u s t p r o v i de a de s c r ip t i o n o f t h e ba s i s f o r t h e c r i t er i o n s e l e c t ed an d m us t incl u de c o p i es o f t h e documentation

demonstrating such eligibility, including c o rr e s p o n de n c e and related ESA consultation documentation b e tw een

you rse l f , the Federal agency or agencies that requested section 7 consultation an d t h e S erv ic es.

• Cr ite r ion E : Yo u r c o n s t r uc t i o n a c t i v i t i es a re a u t h o r i z ed t h r ou gh t h e i s su an c e o f an incidental take p erm i t

u n der s e c t i o n 10 o f t h e E S A

, an d t ha t a u t h o r i z a t i o n a ddre s s e s t h e effe c t s o f the construction/modification

and/or operation of your new or modified source o n fe d er all y

- li s t ed s p e ci es an d de s i g na t ed c r i t ica l h abi t a t

.

Y o u m u s t f o ll o w F W S an d /o r N MF S p r o c e d u res w h en ap p l y in g f o r a n E S A S e c t i o n 10 p erm i t ( s ee 50 C F R

§ 1 7

. 2 2 ( b ) ( 1) f o r F W S an d §22 2

. 22 f o r N M F S )

. A pplica t i o n in s t r u c t i o n s f o r s e c t i o n 10 p erm i t s f o r F W S a n d

N M F S ca n b e o b t ain ed b y acc e s s in g t h e F W S an d N M F S w e b s i t es ( h tt p : // www

. f w s

. g o v an d

http://www.nmfs.noaa.gov ) o r b y c o n t ac t in g t h e app r o p r ia t e F W S a n d N M F S reg i o na l o ff ic e

.

I f yo u ha ve m et t h e re q u i reme n t s o f c r i t er i o n E

, y o u m a y s e l e c t c r i t e r i o n E as the criterion for which your

project is eligible in notifying of coverage under the general permit

. As part of your request for coverage , y o u

m u s t p r o v i de a de s c r ip t i o n o f t h e ba s i s f o r t h e c r i t er i o n s e l e c t ed an d m us t incl u de c o p i es o f t h e applicable

documentation demonstrating such eligibility including c o rr e s p o n de n c e b e tw een you rse l f an d t h e S erv ic es.OMB Control No. 2060

- 0003

Approval expires 4/30/2017

Request for Coverage : Boilers Page 16 of 19

Version 1.0 

## A pp en d i x B

– H i s to r ic P r o p e r ty Sc r e ening P r oce s s

1.0 B a ck gr ound

S e c t i o n 106 o f t h e N H P A r e q u i res F ede r a l a ge nci es t o t ake in t o

acc ou n t t h e effe c t s o f F e d er a l “ u n der t akin gs

, ” su c h a s t h e General

Air Quality Permit for True Minor Source Boilers in Indian Country

,

o n hi s t o r ic p r o p er t i es t h a t a re e i t h er li s t ed o n

, o r e li g ibl e f o r li s t in g

o n

, t h e N a t i o na l R eg i s t er o f Hi s t o r ic P lac es.

T o a ddre s s an y i s s u e s re la t in g t o hi s t o r ic p r o p er t i es i n c o nn e c t i o n

w i t h t h e i s s u anc e o f t hi s p erm i t

, the EPA ha s d ev e l o p ed t h e

s c ree nin g p r o c ess i n t hi s app e n d i x t o e nabl e source

owners/operators t o: (1) app r o p r ia t e ly c o n s i der t h e p o t e n t i a l

i m pac t s

, i f any

, resulting from the construction, modification, and/or

operation of a new or modified emission source o n hi s t o r ic

p r o p er t i es an d, (2) if applicable, de t erm in e w h e t h er a c t i o n s ca n b e

t ak e n t o m i t i g a t e an y su c h i m pac t s

. A l t h ou gh each decision to allow

coverage o f in d i v i d u a l minor sources u n der t hi s p erm i t does n o t

c o n s t i t u t e a s e pa r a t e F eder a l u n der t akin g, t h e s c ree nin g p r o c ess i n

t hi s app e n d i x p r o v i des a n app r o p r ia t e si t e

- s p e c i f i c me an s o f ad dres s in g hi s t o r i c p r o p e r t y i s s u e s i n c o nn e c t i o n w i t h the

EPA ’s i s s u anc e o f t h e p erm i t

.



