CALIFORNIA AIR RESOURCES BOARD



### SIP COMPLETENESS CHECKLIST
(Electronic Format)

*** TO BE COMPLETED BY DISTRICT AND RETURNED TO ARB ***

All rules submitted to the EPA as State Implementation Plan (SIP) revisions must be supported by certain information and documentation for the rule packages to be deemed complete for review by the EPA. Rules will not be evaluated for
approvability by the EPA unless the submittal packages are complete. To assist you in determining that all necessary

materials are includ ed in rules packages sent to the ARB for submittal to the EPA, please fill out the following form and include it with the rule package you send ARB. See the ARB's Guidelines on the Implementation of the 40 CFR 51,

Appendix V , for a more detailed explanati on than is provided here. Adopted rules and rule amendments should be checked against U.S. EPA's Guidance Document for Correcting Common VOC & Other Rule Deficiencies (Little Blue Book, August 21, 2001) to ensure that they contain no elements which will r esult in disapproval by EPA.

District: Placer County Air Pollution Control District

Rule No: 50 3

Rule Titl e: Emission Statement

Date Adopted or Amended: August 12, 2010

ADMINISTRATIVE MATERIALS

Note: All documents should be in electronic format. Items that have signatures, initials, or stamps may be scanned.

Not

Attached Attached N/A

COMPLETE COPY OF THE RULE: Provide an unmarked copy of the entire
rule as adopted or amended by your District Board.

UNDERLINE AND STRIKEOUT COPY OF THE RULE : If an amended rule,

provide a complete copy of the rule i ndicating in underline and strikeout format

all language which has been added, deleted, or changed since the rule was

last adopted or amended.

COMPLETE COPY OF THE REFERENCED RULE(S): For any rule which

includes language specifically referencing another rule, a copy of that other
rule must also be submitted, unless it has already been submitted to EPA as part of a previous SIP submittal.

PUBLIC NOTICE EVIDENCE: Include a copy of the local newspaper clippin g

certification(s), stating the date of publication, which must be at least 30 days before the hearing. As an alternative, include a copy of the actual published notice of the public hearing as it appeared in the local newspaper(s). In this

case, however, enough of the newspaper page must be included to show the date of publication. The notice must specifically identify by title and number

each rule adopted or amended.

RESOLUTION/MINUTE ORDER: Provide the Bo ard Clerk certified resolution

or minute order. This document must include certification that the hearing
was held in accordance with the information in the public notice. It must also
list the rules that were adopted or amended, the date of the public h earing, and a statement of compliance with California Health and Safety Code

Sections 40725

- 40728 (Administrative Procedures Act).

PUBLIC COMMENTS AND RESPONSES: Submit copies of written public

comments made during the notice period and at the publ ic hearing. Also submit any written responses prepared by the District staff or presented to the District Board at the public hearing. A summary of the public comments and responses is adequate. If there were no comments made during the notice

period or at the hearing, please indicate N/A to the left.5/1/2002 CALIFORNIA AIR RESOURCES BOARD



### SIP COMPLETENESS CHECKLIST
(Electronic Format)

TECHNICAL MATERIALS

Not

Attached Attached N/A

RULE EVALUATION FORM: See instructions for completing the Rule Evaluation Form and the accompanying sample form.

NON

- EPA TEST METHODS: Attach all test methods that are referenced in

your rule that do not appear in 40 CFR 51, 60, 61, 63, or have not been

previously submitted to EPA. EPA methods used in other media such as SW846 for solid waste are not automatically approved for air pollution applications. Submittal of test methods that are not EPA

- approved should include the information and follow the procedure described in Region 9’s “Test

Method Review & Evaluati on Process.”

MODELING SUPPORT: Provide if appropriate. In general, modeling support is

not required for VOC and NOx rules to dete rmine their impacts on ozone levels. Modeling is required where a rule is a relaxation that affects large sources ( > 100 TPY) in an attainment area for SO2, directly emitted PM10, CO, or NOx (for NO2 purposes). In cases where EPA is concerned with the

im pact on air quality of rule revisions which relax limits or cause a shift in
emission patterns in a nonattainment area, a reference back to the approved SIP will be sufficient provided the approved SIP accounts for the relaxation

and provided the approved SIP used the current EPA modeling guidelines. If
current EPA modeling guidelines were not used, then new modeling may be
required.

ECONOMIC AND TECHNICAL JUSTIFICATION FOR DEVIATIONS FROM

EPA POLICIES : The District staff report or other information included with the

submittal should discuss all potential relaxations or deviations from RACT, RACM, BACT, BACM, enforceability, attainment, RFP, or other relevant EPA requirements. This includes, for example, demonstrating that exemptions or
emission limits less stringent than the presumptive RACT (e.g., a CTG) meet
EPA’s 5 percent policy, and demonstrating that all source categories exempted from a RACM/BACM rule are de minimus according to EPA’s RACM/BACM policy.

ADDITIONAL MATERIALS : Provide District staff reports and any other

supporting information concerning development of t he rule or rule changes. This information should explain the basis for all limits and thresholds

contained in the rule.