Enclosure 2a

Hours

Per (e.g., week, 

month, year)

Owner Name: _________________________________ Facility Name: __________________________________________

 Process Unit ID: ________________________________________

PART IV. GENERAL FLEXIBLE POLYURETHANE FORAM PRODUCTION INFORMATION

Process unit ID

Year unit 

originally 

installed

Original captial 

cost of unit(s)

Remaining useful life 

of unit

Maximum design 

capacity (e.g., 

lbs/day)

Please complete the following questions for each Flexible Polyurethane Foam Production process unit. You are not expected to 

generate new information for this survey. Only supply data that are readily available to you.

Typical unit operation

1. Please provide the following information for each Flexible Polyurethane Foam Production process unit: 

a. Provide general information for each process unit

Enclosure 2a

Owner Name: _________________________________________ Facility Name: ______________________________

 Process Unit ID: _____________________________

 trains.

b. Provide information on upgrades to each flexible polyurethane foam production process unit and associated air pollution control

Description of upgrades made 

to air pollution control 

devices associated with the 

Description of 

upgrades made to 

the process unit

Year(s) upgrade was 

Process unit ID made

Year(s) upgrade was 

made

Enclosure 2a

Process Unit ID

Total operating and 

maintenance costs 2008 2009 2010

c. Using the format on this page, include operating and maintenance cost information for each 

 process unit. Definitions for different types of costs are taken from EPA Air Pollution Control

 Cost Manual at http://epa.gov/ttn/catc/products.html#cccinfo

Owner Name: _____________________ Facility Name: _______________________________________

 Process Unit ID: ____________________________________

Enclosure 2a

2. Include yearly emissions information in the following table (include source of information). 

Emission 

Point

Process 

Unit ID HAP Pollutant

Tons per year 

2006

Tons per year 

2007

Tons per year 

2008

Tons per year 

2009

Tons per year 

2010

 unit.

Owner Name: __________________________________________ Facility Name: ____________________________

 Process Unit ID: ___________________________

 Include storage tanks or any auxiliary equipment on site, per unit ID and label each as type of



Xylenes (Mixture of o, m, and p Isomers)

Methyl Isobutyl Ketone

2,4-Toluene Diisocyanate

Methylene Chloride

Toluene

Ethyl Benzene

Styrene

Diethanolamine

Benzene

Bis(2-Ethylhexyl)Phthalate

Glycol Ethers

Methanol

4,4'-Methylenediphenyl Diisocyanate

p-Dioxane

1,2-Epoxybutane

Cumene

Vinyl Acetate

Triethylamine

Chloroform

Acetonitrile

Phenol

Cyanide & Compounds

Hexane
Formaldehyde

p-Xylene

Acetaldehyde

Acrylonitrile

Ethylene Glycol
Enclosure 2a

e. Submit a copy of the test reports.

f. For pollutants measured with continuous emissions monitoring systems (CEMS), please submit a copy of the 

most recent Relative Accuracy Test Audit (RATA) for the last 30 day period including those days where manual testing was 

conducted.

Owner Name: __________________________________________ Facility Name: ____________________________

 Process Unit ID: ___________________________

3. Provide information on each emission test conducted at each specific process unit. Please copy this page and provide 

the following information for each test conducted at anytime in the last 5 years.

a. Identify the Process Unit ID: ___________________________________

b. Describe emission release point(s) that were tested: __________________________________________________

c. Date of test: ______________________________________

d. Specify the test method(s) used: ___________________________________________________________________

 _________________________________________________________________________________________________

Enclosure 2a

 Process Unit ID: ___________________________

 (e.g., ductwork, piping, foundation/supports, site preparation): __________________________

 ___________________________________________________________________________________

 ___________________________________________________________________________________

 ___________________________________________________________________________________

 __________________________________________________________________________________

d. Type of control device: _____________________________________________________________

e. Year installed: _____________________________________________________________________

f. Manufacturer: _____________________________________________________________________

g. Model No: ________________________________________________________________________

h. Original installed cost of the control device (capital cost of the control plus installation cost): 

a. Process Unit ID: _____________________________________________________________________

b. Does the process unit have a control device that reduces air pollution : _____ Yes _____ No

Owner Name: ______________________________ Facility Name: ____________________________

4. For each flexible polyurethane foam production process unit, provide the following 

i. List the elements that are included in the installed cost estimate in question IV.5.h 

c. Describe the release point(s) that are being controlled (e.g., equipment or unit operation 

 where the release point is located): __________________________________________________

 __________________________________________________________________________________

 __________________________________________________________________________________

 __________________________________________________________________________________

 __________________________________________________________________________________

 information regarding air pollution control devices. Please copy this page and provide the

 following information for each unit: 

 __________________________________________________________________________________
Operating cost 

information 2008 2009 2010

Control device ID:

Total operating costs

Electricity costs

Wastwater treatment 

costs

Fuel costs

Water costs

Waste disposal costs

Process unit operating 

labor costs

Monitoring, 

recordkeeping, and 

reporting

Other (please describe): 