### 2.0 I n s t r uctions f

or Source Owners/ Op e ra to r s

Y o u a re re q u i red t o f o ll o w t h e s c ree nin g p r o c ess i n t hi s app e n d i x t o de t e r m in e i f the construction, modification or

operation of a new or modified minor source of air pollutants o n y o u r s i t e ha s t h e p o t e n t ia l t o ca u se effe c t s t o hi s t o r i c

p r o p er t i e s

, an d w h e t h er o r n o t y o u n eed t o c o n t ac t you r State Historic Preservation Officer ( S H PO)

, Tribal Historic

Preservation Officer ( T H P O)

, o r o t h er t r iba l re p r e s e n t a t i ve f o r f u r t h er in f o rm a t i o n

. Yo u m a y n o t su b m i t you r request for

coverage under the general permit u n t i l y o u ha ve c o m pl e t ed t hi s s c ree nin g p r o c e s s

. T h e f o ll o w in g f ou r s t e p s d e s c r ib e

h o w app l ica n t s ca n meet t h e hi s t o r i c p r o p erty re q u i r e me n t s u n der t hi s p erm i t

.



### 2.1 Step 1

Ha ve p r i o r p r o f e s s i o na l c u l t u r a l re s o u r c e s u rv e y s o r o t h er ev al u a t i o n s de t e r m i n ed whether h i s t o r i c

p r o p ert i es ex i st in the area of your proposed source? Or, have p r i o r earth d i s t u r banc es p re cl u ded t h e

ex i s t e nc e o f h i s t o r i c p r op ert i e s in the area of your proposed source?

I f it h a s al re a dy b een de t erm i n ed t h a t n o hi s t o r i c p r o p er t i es ex i st in the area of your proposed source ba s ed

o n a v ailabl e in f o rm a t i o n

, incl u d in g in f o rm a t i o n t h a t m a y b e p r o v i ded b y y o u r applica b l e S H P O

, T H P O

, o r

o t h er t r iba l re p re s e n t a t i ve, t h en yo u m a y in d i c a t e t hi s o n y o u r request for coverage under the general

permit

, an d n o f u r t h er s c ree nin g s t e p s a re n e c e s s a r y

.

Similarly, i f e a r t h d i s t u r banc es t ha t h a ve o cc u rred p r i o r t o y o u r p r o je c t ha ve e li m ina t ed t h e p os s ibil i ty t ha t hi s t o r i c

p r o p er t i es ex i st o n y o u r s i te or in the area affected by your new or modified minor source

, y o u m a y in d ica t e t h i s o n

y o u r request for coverage

, an d n o f u r t h er s c ree nin g s t e p s a re n e c e ss a r y

. K ey T e rm s

H i sto r ic p r o p e r ty

- pr e h i s t o r i c o r h i s t o r i c d i s t r i c t s

,

s i te s

, b u i l d i n gs

, s t r uctu r e s

, o r ob j ec t s t h a t a r e

i n c l u d e d i n o r e l i g i b l e fo r i n c l u s i o n i n t h e Na t i ona l

R e g i s ter o f H i s t o r i c P l a c e s

, i n c l u d i n g a r t i f a ct s

,

r ec or ds

, a n d r e m a i n s t h a t a r e r e l a ted to an d l o c a ted

w i t h i n s uch prop e r t i e s

S H PO

– T h e S t a te H i s t o r i c P r e s e rv a t i o n O f f i cer fo r

a p a r t i c u l a r s t a te

T H P O o r T r ibal r e p r ese n t a t i v e

– T h e Tr i b a l H i s t o r i c

P r e s e rv a t i o n O f f i cer fo r a p a r t i c u l a r Tr i b e or

, i f t h e r e i s

n o T H P O

, t h e r e pr e s e n t a t i v e d e s i g n a t e d b y s uch T r i b e

fo r NH P A p u rpo s esOMB Control No. 2060

- 0003

Approval expires 4/30/2017

Request for Coverage : Boilers Page 17 of 19

Version 1.0 After submitting your request for coverage under the general permit , and during the 30

- day period after submitting your

request for coverage under the general permit , the SHPO, THPO, or other tribal representative may request that the EPA

deny coverage under this permit based on concerns about potential adverse impacts to historic properties. The EPA will

evaluate any such request and notify you if any additional information is needed to address adverse impacts to historic

properties before continuing review of your request for coverage under the general permit

.



