OAQ AIR PERMIT APPLICATION FORMS CHECKLIST
State Form 51607 (R4 / 4-08)
INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
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NOTES: · · ·
IDEM - Office of Air Quality - Permits Branch 100 N. Senate Avenue, MC 61-53, Room 1003 Indianapolis, IN 46204-2251 Telephone: (317) 233-0178 or Toll Free: 1-800-451-6027 x30178 (within Indiana) Facsimile Number: (317) 232-6749 www.in.gov/idem/permits/air/index.html
The purpose of this checklist is to help the applicant and IDEM, OAQ ensure that the air permit application packet is administratively complete. This checklist is a required form. Check the appropriate box indicating whether each application form is applicable for the current permit application. The source must submit only those forms pertinent to the current permit application. Place this checklist between the cover sheet and all subsequent forms and attachments that encompass your air permit application packet.
Part A: General Source Data
Applicable? Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y N N N N N N N N N N N N N N N N N N Form ID Title of Form State Form Number When should this form be included in my application packet?
COVER
CHECKLIST
Application Cover Sheet Forms Checklist Basic Source Level Information Plant Layout Diagram Process Flow Diagram Stack / Vent Information Emissions Unit Information Particulate Emissions Summary Criteria Pollutant Emissions Summary HAP Emissions Summary Summary of Additional Information Insignificant Activities Alternative Operating Scenario Affidavit of Nonapplicability Affidavit of Applicability Owners and Occupants Notified Government Officials Notified Renewal Checklist
50639 51607 50640 51605 51599 51606 51610 51612 51602 51604 51611 51596 51601 51600 51603 51609 51608 51755
Include for every application, modification, and renewal, including source specific operating agreements (SSOA). Include for every application, modification, and renewal, including SSOA. Include for every application, modification, and renewal, including SSOA. Include for every new source application, and modification. Include one for every process covered by the application. Include for every new source application, and modification. Include for every process covered by the application. Include if the process has particulate emissions (PM). Include if the process has criteria pollutant emissions. Include if the process has hazardous air pollutant emissions (HAP). Include if the additional information is included. Include if there are unpermitted insignificant activities. Include if an AOS is requested. Include if the standard notification requirements do not apply. Include if the standard notification requirements apply. Include if the standard notification requirements apply. Include if the standard notification requirements apply. Include with every operating permit renewal packet.
GSD-01 GSD-02 GSD-03 GSD-04 GSD-05 GSD-06 GSD-07 GSD-08 GSD-09 GSD-10 GSD-11 GSD-12 GSD-13 GSD-14 GSD-15 RENEWAL
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Page 1 of 6
Indiana Department of Environmental Management Office of Air Quality State Form 51607 (R4 / 4-08)
Air Permit Application Forms Checklist Page 2 of 6
Part B: Process Information
Applicable? Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y N N N N N N N N N N N N N N N N N N N N N N N N N Form ID Title of Form State Form Number When should this form be included in my application packet?
AEF-01 PI-01 PI-02A PI-02B PI-02C PI-02D PI-02E PI-02F PI-02G PI-02H PI-03 PI-04 PI-05 PI-06 PI-07 PI-08 PI-09 PI-10 PI-11 PI-12 PI-13 PI-14 PI-14ALT PI-15 PI-16
Alternate Emission Factor Request Miscellaneous Processes Combustion Unit Summary Combustion: Boilers, Process Heaters, & Furnaces Combustion: Turbines & Internal Combustion Engines Combustion: Incinerators & Combustors Combustion: Kilns Combustion: Fuel Use Combustion: Emission Factors Combustion: Federal Rule Applicability Storage and Handling of Bulk Material Asphalt Plants Brick / Clay Products Electroplating Operations Welding Operations Concrete Batchers Degreasing Dry Cleaners Foundry Operations Grain Elevators Lime Manufacturing Liquid Organic Compound Storage Alternate version of Liquid Organic Compound Storage Portland Cement Manufacturing Reinforced Plastics & Composites
51860 52534 52535 52536 52537 52538 52539 52540 52541 52542 52543 52544 52545 52546 52547 52548 52549 52550 52551 52552 52553 52554 (doc) 52555 (xls) 52556 52557
Submit if you are requesting to use an emission factor other than AP-42. Include one form for each process for which there is not a specific PI form. Include one form to summarize all combustion units (unless SSOA). Include one form for each boiler, process heater, or furnace (unless SSOA). Include one form for each turbine or internal combustion engine (unless SSOA). Include one form for each incinerator or combustor (unless SSOA). Include one form for each kiln (unless SSOA). Include one form for each combustion unit (unless SSOA). Include one form for each combustion unit (unless SSOA). Include one form for each combustion unit (unless SSOA). Include if the process involves the storage and handling of bulk materials. Include for each asphalt plant process (unless general permit). Include for each brick and/or clay products process. Include for each electroplating process. Include for each welding process. Include for each concrete batcher (unless SSOA). Include for each degreasing process (unless SSOA). Include for each dry cleaning process Include for each foundry process Include for each grain elevator (unless SSOA). Include for each lime manufacturing process. Include if the process involves the storage of liquid organic compounds. Include if the process involves the storage of liquid organic compounds and there are several storage vessels. Include for each Portland cement manufacturing process. Include for each reinforced plastics and composites process.
