Survey

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Overview

Instructions
A-1
A-2
B-1
C-1
C-2
D-1
E-1
E-2
E-3
E-4
F-1
F-2
G-1
H-1
I-1
J-1
J-2
J-3
J-4
J-5
J-6
J-7
J-8
J-9
J-10
K-1

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Sheet 1: Instructions

					OMB Control No. 2060-NEW
					Approval Expires XX/XX/XXXX
The public reporting and recordkeeping burden for this collection of information is estimated to average 47 hours per reponse. Send comments on the Agency's need for the information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed survey to this address.
This information request is to be completed for operations that comprise the Aerospace Manufacturing and Rework source category at your facility. The Aerospace Manufacturing and Rework source category includes any facility engaged, either in whole or in part, in the manufacture or rework of commercial, civil, or military aerospace vehicles or components. Aerospace vehicle component means any fabricated part, processed part, assembly of parts, or completed unit, with the exception of electronic components, of any aircraft including but not limited to airplanes, helicopters, missiles, rockets, and space vehicles.
The North American Industrial Classification System (NAICS) codes that describe facilities that may manufacture or rework aerospace vehicle, components, or parts are listed in the table below. This table is not meant to be exhaustive; facilities classified under other NAICS codes may also be required to complete this information request if they perform activities as defined above.
The reporting year for this information request is 2008. If you cannot provide 2008 data, you must contact Kim Teal of the U.S. EPA at 919-541-5580 or [email protected] prior to completing this information request to explain why 2008 data are not available and obtain permission to submit data from another year.
North American Industrial Classification System Codes for the
Aerospace Manufacturing and Rework Industry
NAICS Code			Description
336411			Aircraft Manufacturing
336412			Aircraft Engine and Engine Parts Manufacturing
336413			Other Aircraft Parts and Auxiliary Equipment Manufacturing
336414			Guided Missile and Space Vehicle Manufacturing
336415			Guided Missile and Space Vehicle Propulsion Units and Parts
336419			Other Guided Missile and Space Vehicle Parts and Auxiliary Equipment
481111			Scheduled Passenger Air Transportation
481112			Scheduled Freight Air Transportation
481211			Nonscheduled Chartered Passenger Air Transportation
481212			Nonscheduled Chartered Freight Air Transportation
481219			Other Nonscheduled Air Transportation
You must complete this information request for ALL manufacturing operations that constitute aerospace manufacturing and rework at your facility, regardless of whether the operations are presently regulated under the National Emission Standards for Hazardous Air Pollutants for Aerospace Manufacturing and Rework Facilities (aerospace NESHAP). For example, information must be submitted for the following operations even though they are not regulated by the aerospace NESHAP: chemical milling, metal finishing, electrodeposition, composites processing, manufacture of aircraft transparencies, and wastewater operations, among others. Additionally, you must submit information for operations that may be exempt from regulation under the aerospace NESHAP including, but not limited to, low volume usage coatings, activities associated with the manufacture or rework of space vehicles, certain waterborne coatings, certain cleaning operations, certain primer and topcoat operations, specialty coatings, and certain depainting operations. Finally, you must submit information where control requirements are not specified for operations under the aerospace NESHAP, including the use of specialty coatings, adhesives, adhesive bonding primers, or sealants.
However, this information request does not apply to aerospace manufacturing or rework operations that are regulated under NESHAP other than the aerospace NESHAP, with the exception of the Halogenated Solvent NESHAP. For example, you should not include in your response information regarding chromium electroplating operations regulated under the chromium electroplating NESHAP.

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Sheet 2: A-1

FORM A-1
PARENT COMPANY INFORMATION
Complete this form to identify the parent company of this facility. Your response to Section I, Question 8 (Size of parent company) is an important factor that EPA will use in an economic analysis and to identify small businesses. Please note that the total of all full-time and part-time employees should be reported. This information is required for the parent company, not just this facility.
If your facility is a subsidiary or a branch of a larger company, please ensure the response in Section I contains information about the ultimate owner of this facility and all of its operations.
I. Parent Company / Legal Corporate Owner Information
1. Legal Parent Company / Legal Corporate Name. If your facility is a subsidiary of a larger corporation, franchise, etc. or if you are the owner of multiple facilities, please provide the name of the corporation, franchise, etc. Otherwise, you may respond with N/A.
2. Address 1
3. Address 2
4. City
5. State
6. Zip Code
7. County
8. Size of Parent Company (approximate total number of full-time and part-time employees including all subsidiaries, branches, and related establishments owned):