### 2.2 S t ep 2

I f yo u a re constructing, or modifying a minor source of air pollutants, as defined in 40 CFR § 49.152

, yo u m us t

d e t erm in e i f the construction, modification or operation of the minor source w i l l ha ve a n ef f e c t o n h i s t o r i c

p r o p ert i es.

I f you r an s w er t o t h e q u e s t i o n s i n S t e p 1 i s “n o, ” t h en y o u m us t a s s e s s w h e t h er the ac t i v i t i es re la t ed t o t h e

construction, modification or operation of your new or modified minor source w i l l ha ve a n e ff e c t o n h i s t o r i c p r o p ert i e s.

Activities that could have an adverse effect on historic properties could include, for example:

 Excavations;

 Demolitions of existing buildings;

 Construction of f oundations (e.g., for buildings, tanks or stacks);

 Installations of underground tanks;

 A ddition of impervious surfaces; and

 Increases in truck traffic during excavation, demolition, or construction

.

No t e : T h i s l i s t i s n o t i n t e n ded t o b e ex ha us t i ve. Ot h er activities t ha t a re n o t o n t h i s l i st m a y in v o l ve e a r t h

- d i s t u r b i n g

a c t i v i t i es an d m u s t al

so b e ex a m i n ed f

o r t h eir p o t e n t i a l t o a

f f e c t h i s t o r i c p r o p ert i e s . For more information, go to the

National Park Service, National Register of Historic Places database found at

http://www.nps.gov/history/nr/research/index.htm

.

T he a s se ss m e n t m a y b e ba s ed on a site map of your source and an analysis of h i s t o r i c a l sou r c e s

, kn o w l edge o f t h e a re a

,

a n a s se s s m e n t o f t h e t y p es o f a c t i v i t i es yo u a re e n g a g i n g in

, c o n s i der a t i o n s o f an y c o n t r o l s an d / o r m ana ge m e n t

p r ac t ic es y o u w i l l a d o p t t o e n su re t ha t y o u r a c t i v i t i es w i l l n o t h a ve a n e ff e c t o n h i s t o r i c p r o p ert i es, an d any o t h er

re l ev an t f ac t o rs.

I f y o u de t er m in e ba sed o n t h i s a s s es s m e n t t h a t the activities re la t ed t o t h e construction, modification or operation of

your new or modified minor source w i l l n o t ca u se e ff e c t s to h i s t o r i c p r o p ert i e s

, y o u m a y i n d i c a t e t h i s o n y o u r request for

coverage under the general permit

, an d d o c u m e n t t h e ba s i s f o r you r de t erm i n a t i o n i n your request for coverage an d

n o f u r t h er s c ree nin g s t e p s a re n e c e s s a r y

.

After submitting your request for coverage , and during the 30 days after the receipt of your request for coverage , the

SHPO, THPO, or other tribal representative may request that the EPA delay your coverage under the permit based on

concerns about potential adverse impacts to historic properties. The EPA will evaluate any such request and notify you if

any additional information is needed to address adverse impacts to historic properties before continuing review of your

request for coverage under the general permit

.

I f yo u a re in s t allin g or modifying equipment that ha s t h e p o t e n t i a l t o ha ve a n adverse effe c t o n hi s t o r i c p r o p er t i es, t he n

y o u m u st p r o c eed t o S t ep 3.OMB Control No. 2060

- 0003

Approval expires 4/30/2017

Request for Coverage : Boilers Page 18 of 19

Version 1.0 

### 2.3 Step 3

I f yo u a re constructing or modifying a minor source an d y o u ha v e n o t s a t i sf i ed t h e c o n d i t i o n s i n S t e p s 1

- 2

, yo u

m us t c o n t ac t a n d c o n su l t w i t h t h e app r o p r i a t e h i s t o r i c p re s erv a t i o n a u t h o r i t i es.

