EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

United States Environmental Protection Agency

General Air Quality 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 

Minor Source Hot Mix Asphalt Plants in Indian Country

Last Modified: March 23, 2015

Version 1.0

This request for coverage under the General Air Quality Permit for Minor Source Hot Mix Asphalt Plants in Indian 

Country applies to the construction of new minor source hot mix asphalt plants or the modification of existing minor 

source hot mix asphalt plants in Indian country that meet certain production limitations and fuel restrictions as 

specified below. A hot mix asphalt plant is a facility that manufactures hot mix asphalt by heating and drying 

aggregate and mixing it with asphalt cements, and is comprised only of any combination of the following activities: 

dryers, liquid asphalt storage tanks, fuel oil storage tanks, auxiliary heaters (including hot oil heaters), material 

storage handling and transfer systems, generators, storage bins/silos, storage piles, and haul roads. This general air 

quality permit does not apply to asphalt plants that perform contaminated soil remediation.

This permit is available in Indian country for use by true minor and synthetic minor sources.

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 or synthetic minor source batch or drum hot mix asphalt plant OR you plan 

to modify an existing minor source batch or drum hot mix asphalt plant;

 You are not planning to construct or modify a major source batch or drum hot mix asphalt plant;

 Your new or modified minor source hot mix asphalt plant is located within Indian country;

 Your facility produces only hot mix asphalt;

 Your facility is not located in a severe or extreme ozone nonattainment area (facilities in these areas must 

obtain a site-specific permit);

 You use only natural gas, propane, distillate fuel and biodiesel in the dryer/mixer;

 The asphalt dryer/mixer at your facility is controlled by a baghouse (fabric filter);

 Are located in an ozone attainment, unclassifiable or attainment/unclassifiable area, a marginal or moderate 

ozone nonattainment area, or a serious ozone nonattainment area, and the asphalt production rate at your new 

or modified facility is equal to or less than 83,000 tons per month for a drum mix plant, or 27,000 tons per 

month for a batch mix plant; 

 If located in a serious nonattainment area for carbon monoxide, the new or modified source’s asphalt 

production rate is equal to or less than 33,000 tons per month for a drum mix plant, or equal to or less than 

11,000 tons per month for a batch mix plant;

 You use only the following fuel(s) in the auxiliary heaters: natural gas, propane, distillate fuel and biodiesel;

 The total maximum heat input capacity of the auxiliary heaters (including hot oil heaters) is equal to or less 

than 10 MMBtu/hour;

 You use only diesel, or biodiesel in the stationary engines/generators;

 If located in an attainment, unclassifiable or attainment/unclassifiable area for ozone or a marginal or 

moderate nonattainment area for ozone, the total liquid fuel usage for the generators and engines at your 

new or modified facility is equal to or less than 12,500 gallons per month; 

 If located in a serious ozone nonattainment area, the total liquid fuel usage for the generators and engines 

at your new or modified facility is equal to or less than 5,200 gallons per month;

 Each asphalt storage tank and fuel storage tank has a maximum capacity less than 39,890 gallons;
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 2 of 24

Version 1.0

 You are seeking to co-locate your facility with a stone quarrying, crushing and screening operation and 

would like to limit combined emissions to less than 100 tons per year (tpy) for NSR-regulated pollutants.

You must comply with Conditions 17. and 20.b. in the General Permit and this option is not available in 

serious, severe, or extreme ozone nonattainment areas and serious carbon monoxide (CO) nonattainment 

areas. Sources in these areas would have to seek a site-specific permit to obtain tighter limits to further 

reduce their potential to emit (PTE);

 You demonstrate that you meet one of the criteria listed in Appendix A with respect to the protection of any

and all species that are federally-listed as threatened or endangered under the Endangered Species Act (ESA) 

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

 You have completed the screening processin Appendix B to determine if the construction, modification or 

operation of your new or modified minor source of air pollutants has the potential to cause effectsto historic

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

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

coverage under the General Permit include:

1. The permittee is not in compliance with the provisions of the General permit; 

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

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

requirements in the General Permit;

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

by fraud or misrepresentation; or

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

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

permittee submitted the Request for Coverage.

More Information

This General Air Quality Permit for New or Modified Hot Mix Asphalt Plants in Indian Country is not applicable to:

 Facilities that perform contaminated soil remediation;

 Facilities that produce cold mix asphalt; and

 Facilities located in severe or extreme ozone nonattainment areas.

If your hot mix asphalt facility is co-located with another source, and the potential to emit of the combined source is 

less than the major source thresholds for any NSR-regulated pollutant, you may qualify for coverage under this 

General Permit. 

Information on the definition of a “modification” and potential to emit or “PTE” can be found at 40 CFR 49.152(d) 

and in the “Instructions” document. Additional information on the applicability of the Federal Indian Country Minor 

NSR Rule can be found at 40 CFR 49.153.