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Sheet 3: A-2

FORM A-2
FACILITY INFORMATION
Complete this for for this specific facility.
I. Facility Information
1. Facility Name and Location
Facility Physical Address
Street
City
State
Zip Code
County
Facility Mailing Address
Address 1
Address 2
City
State
Zip Code
Facility Coordinates. Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees, five decimal places)
Longitude (decimal degrees, five decimal places)
Specific location represented (e.g., front door of main building, centroid of property, etc.)
2. Does this facility manufacture, repair, rework, or otherwise modify parts or assemblies for the aerospace industry? If you answer “No” to this question, please provide an explanation in the Comments section of what activities are carried out at this facility and why you should not be considered an aerospace manufacturing or rework facility. If you answer “No” then you do not have to complete any other parts of this information request other than Forms A-1 and A-2.
3. If "Yes," what NAICS codes describe your aerospace operations? NAICS codes may be found at http://www.census.gov/eos/www/naics/. Do not enter Standard Industrial Classification (SIC) codes.
Primary NAICS Code
Other NAICS Code
Other NAICS Code
4. Number of employees (full-time and part-time combined)
Total number of employees at this facility
Total number of employees performing aerospace operations
5. Do you manufacture or rework aerospace components or parts for the following market segments?
Original equipment manufacturing - commercial
Original equipment manufacturing - military
Rework - commercial
Rework - military
6. Operation schedule
hrs/day
days/yr
II. Technical Contact
The technical contact should be able to answer inquires from EPA concerning any information provided in your response.
Name
Technical Contact Title
Telephone
Facsimile (Fax)
Email
III. Other
1. Is the facility a major source of HAP? A major source of HAP is defined as any stationary source or group of stationary sources located within a contiguous area and under common control that emits or has the potential to emit considering controls, in the aggregate, 10 tons per year or more of any hazardous air pollutant.
2. If "No", did the facility take a federally enforceable permit limit of its potential HAP emissions to avoid classification as a major source? If you did take permit limits, specify those limits in the Comments section.
3. Does the facility manufacture other products in addition to aerospace products?
4. If "Yes", list the other products manufactured at the facility.
5. Multiplier to scale up average hourly emissions to maximum hourly emissions (see instructions)
6. Comments (include description of how the maximum hourly emissions multipier listed in #5 was determined)

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Sheet 4: B-1

FORM B-1
SPRAY BOOTH INFORMATION
	Booth 1	Booth 2	Booth 3	Booth 4	Booth 5	Booth 6	Booth 7	Booth 8	Booth 9	Booth 10
I. Booth Description and Location
1. Identification No.
2. Booth Type
3. Dimensions of Building in Which Booth is Located (NOT the dimensions of the booth itself)
Length (ft)
Width (ft)
Height (ft)
4. Airflow Direction in Booth
5. Average Daily Operating Hours
II. Particulate Filters
1. Type of Filter System
2. Filter Control Efficiency (percent)
3. How was the filter control efficiency determined (indicate yes where appropriate)
Testing (specify method)
Filter Manufacturer's Specifications
Engineering Estimate
III. Exhaust Stack
1. Exhaust Stack Location
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees to at least five decimal places)
Longitude (decimal degrees to at least five decimal places)
2. Exhaust Stack Diameter (ft)
3. Exhaust Stack Height (ft)
4. Exhaust Stream Temperature (°F)
5. Exhaust Stream Flow Rate (acfm)
IV. Control Device for Organic Emissions
Complete this section if this spray booth is vented to a control device that reduces the amount of organic emissions.
1. Identification No. (must correspond to ID No. of one of the control devices for which a Form J was completed)
2. Type of Control Device
3. Capture Efficiency
4. How was capture efficiency determined?
Testing (specify method)
Filter Manufacturer's Specifications
Engineering Estimate
V. Comments
Use this section to explain any of the above responses or to provide additional information

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Sheet 5: C-1

FORM C-1

COATINGS

Use Form C-1 for entering coating information in English units (pounds, gallons, etc.). Use Form C-2 for enterning coating information in metric units (kilograms, liters, etc.). DO NOT complete both Form C-1 and Form C-2.

This form has space for entering data for 20 coatings. If you are providing data for more than 20 coatings, please add additional columns as necessary.

