COMBUSTION EQUIPMENT APPLICATION FORM CLASS II OPERATING PERMIT Emission Unit Description: Alternative Operating Scenario: Yes No Insignificant Activity: Yes No If yes, identify exemption regulation: Subject to a Federal Regulation (40 CFR Part 60, 61, or 63): Yes No If yes, identify in process narrative. Description Data Equipment Description BAPC Emission Unit ID and System Number Applicable for Renewal or Revision eg. Unit ID: S2.001 Sys Number: 5 Source Classification Code (SCC) e.g. 3-03-024-04 for Conveyors Manufacturer Date Manufactured Model and Serial Number Max Design Heat [NAC 445B.3135] MMBtu/hour Emissions Released Inside building? yes/no For Reciprocating Internal Combustion Engines (RICE) Only Max Design Horsepower Output hp (kW) Type of Engine Code (See Notes*) Date Constructed month/day/yr Cylinder Displacement liter/cylinder EPA Tier # Location of Emission Source UTM Northing (NAD 83, Zone 11) m UTM Easting (NAD 83, Zone 11) m Operating Parameters /Fuel Usage Fuel Type Operating Time per Day hour/day Operating Time per Year hour/year Hourly Usage Rate Maximum Provide Equipment Specifications unit/hour Annual Usage Rate Maximum unit/year Sulfur Content % Heat Content Btu/unit Start Time if operating less than 24 hours/day hour:minute End Time if operating less than 24 hour:minute Notes* Code Description Code Description LU Limited Use E-SI Emergency Ignition LDG Landfill/Digester Gas SI4SRB Ignition 4-Stroke Rich Burn NECI Non-Emergency Compression Ignition SI4SLB Spark Ignition 4-Stroke Lean Burn ECI Emergency Compression Ignition SI2SLB Spark Ignition 2-Stroke Lean Burn
COMBUSTION EQUIPMENT APPLICATION FORM CLASS II OPERATING PERMIT (continued) Emission Unit Description: Description Data Control Equipment Type of Control Control Efficiency % Pollutant(s) Controlled Manufacturer Manufacturer’s Guarantee Included? yes/N/A 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 Emission Factor (with units) (insert units) Emission Factor Reference Emission pound/hour Emission Limit ton/year Particulate Matter as PM10 Emissions Emission Factor (with units) (insert units) Emission Factor Reference Emission Limit pound/hour Emission Limit ton/year Particulate Matter as PM2.5 Emissions Emission Factor (with units) (insert units) Emission Factor Reference Emission Limit pound/hour Emission Limit ton/year Sulfur Dioxide (SO2) Emissions Emission Factor (with units) (insert units) Emission Factor Reference Emission Limit Emission Limit ton/year Oxides of Nitrogen (NOX) Emissions Emission Factor (with units) (insert units) Emission Factor Reference Emission Limit pound/hour Emission Limit ton/year Carbon Monoxide (CO) Emissions Emission Factor (with units) (insert Emission Factor Reference Emission pound/hour Emission Limit ton/year
CLASS II OPERATING PERMIT (continued) Emission Unit Description: 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 Release Type Vertical/Capped/ Horizontal Particulate Matter (PM) Emissions Emission Factor (with (insert units) Emission Factor Reference Emission Limit pound/hour Emission Limit ton/year Particulate Matter as PM10 Emissions Emission Factor (with units) (insert Emission Factor Reference Emission Limit pound/hour Emission Limit ton/year Particulate Matter as PM2.5 Emissions Emission Factor (with (insert units) Emission Factor Reference Emission Limit pound/hour Emission Limit ton/year Other Pollutants Pollutant Name Emission Factor (with units) (insert units) Emission Factor Reference Emission Limit pound/hour Emission Limit ton/year
Emission Unit Description: Description Data Operating Parameters Material Type Operating Time per Year hour/year Maximum Throughput Maximum Throughput gallon/year Control Equipment Type of Control Control Efficiency % Pollutant(s) Controlled Manufacturer Manufacturer’s Guarantee Included? yes/N/A Volatile Organic Compounds (VOC) Emissions Emission Factor (with units) (insert units) Emission Factor Reference Emission Limit Emission Limit ton/year Other Pollutants Emission Factor (with units) (insert units) Emission Factor Reference Emission Limit pound/hour Emission ton/year