Wh ere y o u a re constructing or modifying a minor source an d y o u cann o t de t erm in e i n S t ep 2 t h a t t his ac t i v i ty w il l n o t

ha ve effe c t s o n hi s t o r ic p r o p er t i e s

, t h en y o u m us t c o n t ac t t h e re l ev a n t S H P O

, T H P O

, o r o t h er t r iba l r e p re s e n t a t i ve t o

re q u est t h e i r v i e w s a s t o t h e lik e lih oo d t h a t hi s t o r i c p r o p er t i es m a y b e adversely affected b y t h e construction,

modification or operation o f your new or modified minor source

.

No t e : A ddre s s es f

o r S H P O s an d T

H POs m a y b e fo u n d o n t h e A dv i s o r y C o un c i l o n H i s t o r i c Preserv a t i o n ’s (ACHP’s) w e b s i t e

( http://www.achp.gov/programs.html ) . I n i n s t a n c es w h ere a t r i b e d o es n o t ha ve a T H PO, y o u s h o u l d c o n t ac t t h e

app r o p r ia t e T r iba l g o ver n m e n t o

ff i c e des i g n a t ed b y t h e t r i b e f o r t h i s p u r

p os e w h en re s p o n d i n g t o t h i s p e r m i t e l i g i b i l i t y

c o n d i t i o n

.

Y o u m u st su b m i t t h e f o ll o w in g m i n i m u m in f o rm a t i o n i n o rder t o p r o p er l y ini t ia t e you r re q u e s t f o r in f o rm a t i o n :

1. Project name (i.e., the name or title most commonly associated with your project);

2. A narrative description of the project;

3. Name, address, phone and fax number, and email address (if available) of the operator;

4. Most recent U.S. Geological Survey map section (7.5 minute quadrangle) showing actual project location and

boundaries clearly indicated; and

5. Sections of sit e map that show locations where activities might cause an adverse effect on historic properties.

Wi t h ou t s u b m i t t in g t hi s m i ni m u m in f o rm a t i o n

, y o ur request cannot be considered. Yo u w il l n eed t o p r o v i de t h e

S H P O

, T H PO

, o r o t h er t r iba l re p rese n t a t i ve a m ini m u m o f 15 cal e n d a r d a y s a f t er t h ey re c e i ve t h ese m a t er ial s t o

res p o n d t o y o u r re q u est f o r in f o rm a t i o n ab ou t y o u r p r o je c t

. Y o u a re a dv i sed t o get a r e c e ip t fr o m t h e p o st o ff ic e o r

o t h er ca rr i er c o n f i rm in g t h e d a t e o n w h i c h y o u r l e tt er w a s re c e i v ed.

I f yo u d o n o t re c e i ve a r e s p o n s e w i t hin 15 cal e n d a r d a y s a f t er re c e ip t b y t h e S H P O

, T H PO

, o r o t h er t r iba l re p re s e n t a t i ve

o f y o u r re q u e s t

, t h en y o u m a y in d ica t e t h i s o n y o u r request for coverage under the general permit

, an d n o f u r t h er

s c ree nin g s t e p s a re n e c e s s a ry

. O r

, i f t h e applicabl e S H PO, T H P O

, o r o t h er t r ib a l re p rese n t a t i ve re s p o n ds t o y o u r re qu est

w i t h a n i n d ica t i o n t h a t n o hi s t o r i c p r o p er t i es w i l l be adversely a ffe c t ed b y t h e construction or modification of your

minor source

, t h en y o u m a y in d ica t e t hi s o n y o u r request for coverage

, and include a copy of the response and n o f u r t h er

s c ree nin g s t e p s a re n e c e ss a r y

. A f t er s u b m i tt in g you r request for coverage

, an d d u r in g t h e 30

- d a ys following the

receipt of your request for coverage

, t h e S H PO

, T H P O

, o r o t h er t r iba l re p rese n t a t i ve m a y re qu est t h a t the EPA place a

hold on a u t h o r i z a t i o n ba sed o n c o nc er n s ab o u t p o t e n t i a l a dver s e i m pac t s t o hi s t o r i c p r o p er t i es. The E P A w il l ev al u a t e

an y s u c h re q u e s t an d n o t i f y y o u i f an y a dd i t i o na l information is needed t o a ddress a d v erse i m pac t s t o h i s t o r i c p r o p er t i es

before continuing review of your request for coverage under the general permit

.