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

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

area’s attainment status.
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 3 of 24

Version 1.0

Sources eligible for the General Permit for New or Modified Minor Source Hot Mix Asphalt Plants may also be subject to 

federal standards under 40 CFR 60 Subpart I – Standards for Performance for Hot Mix Asphalt Facilities, 40 CFR 60 

Subpart IIII – Standards of Performance for Stationary Compression Ignition Internal Combustion Engines, and 40 CFR 63 

Subpart ZZZZ – National Emissions Standards for Hazardous Air Pollutants for Stationary Reciprocating Internal 

Combustion Engines. The conditions applicable to sources seeking coverage under this General Permit are intended to 

be generally consistent with the requirements in these regulations; however, compliance with the applicable 

requirements is required independent of the conditions in the General Permit, and not all requirements applicable 

under Subparts I, IIII, and ZZZZ are necessarily included in the General Permit. The Background Document for the 

General Permit identifies the specific requirements in these Subparts that are intended to be included in the General 

Permit.

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 or being modified.

After you submit the application to the reviewing authority:

 You may not commence construction of your new source or modification 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 if more 

information is needed in writing within 30 days from receipt of your application. 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 procedures 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 request 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 review only for the issue of whether your source qualifies for this General Permit.

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

information in this application, and any suggested methods for minimizing respondent burden, including through the 

use of automated collection techniques, to the Director, Collection Strategies Division, U.S. Environmental Protection 

Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any 

correspondence. Do not send the completed form to this address.
EPA Form No. 5900-343

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

United States Environmental Protection Agency

General Air Quality 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 

Minor Source Hot Mix Asphalt Plants in Indian Country

Last Modified: March 23, 2015

Version 1.0

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

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

General Air Quality Permit for Minor Source Hot Mix Asphalt Facilities 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 for Requesting Coverage 

under the General Air Quality Permit for New or Modified Minor Source Hot Mix Asphalt Plants in Indian Country.”

Section 1: Contact Information

1. Business Name: 2. Date:

3. Site Address: 4. County:

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

owner):

7. Owner: 8. Telephone Number of Owner:

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

Company Name:

c/o:

Address: 

11. Authorized contact regarding this permit application:

Name:

Title:

Phone: 

Email:

FAX:
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 5 of 24

Version 1.0

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

New or Modified Minor Source Hot Mix Asphalt Plants

12. Please list all of the site locations for which you want approval to locate your hot mix asphalt plant. Include the 

site name (if any), street address, city, state, and name of the Indian Reservation. If needed, use additional paper.

You may seek approval for additional locations in the future.

Site Name Street Address City/Town

Area of Indian 

Country

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

Construction/Relocation of a new hot mix asphalt facility in Indian country – no current general permit (please 

describe the proposed new source or location).

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Add a new location for your hot mix asphalt facility already covered by the General Permit (please describe the 

proposed new location).

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Modification of an existing hot mix asphalt facility. Please describe the modification below. The definition of

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

_____________________________________________________________________________________________

_____________________________________________________________________________________________

A hot mix asphalt operation co-located with a stone quarrying, crushing, and screening operation and seeking to 

limit combined emissions to less than 100 tpy for NSR-regulated pollutants. You must comply with Conditions 17.

and 20.b. in the General Permit. This option is not available in serious, severe and extreme ozone nonattainment 

areas and serious CO nonattainment areas (please describe the proposed source).

_____________________________________________________________________________________________

_____________________________________________________________________________________________
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 6 of 24

Version 1.0

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

facility: 

_______________________________________________________________________________________________

_______________________________________________________________________________________________

15. Type of Asphalt Plant: (check all that apply):

Stationary Portable Batch Mix Parallel Flow Drum Mix Counterflow Drum Mix

16. Will your new or modified facility be located in an ozone nonattainment area? Information on the ozone 

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

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

Yes No

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

Marginal Moderate Serious Severe Extreme

Note: If your facility will be located in severe or extreme ozone nonattainment area, it does not qualify 

for this General Permit and you must obtain a site-specific permit from the reviewing authority.

17. Will your new or modified facility be located in a particulate matter (PM10) nonattainment area? Information on 

the attainment status of the area where your facility is or will be located can be found at: 

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

Yes No

If you answered ‘Yes,’ specify the classification of the PM10 nonattainment area:

Moderate Serious

18. Will your new or modified facility be located in a particulate matter (PM2.5) nonattainment area? Information on 

the attainment status of the area where your facility is or will be located can be found at: 

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

Yes No

19. Will your new or modified facility be located in a carbon monoxide (CO) nonattainment area? Information on the 

attainment status of the area where your facility is or will be located can be found at: 

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

Yes No

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

Moderate Serious
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 7 of 24

Version 1.0

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

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

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

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

Pollutant Attainment Area Nonattainment Area

CO 10 tpy 5 tpy

Particulate Matter (PM) 10 tpy 5 tpy

Particulate Matter 

(PM10) 5 tpy 1 tpy

Particulate Matter 

(PM2.5) 3 tpy 0.6 tpy

Sulfur Dioxide (SO2) 10 tpy 5 tpy

Nitrogen Oxides (NOX) 10 tpy 5 tpy

Volatile Organic 

Compounds (VOC) 5 tpy 2 tpy

Yes No

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

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

question.

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

less than 250 tpy for PM, PM10, PM2.5, VOC, NOx, CO, and SO2, each individually? Be sure to include all 

existing, new, and modified emission units at the facility.

Yes No

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

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

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

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

new, and modified emission units at the facility.