________________

Other (please describe): 

________________

 control device.

j. Use the following table to provide the annual cost for operating and maintenance of each 


Enclosure 2a

Process unit ID

Measures or modification made to 

minimuze emissions

Estimated emission 

reduction (lb/yr)

Owner Name: _______________________________ Facility Name: ________________________

 Process Unit ID: _______________________

5. For each process unit identify measures (e.g., annual tune-ups or burners, good comubtion 

practices, pollution prevention measures, or any other emission control approaches that reduce 

HAP emissions) or modifications made to the process unit to reduce emissions:

Enclosure 2a

Emission reduction technique 

descriptions Pollutants affected Reduction efficiency

________________________ _______________________ ____________________

________________________ _______________________ ____________________

________________________ _______________________ ____________________

________________________ _______________________ ____________________

________________________ _______________________ ____________________

________________________ _______________________ ____________________

 ____________________________________________________________________________________

e. At what frequency is parameter monitor quality assurance/control (e.g., calibration) performed?

7. Please submit a copy of any cost information you have for the modification or emission reduction me 

(other than add-on control devices) listed above.

 ____________________________________________________________________________________

 ____________________________________________________________________________________

f. What is annual parameter monitoring cost?

 ____________________________________________________________________________________

Owner Name: __________________________________________ Facility Name: ____________________

_______________________________________________________________________________________

c. At what frequency is parameter monitoring done? ___________________________________________

d. Describe initial and ongoing parameter monitoring quality assurance/control: 

 ____________________________________________________________________________________

 reduce emissions, such as substitutions or product reformulation.

a. Complete fo each emission reduction technique utilized that is not a contro device.

b. What parameters are monitored to ensure operation of the emission reduction technique?

6. Other emission reduction techniques. Include any information about changes made in raw material u 

 Process Unit ID: _______________
________

ethod 

________

________

________

_________

________

____

________

usage to

_____________
Enclosure 2a

Emission 

source(s) causing 

event

Description 

of event

Permit 

conditions 

exceeded 

(Y/N)

Date of 

Event

Duration 

of each 

event 

(hours)

Was the event 

covered by a 

contingency plan 

for controlling 

emissions? 

(Y/N)

Estimates 

of 

emissions 

during 

event 

(pounds)

Basis for 

emissions 

estimate

Any monitoring 

data or control 

system parameter 

monitoring 

collected during 

event? 

(Y/N)

a. Please indicate number of times over the last 3 years that a shutdown and start-up event has occurred: ________

b. Complete the following table for each shutdown and start-up event occurring over the last three years.

Owner Name: __________________________________________ Facility Name: ____________________________

 Process Unit ID: ___________________________

8. Please provide the following information for each process unit during start-up and shutdown operation:

__________________________________________________________________________________

__________________________________________________________________________________

 of the flexible polyuretuane foam production process unit.

k. Are you required to submit periodic and immediate start-up and shutdown reports

 (either stand-alone or contrained within the periodic excess emissions report) to your

 permitting aurhority? ____________________________________________________________

 _______________________________________________________________________________

i. What were the test conditions at the time of testing ? ________________________________

 _______________________________________________________________________________

 _______________________________________________________________________________

 _______________________________________________________________________________

j. Please submit a copy of any test data you have conducted during any start-up or shutdown

 _______________________________________________________________________________

Enclosure 2a

c. Please list the procedures that are followed or any activities that occur during start-up and 

shutdown at this process unit to minimize emissions (e.g., turn off unit, monitor pressure):

d. Is the emission profile of the flexible polyurethane foam production unit differenet during start-up 

and shutdown than during normal operating conditions? _____ Yes _____No

e. If the answer to Part IV 9.d. is yes, please explain, in detail, how and why emissions are different 

__________________________________________________________________________________

__________________________________________________________________________________

f. Do you have test data that show emissions durint start-up or shutdown? __ Yes __ No

g. If yes, when and why did you conduct such testing? __________________________________

Owner Name: ___________________________ Facility Name: ____________________________

 Process Unit ID: ___________________________

 _______________________________________________________________________________

 _______________________________________________________________________________

h. Please identify the emissions test method(s) used during start-up or shutdown.

 _______________________________________________________________________________

 _______________________________________________________________________________

Enclosure 2a

Longitude Latitude

Height of 

release point 

(feet)

Exit of velocity 

of vent release 

point 

(feet/second)

Exit 

temperature of 

vent/flue gas 

(F)

Diameter of 

release point 

(feet)

Owner Name: ___________________________ Facility Name: ____________________________

 Process Unit ID: ___________________________

9. Stack Relase Parameters for Emission Points

 Please provide the following information for all emission release points for use in righ modeling

Location of release point (decimal 

degrees, minimum 5 digits beyond 

Emission decimal)

Point Process Unit ID

Height of 

release point Release Height

Longitude Latitude (ft) (ft)

Location of release point 

(decimal degrees, 

minimum 5 digits beyond 

Emission decimal)

Point

Process Unit 

ID

Longitude: Measure in decimal degrees of the angular distance on a meridan east or 

west of the prime meridian Negative (-) data point for N. American. Includle (-) sign. 