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Indiana Department of Environmental Management Office of Air Quality State Form 51607 (R4 / 4-08)
Air Permit Application Forms Checklist Page 3 of 6
Part B: Process Information
Applicable? Y Y Y Y Y Y N N N N N N Form ID Title of Form State Form Number When should this form be included in my application packet?
PI-17 PI-18 PI-19 PI-20 PI-21 PI-22
Blasting Operations Mineral Processing Surface Coating & Printing Operations Woodworking / Plastic Machining Site Remediation Ethanol Plants (Under Development)
52558 52559 52560 52561 52570 None
Include for each blasting process (unless SSOA). Include if the process involves mineral processing (unless SSOA). Include for each surface coating or printing process (unless SSOA). Include for each woodworking or plastic machining process (unless SSOA). Include for each soil remediation process. Include for each ethanol plant.
Part C: Control Equipment
Applicable? Y Y Y Y Y Y Y Y Y Y N N N N N N N N N N Form ID Title of Form State Form Number When should this form be included in my application packet?
CE-01 CE-02 CE-03 CE-04 CE-05 CE-06 CE-07 CE-08 CE-09 CE-10
Control Equipment Summary Particulates Baghouse / Fabric Filter Particulates Cyclone Particulates Electrostatic Precipitator Particulates Wet Collector / Scrubber / Absorber Organics Flare / Oxidizer / Incinerator Organics Adsorbers Organics Condenser Reduction Technology Miscellaneous Control Equipment
51904 51953 52620 52621 52622 52623 52624 52625 52626 52436
Include if add-on control equipment will be used for the process. Include for each baghouse or fabric filter. Include for each cyclone. Include for each electrostatic precipitator. Include for each wet collector, scrubber, or absorber. Include for each flare, oxidizer, or incinerator. Include for each adsorber. Include for each condenser. Include for each control device using reduction technology (e.g., SCR, SNCR). Include one form for equipment for which there is not a specific CE form.
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Indiana Department of Environmental Management Office of Air Quality State Form 51607 (R4 / 4-08)
Air Permit Application Forms Checklist Page 4 of 6
Part D: Compliance Determination for Part 70 Sources
Applicable? Y Y Y Y Y N N N N N Form ID Title of Form State Form Number When should this form be included in my application packet?
CD-01 CD-02 CD-03 CD-04 FED-03
Emissions Unit Compliance Status Compliance Plan by Applicable Requirement Compliance Plan by Emissions Unit Compliance Schedule and Certification Compliance Assurance Monitoring
51861 51862 51863 51864 53377
Include for every Title V application, including modifications. Include for every Title V application, including modifications. Include for every Title V application, including modifications. Include for every Title V application, including modifications and renewal. Include for every Title V application, including modifications.
Part E: Best Available Control Technology
Applicable? Y Y Y Y Y N N N N N Form ID Title of Form State Form Number When should this form be included in my application packet?
BACT-01 BACT-01a BACT-01b BACT-02 PSD / EO-01
Analysis of Best Available Control Technology Background Search: Existing BACT Determinations Cost/Economic Impact Analysis Summary of Best Available Control Technology PSD / Emission Offset Checklist
None None None None None
Include for every BACT application. Include for every BACT application. Include for every BACT application. Include for every BACT application. Include for every PSD application and every NSR application that requires emission offsets.
Part F: Emission Credit Registry
Applicable? Y Y Y Y N N N N Form ID Title of Form State Form Number When should this form be included in my application packet?
EC-01 EC-02 EC-03 EC-04
Generation of Emission Credits Transfer of Emission Credits Use of Emission Credits Emission Credit Request
51783 51784 51785 51906
Include if the modification results in emission reductions. Submit whenever registered emission credits are transferred. Include if the modification requires the use of emission credits for offsets. Submit if you are looking for emission credits for offsets.