Pollutant Nonattainment Classification NSR Major Source Threshold

Ozone Marginal 100 tpy of VOC or NOX

Moderate 100 tpy of VOC or NOX

Serious 50 tpy of VOC or NOX

Severe 25 tpy of VOC or NOX
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 8 of 24

Version 1.0

Pollutant Nonattainment Classification NSR Major Source Threshold

Extreme 10 tpy of VOC or NOX

PM10 Moderate 100 tpy

Serious 70 tpy

CO Moderate 100 tpy

Serious 50 tpy

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

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

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

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

23. Projected asphalt production rate after construction/modification/relocation: 

 Tons/month: _____________

24. Does or will this facility perform contaminated soil remediation? 

Yes No

If you answered ‘Yes’ to this question, your facility does not qualify for a general permit and you must 

obtain a site-specific permit from your reviewing authority.

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

Permit for New or Modified Minor Source Hot Mix Asphalt Plants

Information regarding the emission units at your facility is required by 40 CFR 49.154 and 40.160. Please 

provide the information below for all equipment at your facility. For each emissions unit, include supporting 

documentation for the PTE of the unit with your Request for Coverage. In addition, for existing emissions units, 

include the most recent actual annual emissions. See 40 CFR 49.154(a)(2). (For more information on how to 

calculate actual emissions, you may go to: http://www.epa.gov/air/tribal/tribalnsrcalculators.html.) As needed, 

please include other relevant information with your notification (including any equipment not identified 

below).

Dryer

25. Dryer ID: _________________

26. Construction/Modification Date of the Dryer (mm/dd/yyyy; actual or anticipated): _________________ 

27. Dryer Burner Capacity (MMBtu/hour): _____________________ 
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 9 of 24

Version 1.0

28. Fuel(s) Used in the Dryer:

Natural Gas Propane Distillate Fuel Biodiesel 

29. Is the dryer/mixer controlled by a baghouse (fabric filter) or venturi scrubber? 

Yes No

If you answered No to this question, your facility does not qualify for a general permit and you must 

obtain a site-specific permit from reviewing authority.

30. Internal Combustion Engines (including emergency generators)

Unit ID 

#

Unit Description Maximum Rated 

Capacity (HP)

Types of Fuel(s) 

Used1

Manufactured 

Date

(mm/dd/yyyy)

Model 

Year

31. Auxiliary Heaters

Unit ID 

#

Unit Description

Maximum Heat 

Input Capacity 

(MMBtu/hour)

Types of Fuel(s) 

Used2

Construction 

Date

(mm/dd/yyyy)

Total Heat Input Capacity:

3

 

1 Only diesel fuel or biodiesel are allowed in this General Permit.

2 Only natural gas, propane, distillate fuel and biodiesel are allowed in this General Permit.

3

In order to qualify for this General Permit, the total heat input capacity of the auxiliary heaters cannot exceed 10 MMBtu/hour.
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 10 of 24

Version 1.0

32. Material Handling, Transferring, Loading, and Storage Equipment

Unit ID 

#

Unit Description

Maximum 

Capacity 

(ton/hour)

Construction Date 

(mm/dd/yyyy)

Type of Control 

(if any)

33. Volatile Liquid Storage Tanks

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

each storage tank.

Unit ID#

Type of 

Liquid

Capacity 

(gallons)

Vapor pressure 

of liquid (psi)

Is the tank above 

or underground?

Date of 

installation (if 

existing)
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 11 of 24

Version 1.0

Section 4: Information on Completing Screening Processes that Have to Be Satisfied to Request 

Coverage under the General Air Quality Permit for New or Modified Minor Source Hot Mix Asphalt 

Plants

34. Threatened or Endangered Species

Have you demonstrated that you meet one of the criteria listed in Appendix A with respect to the

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

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

request coverage under this permit.

Yes No

If you answered ‘Yes,’ then you need to provide the appropriate documentation to the EPA to qualify for 

coverage under this permit. Please indicate under which criterion in Appendix A you are satisfying this 

requirement:

A B C D E

35. Historic Properties

Have you completed the screening processin Appendix B to determine if the construction, modification or 

operation of your new or modified minor source of air pollutants has the potential to cause effectsto historic

properties (pursuant to the NHPA)? If you answered ‘No,’ you cannot request coverage under this permit.

Yes No

If you answered ‘Yes,’ then provide the appropriate documentation to the EPA to qualify for coverage 

under this permit.

Section 5: Additional Information about this General Air Quality Permit for New or Modified 

Minor Source Hot Mix Asphalt Plants

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

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

rates shown in the following table:

Pollutant of 

Concern

Attainment, Unclassifiable or 

Attainment/Unclassifiable

Areas

Nonattainment Areas

CO 80 tpy

80 tpy

(moderate areas)

40 tpy

(serious areas)

PM10 26 tpy

26 tpy

(moderate areas)

26 tpy

(serious areas)

PM2.5 14 tpy 14 tpy
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 12 of 24

Version 1.0

Pollutant of 

Concern

Attainment, Unclassifiable or 

Attainment/Unclassifiable

Areas

Nonattainment Areas

SO2 18 tpy 18 tpy

NOX 71 tpy

71 tpy

(marginal and moderate ozone areas)

45 tpy

(serious ozone areas)

VOC 28 tpy

28 tpy

(marginal and moderate ozone areas)

18 tpy

(serious ozone areas)

For a hot mix asphalt operation co-located with a stone quarrying, crushing, and screening operation, the emission 

limitations and standards in Conditions 17. and 20.b of the General Permit are expected to ensure the source-wide 

emissions are below the rates shown in the following table:

Pollutant of 

Concern

Attainment, Unclassifiable or 

Attainment/Unclassifiable

Areas

Nonattainment Areas

CO 78 tpy

78 tpy

(moderate areas)

Not applicable

(serious areas)

PM 86 tpy Not applicable

PM10 63 tpy

63 tpy

(moderate areas)

63 tpy

(serious areas)

PM2.5 30 tpy 30 tpy

SO2 18 tpy 18 tpy

NOX 90 tpy

Not applicable

(serious and above ozone areas)

90 tpy

(marginal and moderate ozone areas)

VOC 27 tpy

Not applicable

(serious and above ozone areas)

27 tpy

(marginal and moderate ozone areas)

You should contact your reviewing authority if you intend to rely on the emission limitations and standards in this 

General Permit to prevent having to obtain a Title V permit.
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 13 of 24

Version 1.0

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

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

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

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

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

Name: _____________________________Name: ____________________________Date:__________

(Signature) (Print or Type)

Title: _____________________________________
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 14 of 24

Version 1.0

Appendix A – Threatened or Endangered Species Requirements

The purpose of this appendix is to assist you in completing the screening procedure for addressing threatened or 

endangered species prior to submitting your request for coverage under a General Air Quality Permit for New or 

Modified Minor Source Hot Mix Asphalt Plants in Indian Country. In order to be eligible for coverage under the General 

Permit, you must demonstrate that you qualify under one of the criteria listed in this appendix with respect to the

protection of speciesthat are federally-listed as threatened or endangered under the ESA or of habitat that is

federally-designated as “critical habitat” under the ESA.

This appendix provides you information on the following:

• Section 1.0: Listed Species Eligibility Criteria and

• Section 2.0: Guidance for Determining Which Listed Species Criterion Applies.

1.0 Listed Species Eligibility Criteria

To be eligible for coverage under the General Permit, you must obtain confirmation from the EPA that you completed 

the screening procedure and meet one of the eligibility criteria listed below. You must also specify in your submittal the

basis for your selection of the applicable eligibility criterion and provide documentation supporting the criterion 

selected. If you have not obtained confirmation from the EPA regarding listed species eligibility criteria, you will not be 

eligible for coverage under the General Permit, and you must apply for a site-specific permit. 

Note: (1) Your determination must provide sufficient documentation to support your determination that you satisfy the

requirements of the particular criterion you have selected. (2) While coordination between you and the U.S. Fish and Wildlife 

Service (FWS) and/or the National Marine Fisheries Service (NMFS; together, the “Services”) is not necessarily required in all cases,

the EPA encourages you to coordinate with the relevant Service(s) and to do so early in the planning process prior to submitting

your notification of coverage.

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

any of the eligibility criteria (A-E) in this section to remain eligible for coverage under the General Permit. 

Documentation of these requirements shall be maintained by the permittee for the duration of time the affected 

emissions unit(s) is (are) covered under the General Permit.

The following is a summary of the five eligibility criteria. See Section 2.0 for detailed instructions to determine which 

criterion applies for your specific action:

Criterion A:

No federally-listed threatened or endangeredspecies or designated critical habitat(s) of such species are likely to occur

within the action area for your project.

4

 

4 Action area means all areas to be affected directly or indirectly by your project and may be broader than the immediate 

project area [See, e.g., 50 CFR 402.02].
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 15 of 24

Version 1.0

Criterion B:

Federally-listed threatened or endangeredspecies or their designated critical habitat(s) are likely to occur within the action 

area of your source, but the construction and operation of your new minor source or construction and operation of the 

modification to your existing minor source is not likely to adversely affect listed threatened or endangered species or

critical habitat. This determination may include consideration of any air pollution controls or other changes to the 

construction and/or operation of your new or modified source that you will adopt to ensure that construction, modification 

and operation of your new or modified source are not likely to adversely affect listed species or critical habitat. To 

make this certification, you must include the following in your request for coverage documentation: (1) identify any 

federally listed species and/or designated critical habitat located within the action area of your source; (2) the distance

between yoursite and the listed species or designated critical habitat (in miles); and (3) any other information 

necessary (e.g., a detailed map of the action area and supporting justification) to show that the 

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

listed threatened or endangered species or their critical habitat. 

Criterion C:

Coordination between you and the Service(s) has been concluded and has addressed the effects of your new or 

modified minor source’s construction/modification and operation on federally-listed threatened or endangered species

and federally-designated critical habitat. The coordination must result in a written concurrence from the relevant

Service(s) that your new or modified minor source’s construction/modification and operation are not likely to adversely

affect listed species or critical habitat. You must include copies of the correspondence between yourself and the

Service(s) with your submittal.

Criterion D:

Consultation between another Federal Agency and the Service(s) undersection 7 of the ESA has been concluded. The

consultation must have addressed the effects of your minor source’s construction/modification and operation on

federally-listed threatened or endangered species and federally-designated critical habitat. The result of this

consultationmust be either:

1. A biological opinion that concludesthat the action in question (taking into account the effects of your

source’s construction/modification and operation) is not likely to jeopardize the continued existence of

listed species, or result in the destruction or adverse modification of critical habitat; or

2. Written concurrence from the applicable Service(s) with a finding that the source’s 

construction/modification and operation are not likely to adversely affect federally-listed species or

federally-designated critical habitat.

You must include copies of the relevant documentation cited above in your submittal.

