Emissions Data Questionnaire Linked Spreadsheet 030308

---

Overview

DioxinFurans
PAH
Inorganic HAP
Organic HAP and CO
PM and Metals

---

Sheet 1: DioxinFurans

	You should provide the most recent stack test data available at for each pollutant at each combustion unit (excluding small gas fired units that were covered under Part II.A). To provide the results of more than one test, you may copy and paste this worksheet. Please indicate the appropriate facility name and combustor ID at the top of each worksheet. When complete, e-mail this spreadsheet to [email protected].
Facility Name:
Combustor ID:
Control Device Configuration:						(you may enter control device as listed in questions II.B.3.a1 or II.B.3.a6, or other (with description), if the control device during the test was not listed in the survey section II.B.3)
Parameter	Sample #1	Sample #2	Sample #3	Test Average	Steam Output (1000 lb/hr)	Unitsa	Units Other Description	Test Method Used	Test Location	Note
	Enter numerical value when available. If the test results are below detection limit, please note the detection limit in brackets (e.g., [< 0.010]).					Select appropriate unit from list. If other is selected please describe units in column H at right.		Enter the name of the Test Method used.	Indicate whether the test occurred upstream or downstream of a control device(s)	For all pollutants, provide any other information supporting information you think is necessary about this test report.
Sample Date (mm/dd/yyyy)
Required Operating Parameters During Test
Fuel 1 Input Rate
Fuel 2 Input Rate
Fuel 3 Input Rate
Fuel 4 Input Rate (insert rows for additional fuels as necessary)
Emission Data
Dioxin/Furans										Indicate basis here by entering TM, TEQ, Other (total mass, toxic equivalent concentration, other) here:
Other Operating Parameters During Test	(These parameters are only required if emission units are provided in units of concentration)
Dry or Wet Basis						Wet or Dry
% CO2
% O2
Exhaust Stream %Moisture
Exhaust Flowrate						acfm or dscfm
Exhaust Temperature						C or F

---

Sheet 2: PAH

	You should provide the most recent stack test data available at for each pollutant at each combustion unit (excluding small gas fired units that were covered under Part II.A). To provide the results of more than one test, you may copy and paste this worksheet. Please indicate the appropriate facility name and combustor ID at the top of each worksheet. When complete, e-mail this spreadsheet to [email protected].
Facility Name:
Combustor ID:
Control Device Configuration:						(you may enter control device as listed in questions II.B.3.a1 or II.B.3.a6, or other (with description), if the control device during the test was not listed in the survey section II.B.3)
Parameter	Sample #1	Sample #2	Sample #3	Test Average	Steam Output (1000 lb/hr)	Unitsa	Units Other Description	Test Method Used	Test Location	Note
	Enter numerical value when available. If the test results are below detection limit, please note the detection limit in brackets (e.g., [< 0.010]).					Select appropriate unit from list. If other is selected please describe units in column H at right.		Enter the name of the Test Method used.	Indicate whether the test occurred upstream or downstream of a control device(s)	For all pollutants, provide any other information supporting information you think is necessary about this test report.
Sample Date (mm/dd/yyyy)
Required Operating Parameters During Test
Fuel 1 Input Rate
Fuel 2 Input Rate
Fuel 3 Input Rate
Fuel 4 Input Rate (insert rows for additional fuels as necessary)
Emission Data
7-PAH*
15-PAH**
Other Operating Parameters During Test	(These parameters are only required if emission units are provided in units of concentration)
Dry or Wet Basis						Wet or Dry
% CO2
% O2
Exhaust Stream %Moisture
Exhaust Flowrate						acfm or dscfm
Exhaust Temperature						C or F
*7-PAH means: benz(a)anthracene, benzo(a)pyrene, benzo(b)fluoranthene, benzo(k)fluoranthene, chrysene, dibenz(a,h)anthracene, and indeno(1,2,3-cd)pyrene
** 15-PAH means acenaphthene, acenaphthylene, anthracene, benzo(a)anthracene, benzo(a)pyrene, benzo(b)fluoranthene, benzo(g,h,i)perylene, benzo(k)fluoranthene, dibenzo(a,h)anthracene, dibenzofuran, fluoranthene, fluorene, Indeno(1,2,3-cd)pyrene, phenanthrene, and pyrene)