I f w i t hi n 15 cal e n d a r d a y s o f re c e ip t o f y o u r re q u e s t t h e ap p lica b l e S H P O

, T H P O

, o r o t h er t r ib a l re p re s e n t a t i ve

re s p o n ds w i t h a re q u est f o r a dd i t i o na l i n f o rm a t i o n o r f o r f u r t h er c o n s u l t a t i o n reg a rd in g app r o p r ia t e m e a su r e s f o r

t re a t me n t o r m i t i g a t i o n o f effe c t s o n h i s t o r i c p r o p er t i es ca u sed b y t h e construction, modification or operation of your

minor source

, y o u m us t c o m pl y w i th t h i s re q u e s t an d p r o c eed t o S t ep 4

.OMB Control No. 2060

- 0003

Approval expires 4/30/2017

Request for Coverage : Boilers Page 19 of 19

Version 1.0 

### 2.4 Step 4

Co n s u l t a t i o n w i th you r app l i ca b l e S H PO, T H PO, o r o t h er t r i b a l re p rese n t a t i v e.

I f, f o ll o w in g y o u r d i s c us s i o n s w i t h t h e app r o p r ia t e h i s t o r i c p reserv a t i o n a u t h o r i t i es i n S t ep 5, t h e applicabl e S H P O

, T H P O

,

o r o t h er t r iba l re p r e se nta t i ve re q u es t s a dd i t i o na l in f o rm a t i o n o r f u r t h er c o n s u l t a t i o n

, y o u m us t res p o n d w i t h s u c h

in f o rm a t i o n o r c o n s u l t to de t erm in e i m pac t s and appropriate measures to mitigate such impacts t o hi s t o r i c p r o p er t i es

t ha t m a y b e cau sed b y t h e construction, modification or operation of your new or modified minor source s i t e. I f a s a

re s u l t o f y ou r d i s c us s i o n s w i t h t h e app li cabl e S H P O

, T H P O

, o r t r iba l re p re s e n t a t i ve, y o u e n t er i n t o

, an d c o m ply w i t h

, a

w r i tt en a greeme n t reg a rd in g t re a t me n t a n d /o r m i t i g a t i o n o f i m pac ts o n y o u r s i t e, t h en y o u m a y in d ica t e t h i s o n y o u r

request for coverage and include a copy of the written agreement, an d n o f u r t h er s c ree nin g s t e p s a re n e c es s a r y

.

I f, h o w ever, a greeme n t o n a n app r o p r ia t e t re a tme n t o r m i t i g a t i o n pla n c ann o t be re ach ed b e tw een yo u a n d t h e S H P O

,

T H PO

, o r o t h er t r iba l re p re s e n t a t i ve w i t hi n 30 d a y s o f y o ur re s p o n se t o t h e S H PO

, T H P O

, o r o t h er t r iba l

re p rese n t a t i ve’s re q u est f o r a d d i t i o na l in f o rm a t i o n o r f u r t h er c o n s u l t a t i o n

, y o u m a y s u b m i t y o u r request for coverage

, b u t y o u m u st in d ica t e t h a t yo u ha ve n o t n eg o t ia t ed me a s u res t o a v o i d o r m i t i g a t e su c h e f fe c t s. Yo u m u st al so incl u de

with your request for coverage under the general permit t h e f o ll o w in g d o c u me n t a t i o n :

1. Copies of any written correspondence between you and the SHPO, THPO, or other tribal representative; and

2. A description of any significant remaining disagreements as to mitigation measures between you and the SHPO,

THPO, or other tribal representative.

After submitting your request for coverage under the general permit , and during the 30

- day period after the receipt of

your request for coverage under the general permit , the SHPO, THPO, ACHP or other tribal representative may request

that the EPA place a hold on authorization based upon concerns regarding potential adverse effects to historic

properties. The EPA, in coordination with the SHPO, THPO, ACHP or other tribal representative, will evaluate any such

request and notify you if any additional measures to address potential adverse ef fects to historic properties are

necessary.