Criterion E:

You have obtained an incidental take permit from the Service(s) under section 10 of the ESA in connection with your 

construction/modification and operation activities, and this permit addressesthe effects of the source on relevant 

federally-listed species and federally-designated critical habitat. You must include copies of the incidental take permit 

and associated documentation and correspondence between yourself and the Service(s) with your submittal.
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

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2.0 Determining Which Criterion Applies

To qualify for the General Permit, you need to meet one of the five criteria listed above. You must follow the

proceduresin Steps 1 through 5 below to determine the listed species criterion, if any, under which your project is

eligible for permit coverage.

Step 1 - Determine if Previous or Separate Assessments Have Already Addressed Your Source

You should first determine whether you are eligible to select either Criterion D or E based on an ESA section 7 

consultation previously completed by another Federal Agency (Criterion D) or an ESA section 10 permit (Criterion E)

issued by the Service(s) as follows: 

Meeting Criterion D: If consultation under section 7 of the ESA has been concluded in connection with another Federal 

Agency’s involvement with your source, you may be eligible to select Criterion D. To be eligible to select Criterion D, you 

must confirm that all the following are true: 

 A consultation between a Federal Agency and the Service(s) under section 7 of the ESA has been concluded. 

Consultations can be either formal or informal, and would have occurred in connection with a separate action by 

a separate Federal Agency (e.g., as part of a separate Federal Agency’s authorization for you to construct or 

operate your business in Indian country). The consultation must have addressed the effects of the construction, 

modification and operation of your new or modified source on all federally-listed threatened or endangered 

species and all federally-designated critical habitat in your action area. The result of this consultation must be 

either: 

a. A biological opinion that concludes that the construction, modification and operation of your new or 

modified source is not likely to jeopardize the continued existence of any listed species, nor result in the 

destruction or adverse modification of any designated critical habitat. The consultation must have included 

consideration of the effects of your facility’s emissions and other related activities on all listed species and 

designated critical habitat in your action area; or 

b. Written concurrence (e.g., letter of concurrence) from the applicable Service(s) with a finding that the

construction, modification and operation of your new or modified source are not likely to adversely affect 

listed species or designated critical habitat. The consultation must have included the effects of your 

facility’s emissions and other related activities on all the listed species and designated critical habitat in 

your action area. 

 The consultation remains current, in accordance with 50 CFR § 402.16; or, if re-initiation of consultation is 

required (e.g., due to a new species listing or critical habitat designation or new information), such reinitiated 

consultation is concluded, and the result of the consultation is consistent with the statements above. Attach a 

copy of any consultation re-initiation documentation from the Service(s) or other consulting Federal Agency. 

If all of the above are true, you may select Criterion D. You must also provide a description of the basis for the 

criterion selected. In your submittal you must also provide the Biological Opinion (or Public Consultation Tracking 

System tracking number) or concurrence letter and any other documentation supporting your determination.

If any of the above is not true, you may not select Criterion D. For example: if the biological opinion or written 

concurrence from the Service(s) did not include the effects of your source’s air emissions or other-related activities as 

described above; or if the previous consultation covered some but not all of the listed species or critical habitat in your 

action area; or if the consultation is no longer current (e.g., due to new species listings); then you are not eligible under 

Criterion D.
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 17 of 24

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Meeting Criterion E: You have obtained an incidental take permit under section 10 of the ESA, and this permit

addresses the effects of the construction/modification and operation of your new or modified source on federallylisted species and designated critical habitat in your action area. 

You may rely on a section 10 permit that you have previously obtained so long as it addresses the 

construction/modification and operation of your new or modified source and all federally-listed species and 

designated critical habitat in your action area. (Note: If you do not hold a section 10 permit already, you can 

consider obtaining one, however, it may be more efficient to instead meet the requirements for Criterion A, B or C 

as described in Steps 2 – 5.)

If you choose to apply for a new section 10 permit, you must follow applicable Service procedures (see 50 CFR §

17.22(b)(1) for FWS and § 222.22 for NMFS). Application instructionsfor section 10 permitsfor FWS and NMFS can be

obtained by accessing the FWS and NMFS websites (http://www.fws.gov and http://www.nmfs.noaa.gov) or by

contacting the appropriate FWS and NMFS regional office. 

If the above is true, you may select Criterion E. You must also provide a description of the basis for the criterion 

selected. In your submittal you must provide a copy of the permit issued by the Service(s). 

If the above is not true, you may not select Criterion E at this time and must proceed to Step 2. For example, if a 

permit has been issued under section 10 of the ESA, but the permit did not consider the effects of the facility’s air 

emissions and/or emission-related activities on all federally listed species and designated critical habitat on your 

species list, you are not eligible under Criterion E.

Step 2 - Determine if Listed Threatened or Endangered Species or their Designated Critical Habitat(s) are Likely to

Occur within the Action Area of your Minor Source.

You must determine,to the best of your knowledge, whether speciesfederally listed as either threatened or

endangered, or their designated critical habitat(s), are located within the action area of your minor source.5 This is a twostep process. The first step is to determine your action area. When defining the boundaries of your action area, you should 

take into account the following criteria:

 Ground disturbance – Effects during construction, maintenance and operation of the facility should be 

considered.