Ex. -123.234561. For point sources this represents the center of the source; for 

fugitive sources this is the southwest corner if the fugitive angle is zero, or the western 

 

Notes on Modeling Data:

Coordinates: For geographic coordinates, provide either latitude and longitude or 

UTM coordinates with zone. Latitude and longitude should be provided in decimal 

degrees, with 6 digits to right of decimal point, and an indication of the associated 

NAD (North American Datum, either NAD27 or NAD83. If left blank, NAD83 will be 

Latitude: Measure in decimal degrees of the angular distance on a meridian north or 

south of the equator. Positive (+) data point for N. America. Include (+) sign.

Ex. +78.123456. For point sources this represents the center of the source; for fugitive 

sources this is the southwest corner if thefugitive angle is zero, or the western most 

corner if the fugitive angle is greater than zero.

Owner Name: ___________________________ Facility Name: ____________________________

10. Non point releases. Please include a listing of fugitive releases, including the following

 information per release point. Please include "no releases" if this question does not

 apply. Notes on modeling data definitions are below.
 

 

 

most corner if the fugitive angle is greater than zero.

Angle of Rotation: Angle of rotation specifies the rotation of the source from north 

(in the clockwise direction). The location coordinates (UTM or latitude and longitude) 

should reflect the southwest corner of the area source. The x-dimension should 

reflect the length of the source in the easterly direction, or in the southeasterly 

direction if the source is rotated. The y-dimension should reflect the length in the 

northerly direction, or the northeasterly direction if the source is rotated.
Angle of Rotation 

x (length, ft) y (width, ft) (degrees)

Dimension of Source
Enclosure 2a

 _______________________________________________________________________________

n. What control devices are upstream of the scrubber? _________________________________

o. What control devices are downstream of the scrubber? ______________________________

l. Average outlet gas temperature for each scurbber: ________________________________o

F

m. Please describe the source and quality of the water fed to the scrubber (e.g., effluent 

 water with a total solids content of _____): _________________________________________

 _______________________________________________________________________________

 _______________________________________________________________________________

 _______________________________________________________________________________

k. Mist eliminator: _____ Yes _____ No

 _______________________________________________________________________________

 _______________________________________________________________________________

c. Type of scrubber: _______________________________________________________________

d. Design pollutant-laden gas inlet flow rate: ______acfm

e. Design pollutant-laden gas inlet temperature: ________oF

f. Scrubbing medium (describe): ____________________________________________________

g. Influent scrubbing medium pH: ___________________________________________________

h. Effluent scurbbing medium pH: ___________________________________________________

i. Scrubber water flow: _________________________________________________ gals/min (?)

j. Scrubber pressure drop (across each scrubber--provide units): _________________________

b. Please list the pollutants that the scrubber is intended to reduce or remove.

Owner Name: ___________________________ Facility Name: ____________________________

 Process Unit ID: ___________________________

11. Scrubber

a. Does the flexible polyurethane foam production process unit have a scurbber? 

_____ Yes _____ No

Enclosure 2a

 Process Unit ID: ___________________________

Legal Owner Name:

Facility Name:

Process Unit ID:

Process Unit ID for controlled processes:

Stack or Vent Height (ft)

Stack or Vent Diameter (ft)

Manufacturer/Model

Original Installation Date

Gas flow rate to condenser (acfm)

Inlet gas temerature (oF)

Compound Name

Volume Fraction

Compound Name

Volume Fraction

Compound Name

Volume Fraction

Compound Name

Volume Fraction

Describe any plans to replace or upgrade the adsorber

Owner Name: ___________________________ Facility Name: ____________________________

12. Carbon Adsorber

 Please include a copy of this table for each carbon adsorber controlling emissions from 

 flexible polyurethane foam production process unit.

CARBON ADSORBER

Organic compounds in inlet gas stream

Vendor guarantee on adsorber efficient (attach copy)

Describe preventative maintenance procedures and frequency

List all monitoring methods used, including parameters and frequency


Xylenes (Mixture of o, m, and p Isomers)

Methyl Isobutyl Ketone

2,4-Toluene Diisocyanate

Methylene Chloride

Toluene

Ethyl Benzene

Styrene

Diethanolamine

Benzene

Bis(2-Ethylhexyl)Phthalate

Glycol Ethers

Methanol

4,4'-Methylenediphenyl Diisocyanate

p-Dioxane

1,2-Epoxybutane

Cumene

Vinyl Acetate

Triethylamine

Chloroform

Acetonitrile

Phenol

Cyanide & Compounds

Hexane

Formaldehyde

p-Xylene

Acetaldehyde

Acrylonitrile

Ethylene Glycol