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Indiana Department of Environmental Management Office of Air Quality State Form 51607 (R4 / 4-08)
Air Permit Application Forms Checklist Page 5 of 6
Part G: Plantwide Applicability Limits
Applicable? Y Y Y Y N N N N Form ID Title of Form State Form Number When should this form be included in my application packet?
PAL-01 PAL-02 PAL-03 PAL-04
Actuals Plantwide Applicability Limit Revised Plantwide Applicability Limit Plantwide Applicability Limit Renewal Request for Termination of Plantwide Applicability Limit
52451 52452 52453 52454
Include if the modification results in emission reductions. Submit whenever registered emission credits are transferred. Include if the modification requires the use of emission credits for offsets. Submit if you are looking for emission credits for offsets.
Part H: Air Toxics
Applicable? Y Y Y N N N Form ID Title of Form State Form Number When should this form be included in my application packet?
FED-01 FED-02 No Form ID
Summary of Federal Requirements NSPS & NESHAP MACT Pre-Construction Review MACT Initial Notification
53512 51905 None
Include for each 40 CFR Part 60 NSPS, 40 CFR Part 61 NESHAP, and 40 CFR Part 63 NESHAP applicable to the process. Include if constructing or modifying a process subject to a Part 63 NESHAP. This form is available on the U.S. EPA website. Completed notifications should be submitted to the IDEM Compliance Branch.
Part I: Special Permits
Applicable? Y Y Y Y N N N N Form ID Title of Form State Form Number When should this form be included in my application packet?
INTERIM ASPHALT NOXBTP ACIDRAIN
Interim Approval Asphalt General Permit NOX Budget Permit Phase 2 Acid Rain Permit
None None None None
Submit if you are applying for interim operating approval. Submit if you are applying for or modifying an asphalt plant general permit. Submit if you are a power plant or if you have opted in to the NOX budget trading program. Submit if you are applying for, modifying, or renewing a Phase 2 Acid Rain permit.
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Indiana Department of Environmental Management Office of Air Quality State Form 51607 (R4 / 4-08)
Air Permit Application Forms Checklist Page 6 of 6
Part J: Source Specific Operating Agreements (SSOA)
Applicable? Y Y N N Form ID Title of Form State Form Number When should this form be included in my application packet?
OA-01 OA-02
Summary of Application and Existing Agreements Industrial / Commercial Surface Coating Operations -OR- Graphic Arts Operations (326 IAC 2-9-2.5) Surface Coating or Graphic Arts Operations (326 IAC 2-9-3) Woodworking Operations (326 IAC 2-9-4) Abrasive Cleaning Operations (326 IAC
2-9-5)
53438
Submit if you are applying for or modifying a Source Specific Operating Agreement. Submit if you are applying for or modifying a SSOA for industrial or commercial surface coating operations not subject to 326 IAC 8-2; or graphic arts operations not subject to 326 IAC 8-5-5. Submit if you are applying for or modifying a SSOA for surface coating or graphic arts operations. Submit if you are applying for or modifying a SSOA for woodworking operations. Submit if you are applying for or modifying a SSOA for abrasive cleaning operations. Submit if you are applying for or modifying a SSOA for grain elevators. Submit if you are applying for or modifying a SSOA for sand and gravel plants. Submit if you are applying for or modifying a SSOA for crushed stone processing plants. Submit if you are applying for or modifying a SSOA for ready-mix concrete batch plants. Submit if you are applying for or modifying a SSOA for coal mines and coal preparation plants. Submit if you are applying for or modifying a SSOA for automobile refinishing operations. Submit if you are applying for or modifying a SSOA for degreasing operations. Submit if you are applying for or modifying a SSOA for external combustion sources. Submit if you are applying for or modifying a SSOA for internal combustion sources.
53439 53440 53441 53442 53443 53444 53445 53446 53447 53448 53449 53450 53451
Y Y Y Y Y Y Y Y Y Y Y Y
N N N N N N N N N N N N
OA-03 OA-04 OA-05 OA-06 OA-07 OA-08 OA-09 OA-10 OA-11 OA-12 OA-13 OA-14
Grain Elevators (326 IAC 2-9-6) Sand And Gravel Plants (326 IAC 2-9-7) Crushed Stone Processing Plants (326
IAC 2-9-8)
Ready-Mix Concrete Batch Plants (326
IAC 2-9-9)
Coal Mines And Coal Preparation Plants
(326 IAC 2-9-10)
Automobile Refinishing Operations (326
IAC 2-9-11)
Degreasing Operations (326 IAC 2-9-12) External Combustion Sources (326 IAC
2-9-13)
Internal Combustion Sources (326 IAC
2-9-14)