 Changes in water quality/quantity (both surface and groundwater) – This would include effects that may extend 

far beyond the footprint of the facility. An example may be stormwater runoff from impervious surfaces 

(containing sediments or other contaminants) on the site that may reach water bodies (including ditches that 

empty into water bodies) some distance from a facility. All receiving water bodies that could receive pollutants 

from the facility’s construction, maintenance, or operation should be included in the action area.

 Air Quality Impacts – Effects during construction, maintenance and operation of the facility should be 

considered.

 Lighting effects – Effects during construction, maintenance and operation of the facility should be considered.

 

5

For definitions of terms that you might encounter when addressing the listed species requirements, go to:

http://www.fws.gov/midwest/endangered/glossary/index.html and http://www.fws.gov/northeast/nyfo/es/actionarea.htm.
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

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 Noise Disturbance – Effects during construction, maintenance and operation of the facility should be considered.

Note: If you have questions about determining the extent of the action area, you should coordinate with the 

local Service field office as noted below. If site-specific conditions exist such that the action area would be 

limited to the facility footprint, but that fact may not be obvious from a map or figure, submit a narrative 

description of the action area in addition to a map for evaluation of the action area selected. To determine

the field office that correspondsto your project site, visit:

http://www.fws.gov/endangered/regions/index.html and http://www.nmfs.noaa.gov/ (under the left tab for

“Regions”).

After determining the boundaries of the action area, you will next determine if listed species and/or critical habitat are

expected to exist there. Relevant sources of information regarding the locations of listed species and critical habitats are 

often organized along county and/or township lines. You should thus first identify the counties and/or townships within 

which your action area is located. You would then consult relevant sources of information regarding the locations of listed 

species and critical habitats. The local offices of the FWS and NMFS often maintain lists of federally listed threatened or 

endangered species on their Internet sites. For FWS terrestrial and aquatic species information, you can use the FWS online mapping tool, the Information, Planning, and Consultation System, located at http://www.fws.gov/ipac/.

In most cases, listed species and designated critical habitat lists will allow you to determine if any such species or

habitat exists in your county or township. You can also find critical habitat designations and associated

requirements at 50 CFR Parts 17 and 226 (see http://www.access.gpo.gov). You may also use the FWS Critical 

Habitat Portal (see http://criticalhabitat.fws.gov/crithab/).

 If there are no listed species and/or critical habitat in the counties/townships where your action area is 

located you may select Criterion A. You must also provide a description of the basis for the criterion selected

and provide documentation supporting the criterion selected in your submittal.

 If there are listed species and/or critical habitat in the counties/townships in your action area, you should

contact your local FWS or NMFS office to determine if the listed species are known to exist within the 

specific action area of your minor source and if any designated critical habitat areas overlap the action area of 

your minor source.

o If your local FWS or NMFS office indicatesthat these species and/or critical habitat could exist within the 

action area of your minor source, you must do one of the following to determine if the species and/or 

critical habitat may actually be present in or may use your action area:

 Conduct visual inspections. This method may be particularly suitable for sites that are smaller in 

size or located in non-naturalsettings such as highly urbanized areas or industrial parks where

there is little or no natural habitat.

 Conduct a formal biologicalsurvey. In some cases, particularly for larger sites, biologicalsurveys

may be an appropriate way to assess whetherspecies are located within the action area of your

minor source. Biologicalsurveys are frequently performed by environmental consulting firms. A

biological survey may in some cases be useful to conduct in conjunction with Steps 3, 4 or 5 of

these instructions.

 If, after performing one or more of the assessments above, you determine that there are no listed species 

or critical habitat in your action area, you may select Criterion A. You must also provide a description of the

basis for the criterion selected and provide documentation supporting the criterion selected in your submittal.
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

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 If, listed species or critical habitat are located in your action area then proceed to step 3.

2.3 Step 3

Determine if the Construction/Modification or Operation of Your New or Modified Minor Source is Likely to

Adversely Affect Listed Threatened or Endangered Species or Designated Critical Habitat

If in Step 2 you determine, based on communication with your local FWS or NMFS office, or otherwise,that listed

species and/or critical habitat could exist within the action area of your new or modified minor source, you must

next assess whether the construction/modification or operation of your new or modified minor source islikely to adversely

affect listed threatened or endangered species or designated critical habitat.

Potential adverse effects from construction/ modification and operation activitiesinclude direct and indirect effects and 

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

 Habitat Disturbance. Surface disturbance activities such as excavation,site development, grading, and associated 

light and noise may adversely affect listed species or their habitat. 

 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 that can affect listed species or their habitat. 

The scope of effectsto consider will vary with each site and project. If you are having difficulty determining whether

your project is likely to adversely affect listed species or critical habitat, or one of the Services has already raised

concernsto you, you should contact the appropriate office of the FWS or NMFS for assistance.

 If adverse effectsto listed threatened or endangered species or their critical habitat are not likely, then you

may select Criterion B. You must provide the following specific information with your submittal:

1 . The federally listed species and/or designated habitat that are located within the action area of your minor 

source;

2 . The distance between your site and the listed species or designated critical habitat (in miles); and

3 . Any other information necessary to show that the construction/modification and operation of your source are 

not likely to cause any adverse effects to the listed threatened or endangered species or their critical habitat.

