15. Will the facility violate any “Applicable requirement” pursuant to NAC 445B.019? Yes No 16. Verify facility’s compliance status for the following regulations and describe the reason for exemption if applicable: FEDERALLY ENFORCEABLE REQUIREMENTS NAC 445B.225 Compliant Exempt Reason for Exemption NAC 445B.315(3)(h) Compliant Exempt Reason for Exemption NAC 445B.315(3)(i) Compliant Exempt Reason for Exemption NAC 445B.315(3)(k) Compliant Exempt Reason for Exemption 40 CFR 52.21(r)(4) Compliant Exempt Reason for Exemption NAC 445B.252 Compliant Exempt Reason for Exemption NAC 445B.22067 Compliant Exempt Reason for Exemption NAC 445B.22093 Compliant Exempt Reason for Exemption NAC Compliant Exempt Reason for Exemption NAC 445B.227 Compliant Exempt Reason for Exemption 40 CFR Parts 60.1-60.19, 61.01-61.19, 63.1-63.15, and 70 Compliant Exempt Reason for Exemption 40 CFR Part 82 Compliant Exempt Reason for Exemption NAC 445B.230 Compliant Exempt Reason for Exemption NAC 445B.22017 Compliant Exempt Reason for Exemption STATE REQUIREMENTS NRS 445B.470 Compliant Exempt Reason for Exemption NAC 445B.22013 Compliant Exempt Reason for Exemption NAC 445B.326(1) Compliant Exempt Reason for Exemption NAC 445B.22087 Compliant Exempt Reason for Exemption NAC Compliant Exempt Reason for Exemption
COMBUSTION EQUIPMENT APPLICATION FORM CLASS I OPERATING PERMIT (continued) Emission Unit Description: NOTE: Uncontrolled emissions must ALWAYS be provided. Description Data Sulfur Dioxide (SO2) Emissions Uncontrolled Emission Factor (insert units) Uncontrolled Emission Factor Reference Uncontrolled Emission pound/hour Uncontrolled Emission Limit ton/year Controlled Emission Factor (insert units) Controlled Emission Factor Reference Controlled Emission Limit Controlled Emission Limit ton/year Oxides of Nitrogen (NOX) Emissions Uncontrolled Emission Factor (insert units) Uncontrolled Emission Factor Reference Uncontrolled Emission Limit pound/hour Uncontrolled Emission Limit ton/year Controlled Emission Factor (insert units) Controlled Emission Factor Reference Controlled Emission Limit pound/hour Controlled Emission Limit ton/year Carbon Monoxide (CO) Emissions Uncontrolled Emission Factor (insert units) Uncontrolled Emission Factor Reference Uncontrolled Emission Limit pound/hour Uncontrolled Emission Limit ton/year Controlled Emission Factor (insert Controlled Emission Factor Reference Controlled Emission Controlled Emission ton/year Volatile Organic Compounds (VOC) Emissions Uncontrolled Emission Factor (insert units) Uncontrolled Emission Factor Reference Uncontrolled Emission Limit Uncontrolled Emission Limit ton/year Controlled Emission Factor (insert Controlled Emission Factor Reference Controlled Emission Limit Controlled Emission Limit ton/year
STORAGE SILO APPLICATION FORM I OPERATING PERMIT Emission Unit Description: Alternative Operating Scenario: Yes No Insignificant Activity: Yes No If yes, identify exemption regulation: Description Data Silo Loading Silo Unloading Equipment Description BAPC Emission Unit ID and System Number Applicable for Renewal or Revision eg. Unit ID: S2.001, PF1.001 System Number: 05 Source Classification Code (SCC) e.g. 3-03-024-04 for Conveyors Manufacturer Date Manufactured Model Number Equipment Dimensions (LxWxH) feet Drop Dimensions (LxWxH) if applicable feet Emissions Released Inside building? yes/no Location of Emission Source UTM Northing (NAD 83, Zone 11) m UTM Easting (NAD 83, Zone 11) m Operating Parameters Material Type Processed Operating Time per Day hour/day Operating Time per Year hour/year Hourly Throughput Rate unit/hour Annual Throughput Rate unit/year Batch Process if applicable unit/batch Start Time if operating less than 24 hours/day hour:minute End Time if operating less than 24 hours/day hour:minute Control Equipment Type of Control Control Efficiency % Pollutant(s) Controlled Manufacturer Manufacturer’s Guarantee Included? yes/N/A
STORAGE SILO APPLICATION FORM CLASS I OPERATING PERMIT (continued) Emission Unit Description: NOTE: Uncontrolled emissions must ALWAYS be provided. Description Data Silo Loading Silo Unloading Stack Parameters Stack Height feet Stack Inside Diameter feet Stack Temperature ºF Stack Exit Velocity feet/second Actual Gas Volume Flow Rate acfm Dry Gas Volume Flow Rate dscfm Stack Release Type Vertical/Capped/ Horizontal Particulate Matter (PM) Emissions Uncontrolled Emission Factor (insert Uncontrolled Emission Factor Reference Uncontrolled Emission Limit pound/hour Uncontrolled Emission Limit ton/year Controlled Emission Factor (insert units) Controlled Emission Factor Reference Controlled Emission Limit pound/hour Controlled Emission Limit ton/year Particulate Matter as PM10 Emissions Uncontrolled Emission Factor (insert units) Uncontrolled Emission Factor Reference Uncontrolled Emission Limit pound/hour Uncontrolled Emission Limit ton/year Controlled Emission Factor (insert units) Controlled Emission Factor Reference Controlled Emission Limit pound/hour Controlled Emission Limit ton/year Particulate Matter as PM2.5 Emissions Uncontrolled Emission Factor (insert units) Uncontrolled Emission Factor Reference Uncontrolled Emission Limit pound/hour Uncontrolled Emission ton/year Controlled Emission Factor (insert units) Controlled Emission Factor Reference Controlled Emission Limit pound/hour Controlled Emission Limit ton/year Other Pollutants Pollutant Name Uncontrolled Emission Factor (insert units) Uncontrolled Emission Factor Reference Uncontrolled Emission Limit pound/hour Uncontrolled Emission Limit ton/year Controlled Emission Factor (insert units) Controlled Emission Factor Reference Controlled Emission Limit pound/hour Controlled Emission Limit ton/year
STORAGE SILO APPLICATION FORM I OPERATING PERMIT (continued) Emission Unit Description: Subject to a Federal Regulation specific to the emission unit (e.g. 40 CFR Part 60, 61, 63, 64, 76, or Yes No If yes, identify regulation and applicability and include required analysis or plans (e.g. siting analysis or Continuous Assurance Monitoring (CAM) plans). Subject to a State Regulation specific to the emission unit (e.g. NAC 445B.2203, NAC 445B.22047, NAC 445B.22033, NAC 445B.22017): Yes No If yes, identify regulation and applicability. Identify standards for work practices which affect emissions for all regulated air pollutants (e.g. At all times, including startup, shutdown and malfunction). Identify and describe compliance and performance testing with reference to any applicable test methods, monitoring devices, compliance plan, or activities required to determine compliance with an applicable requirement (e.g. Emissions from this unit will be monitored by CEMS and/or COMS for the specific pollutant(s) (NOX, CO, etc.)).