---

Sheet 3: Inorganic HAP

	You should provide the most recent stack test data available at for each pollutant at each combustion unit (excluding small gas fired units that were covered under Part II.A). To provide the results of more than one test, you may copy and paste this worksheet. Please indicate the appropriate facility name and combustor ID at the top of each worksheet. When complete, e-mail this spreadsheet to [email protected].
Facility Name:
Combustor ID:
Control Device Configuration:						(you may enter control device as listed in questions II.B.3.a1 or II.B.3.a6, or other (with description), if the control device during the test was not listed in the survey section II.B.3)
Parameter	Sample #1	Sample #2	Sample #3	Test Average	Steam Output (1000 lb/hr)	Unitsa	Units Other Description	Test Method Used	Test Location	Note
	Enter numerical value when available. If the test results are below detection limit, please note the detection limit in brackets (e.g., [< 0.010]).					Select appropriate unit from list. If other is selected please describe units in column H at right.		Enter the name of the Test Method used.	Indicate whether the test occurred upstream or downstream of a control device(s)	For all pollutants, provide any other information supporting information you think is necessary about this test report.
Sample Date (mm/dd/yyyy)
Required Operating Parameters During Test
Fuel 1 Input Rate
Fuel 2 Input Rate
Fuel 3 Input Rate
Fuel 4 Input Rate (insert rows for additional fuels as necessary)
Emission Data
Hydrogen Chloride (HCl)
Hydrogen Flouride (HF)
Chlorine (Cl2)
Other Operating Parameters During Test	(These parameters are only required if emission units are provided in units of concentration)
Dry or Wet Basis						Wet or Dry
% CO2
% O2
Exhaust Stream %Moisture
Exhaust Flowrate						acfm or dscfm
Exhaust Temperature						C or F

---

Sheet 4: Organic HAP and CO

	You should provide the most recent stack test data available at for each pollutant at each combustion unit (excluding small gas fired units that were covered under Part II.A). To provide the results of more than one test, you may copy and paste this worksheet. Please indicate the appropriate facility name and combustor ID at the top of each worksheet. When complete, e-mail this spreadsheet to [email protected].
Facility Name:
Combustor ID:
Control Device Configuration:						(you may enter control device as listed in questions II.B.3.a1 or II.B.3.a6, or other (with description), if the control device during the test was not listed in the survey section II.B.3)
Parameter	Sample #1	Sample #2	Sample #3	Test Average	Steam Output (1000 lb/hr)	Unitsa	Units Other Description	Test Method Used	Test Location	Note
	Enter numerical value when available. If the test results are below detection limit, please note the detection limit in brackets (e.g., [< 0.010]).					Select appropriate unit from list. If other is selected please describe units in column H at right.		Enter the name of the Test Method used.	Indicate whether the test occurred upstream or downstream of a control device(s)	For all pollutants, provide any other information supporting information you think is necessary about this test report.
Sample Date (mm/dd/yyyy)
Required Operating Parameters During Test
Fuel 1 Input Rate
Fuel 2 Input Rate
Fuel 3 Input Rate
Fuel 4 Input Rate (insert rows for additional fuels as necessary)
Emission Data
acetaldehyde
benzene
formaldehyde
toluene
xylenes
CO
Other Operating Parameters During Test	(These parameters are only required if emission units are provided in units of concentration)
Dry or Wet Basis						Wet or Dry
% CO2
% O2
Exhaust Stream %Moisture
Exhaust Flowrate						acfm or dscfm
Exhaust Temperature						C or F

---

Sheet 5: PM and Metals

	You should provide the most recent stack test data available at for each pollutant at each combustion unit (excluding small gas fired units that were covered under Part II.A). To provide the results of more than one test, you may copy and paste this worksheet. Please indicate the appropriate facility name and combustor ID at the top of each worksheet. When complete, e-mail this spreadsheet to [email protected].
Facility Name:
Combustor ID:
Control Device Configuration:						(you may enter control device as listed in questions II.B.3.a1 or II.B.3.a6, or other (with description), if the control device during the test was not listed in the survey section II.B.3)
Parameter	Sample #1	Sample #2	Sample #3	Test Average	Steam Output (1000 lb/hr)	Unitsa	Units Other Description	Test Method Used	Test Location	Note
	Enter numerical value when available. If the test results are below detection limit, please note the detection limit in brackets (e.g., [< 0.010]).					Select appropriate unit from list. If other is selected please describe units in column H at right.		Enter the name of the Test Method used.	Indicate whether the test occurred upstream or downstream of a control device(s)	For all pollutants, provide any other information supporting information you think is necessary about this test report.
Sample Date (mm/dd/yyyy)
Required Operating Parameters During Test
Fuel 1 Input Rate
Fuel 2 Input Rate
Fuel 3 Input Rate
Fuel 4 Input Rate (insert rows for additional fuels as necessary)
Emission Data
Mercury (Hg)
Arsenic (As)
Beryllium (Be)
Cadmium (Cd)
Chromium (Cr)
Lead (Pb)
Manganese (Mn)
Nickel (Ni)
Selenium (Se)
Particulate Matter (front half)
Particulate Matter (total, including condensibles)
Other Operating Parameters During Test	(These parameters are only required if emission units are provided in units of concentration)
Dry or Wet Basis						Wet or Dry
% CO2
% O2
Exhaust Stream %Moisture
Exhaust Flowrate						acfm or dscfm
Exhaust Temperature						C or F