 If adverse effects to listed threatened or endangered species or their critical habitat are likely, you must 

follow Step 4 below.
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

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2.4 Step 4

Determine if Measures Can Be Implemented to Avoid Adverse Effects

If you determine in Step 3 that adverse effects from the construction/modification or operation of your new or 

modified minor source are likely to occur, you can still select eligibility Criterion B if you undertake appropriate

measuresto avoid or eliminate the likelihood of adverse effects prior to seeking coverage under the General Permit. 

These measures may involve relatively simple changesto construction activitiessuch as re-routing construction to

bypass an area where species are located, relocating source activities, or modifying the “footprint” of the site.

 If you are able to implement appropriate measuresto avoid the likelihood of adverse effects, then you may

select Criterion B. The measures you adopt to avoid or eliminate adverse effects must be implemented for the

duration of the construction/modification and operation of your new or modified minor source and your

coverage under this General Permit. You must also provide a description of the basis for the criterion selected,

and the following specific information on your request for coverage form: ( 1) the federally listed species

and/or designated habitat that are located within the action area of your minor source; ( 2) the distance between

your source and the listed species or designated critical habitat (in miles); and (3) what steps were or will be 

taken to avoid the likelihood of adverse effects.

 If you cannot determine sufficient measuresto implement to avoid the likelihood of adverse effects, you

must follow the proceduresin Step 5.

2.5 Step 5

Coordinate with the Service(s)

If in Step 4 you cannot determine sufficient measuresto avoid the likelihood of adverse effects, you must contact the

applicable Service(s). You may still be eligible for coverage under theGeneral Permit if the likely adverse effects can be

addressed through meeting criterion C.

 Criterion C: You have coordinated with the Service(s) and have addressed the effects of the 

construction/modification and operation of your new or modified minor source on federally-listed threatened

or endangered species and federally-designated critical habitat. The Service(s) must provide written 

concurrence that the construction/modification and operation of your new or modified minor source is not

likely to adversely affect listed species or critical habitat.

o If you have obtained the Service(s) written concurrence as described above, then you may select Criterion C.

As part of your submittal, you must provide a description of the basis for the criterion selected and must

include copies of the correspondence between you and the applicable Service(s).
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 21 of 24

Version 1.0

Appendix B – Historic Property Screening Process

1.0 Background

The purpose of this appendix is to assist you in completing the

screening procedure for addressing historic properties that are 

either listed on, or eligible for listing on, the National Register for 

Historic Places prior to submitting your request for coverage under 

a General Air Quality Permit for New or Modified Minor Source Hot 

Mix Asphalt Plants in Indian Country. In order to be eligible for

coverage under the General Permit, you must demonstrate that

you qualify under one of the criteria listed in this appendix with

respect to the protection of historic properties under the NHPA.

To address any issues relating to historic properties, the EPA has

developed the screening process in this appendix to enable source 

owners/operatorsto: (1) appropriately consider the potential

impacts, if any, resulting from the construction, modification, and/or 

operation of a new or modified emission source on historic 

properties and, (2) if applicable, determine whether actions can be

taken to mitigate any such impacts. Although each decision that a specific minor source meets the requirements for coverage 

under this General Permit does not constitute a separate Federal undertaking, the screening process in this appendix

provides an appropriate site-specific means of addressing historic property issuesin connection with coverage under the 

General Permit.

If the impacts from your source have already been reviewed under another Federal agency’s approval process (e.g., the 

Bureau of Indian Affairs authorizing operation of your source in Indian country) then documentation from that review 

may satisfy the requirements of this section. In some cases the review by another agency will have evaluated the 

impacts from site disturbance activities (e.g., site clearing), but not from air emissions. In such cases supplemental 

evaluation may be required to complete the analysis.

2.0 Instructions for Source Owners/Operators

You are required to follow the screening process in this appendix to determine if the construction, modification or 

operation of a new or modified minor source of air pollutants on your site has the potential to cause effectsto historic

properties, and whether or not you need to contact your State Historic Preservation Officer (SHPO), Tribal Historic 

Preservation Officer (THPO), or other tribal representative for further information. You may not submit your 

Notification of Coverage under the General Permit until you have completed this screening process and obtained 

confirmation of satisfactory completion from the EPA. The following foursteps describe how applicants can meet the

historic property requirements under this permit.

Key Terms

Historic property- prehistoric or historic districts,

sites, buildings, structures, or objects that are

included in or eligible for inclusion in the National

Register of Historic Places, including artifacts,

records, and remains that are related to and located

within such properties

SHPO – The State Historic Preservation Officer for 

a particular state

THPO or Tribal representative – The Tribal Historic 

Preservation Officer for a particular Tribe or, if there is 

no THPO, the representative designated by such Tribe

for NHPA purposes
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EPA ICR No. 1230.27

OMB Control No. 2060-0003

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Step 1

Have prior professional cultural resource surveys or other evaluations determined whether historic

properties exist in the area of your proposed source? Or, have prior earth disturbances precluded the 

existence of historic properties in the area of your proposed source?

If it has already been determined that no historic properties exist in the area of your proposed source based

on available information, including information that may be provided by your applicable SHPO, THPO, or

other tribal representative,then you may submit the appropriate documentation of “no historic properties 

affected” with your submittal, and no furtherscreening steps are necessary.

Similarly, if earth disturbancesthat have occurred prior to your project have eliminated the possibility that historic

properties exist on your site or in the area affected by your new or modified minor source, then you may submit the 

appropriate documentation of “no historic properties affected” with your submittal, and no furtherscreening steps are

necessary.

During the 30-day period following receipt of your screening process documentation by the EPA, the SHPO, THPO, or 

other tribal representative may request that the EPA deny coverage under the General 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.

Step 2

If you are constructing, or modifying a minor source of air pollutants, as defined in 40 CFR § 49.152, you must

determine if the construction, modification or operation of the minor source will have an effect on historic 

properties.

If your answer to the questionsin Step 1 is “no,” then you must assess whether the activitiesrelated to the

construction, modification or operation of your new or modified minor source will have an effect on historic properties.

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

 Excavations;

 Demolitions of existing buildings;

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

 Installations of underground tanks;

 Addition of impervious surfaces; and

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

Note: This list is not intended to be exhaustive. Other activitiesthat are not on this list may involve earth-disturbing

activities and must also be examined for their potential to affect historic properties. 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. 

The assessment may be based on a site map of your source and an analysis of historicalsources, knowledge of the area, 

an assessment of the types of activities you are engaging in, considerations of any controls and/or management

practices you will adopt to ensure that your activities will not have an effect on historic properties, and any other

relevant factors.
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 23 of 24

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If you determine based on this assessmentthat the activities related to the construction, modification or operation of 

your new or modified minor source will not cause effectsto historic properties, then you may submit the appropriate 

documentation of “no historic properties affected” with your submittal, and no furtherscreening steps are necessary.

During the 30-day period following receipt of your screening process documentation by the EPA, the SHPO, THPO, or 

other tribal representative may request that the EPA delay your coverage under the General 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.

If you are installing or modifying equipment that has the potential to have an adverse effect on historic properties, then

you must proceed to Step 3.

Step 3

If you are constructing or modifying a minor source and you have not satisfied the conditionsin Steps 1-2, you

must contact and consult with the appropriate historic preservation authorities.

Where you are constructing or modifying a minor source and you cannot determine in Step 2 that this activity will not

have effects on historic properties,then you must contact the relevant SHPO, THPO, or other tribal representative to 

request their views as to the likelihood that historic properties may be adversely affected by the construction, 

modification or operation of your new or modified minor source.

Note: Addressesfor SHPOs and THPOs may be found on the Advisory Council on Historic Preservation’s(ACHP’s) website

(http://www.achp.gov/programs.html). In instances where a tribe does not have a THPO, you should contact the

appropriate Tribal government office designated by the tribe for this purpose when responding to this permit eligibility 

condition.

You must submit the following minimum information in order to properly initiate your request for information:

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 site map that show locations where activities might cause an adverse effect on historic properties.

Without submitting this minimum information, your request cannot be considered. You will need to provide the

SHPO, THPO, or other tribal representative a minimum of 15 calendar days after they receive these materialsto

respond to your request for information about your project. You are advised to get a receipt from the post office or 

other carrier confirming the date on which your letter was received.

If you do not receive a response within 15 calendar days after receipt by the SHPO, THPO, or other tribal representative

of your request, then you may indicate this in your submittal, and no furtherscreening steps are necessary.Or, if the

applicable SHPO, THPO, or other tribal representative respondsto your request with an indication that no historic

properties will be adversely affected by the construction or modification of your minor source, then you may submit the 

appropriate documentation of “no adverse effects” with your submittal, and no further screening steps are necessary.
EPA Form No. 5900-342

EPA ICR No. 1230.27

OMB Control No. 2060-0003

Approval expires 4/30/2017

Request for Coverage: Hot Mix Asphalt Plants Page 24 of 24

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If within 15 calendar days of receipt of your request the applicable SHPO, THPO, or other tribal representative 

responds with a request for additional information or for further consultation regarding appropriate measures for 

treatment or mitigation of effects on historic properties caused by the construction, modification or operation of your 

minor source, you must comply with this request and proceed to Step 4.

During the 30-day period following receipt of your screening process documentation by the EPA, the SHPO, THPO, or 

other tribal representative may request that the EPA place a hold on authorization 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.

2.4 Step 4

Consultation with your applicable SHPO, THPO, or other tribal representative.

If, following your discussions with the appropriate historic preservation authoritiesin Step 3, the applicable SHPO, THPO,

or other tribal representative requests additional information or further consultation, you must respond with such

information or consult to determine impacts and appropriate measures to mitigate such impacts to historic properties

that may be caused by the construction, modification or operation of your new or modified minor source site. If after 

consultation it is determined that there will be no adverse effects to historic properties, then you may submit the 

appropriate documentation of “no adverse effects” with your submittal, and no further screening steps are necessary. If as

a result of your discussions with the applicable SHPO, THPO, or tribal representative, you enter into, and comply with, a 

written agreement regarding treatment and/or mitigation of impacts on yoursite, then you may submit the appropriate 

documentation of “adverse effects” with your submittal.

If, however, agreement on an appropriate treatment or mitigation plan cannot be reached between you and the SHPO,

THPO, or other tribal representative within 30 days of your response to the SHPO, THPO, or other tribal

representative’srequest for additional information or further consultation, you may submit your screening process 

documentation, but you must indicate that you have not negotiatedmeasuresto avoid or mitigate such effects. You

must also include the following with your submittal:

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.

During the 30-day period following receipt of your submittal by the EPA, the SHPO, THPO, ACHP or other tribal 

representative may request that the EPA place a hold on confirmation 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 effects to historic 

properties are necessary.