Coating 1

Coating 2

Coating 3

Coating 4

Coating 5

Coating 6

Coating 7

Coating 8

Coating 9

Coating 10

Coating 11

Coating 12

Coating 13

Coating 14

Coating 15

Coating 16

Coating 17

Coating 18

Coating 19

Coating 20

I. Coating Information

1. Identification No.

2. Manufacturer

3. Product Name

4. Is this coating regulated under the Aerospace Manufacturing and Rework Operations National Emission Standards for Hazardous Air Pollutants (40 CFR 63, subpart GG)?

5. If "Yes," what is the coating type?

6. If "No," what is the specialty coating type?

II. Coating Usage and Physical Properties

1. Total Volume Used for the Reporting Year for all coating operations (gals)

2. As-Applied Coating Physical Properties

Coating Density (lb coating/gal coating)

Total Organic HAP Mass Fraction (lb HAP/lb coating)

Total Inorganic HAP Mass Fraction (lb HAP/lb coating)

Solids Mass Fraction (lb solids/lb coating)

Solids Volume Fraction (gal solids/gal coating)

3. Speciated HAP (Organic and Inorganic) Content

To avoid double counting, do not report the same HAP emissions under different CAS numbers or as different compounds. For example, do not report both "total chromium" and "hexavalent chromium" for a single chromium compound contained in a coating. The correct reporting method, particularly for chromium compounds, glycol ethers, and polycyclic organic matter, is to report the specific compound (e.g., strontium chromate, ethylene glycol dibutyl ether) rather than the general class of HAP (e.g., chromium compounds, glycol ethers).

HAP Name

CAS No.

HAP Mass Fraction (lb HAP/lb coating)

HAP Name

CAS No.

HAP Mass Fraction (lb HAP/lb coating)

HAP Name

CAS No.

HAP Mass Fraction (lb HAP/lb coating)

HAP Name

CAS No.

HAP Mass Fraction (lb HAP/lb coating)

HAP Name

CAS No.

HAP Mass Fraction (lb HAP/lb coating)

III. Coating Usage by Spray Booth

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Application of Coating Outside of a Spray Booth - Application Method

Portion of Annual Coating Usage Applied Outside of a Booth (percent)

IV. Comments

Use this section to explain any of the above responses or to provide additional information

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Sheet 6: C-2

FORM C-2

COATINGS

Use Form C-1 for entering coating information in English units (pounds, gallons, etc.). Use Form C-2 for enterning coating information in metric units (kilograms, liters, etc.). DO NOT complete both Form C-1 and Form C-2.

This form has space for entering data for 20 coatings. If you are providing data for more than 20 coatings, please add additional columns as necessary.

Coating 1

Coating 2

Coating 3

Coating 4

Coating 5

Coating 6

Coating 7

Coating 8

Coating 9

Coating 10

Coating 11

Coating 12

Coating 13

Coating 14

Coating 15

Coating 16

Coating 17

Coating 18

Coating 19

Coating 20

I. Coating Information

1. Identification No.

2. Manufacturer

3. Product Name

4. Is this coating regulated under the Aerospace Manufacturing and Rework Operations National Emission Standards for Hazardous Air Pollutants (40 CFR 63, subpart GG)?

5. If "Yes," what is the coating type?

6. If "No," what is the specialty coating type?

II. Coating Usage and Physical Properties

1. Total Volume Used for the Reporting Year for all coating operations (liters)

2. As-Applied Coating Physical Properties

Coating Density (kg coating/L coating)

Total Organic HAP Mass Fraction (kg HAP/kg coating)

Total Inorganic HAP Mass Fraction (kg HAP/kg coating)

Solids Mass Fraction (kg solids/kg coating)

Solids Volume Fraction (L solids/L coating)

3. Speciated HAP (Organic and Inorganic) Content

To avoid double counting, do not report the same HAP emissions under different CAS numbers or as different compounds. For example, do not report both "total chromium" and "hexavalent chromium" for a single chromium compound contained in a coating. The correct reporting method, particularly for chromium compounds, glycol ethers, and polycyclic organic matter, is to report the specific compound (e.g., strontium chromate, ethylene glycol dibutyl ether) rather than the general class of HAP (e.g., chromium compounds, glycol ethers).

HAP Name

HAP Mass Fraction (kg HAP/kg coating)

HAP Name

HAP Mass Fraction (kg HAP/kg coating)

HAP Name

HAP Mass Fraction (kg HAP/kg coating)

HAP Name

HAP Mass Fraction (kg HAP/kg coating)

HAP Name

HAP Mass Fraction (kg HAP/kg coating)

III. Coating Usage by Spray Booth

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Spray Booth Identification No. (from Form B-1)

Portion of Annual Coating Usage in this Booth (percent)

Application of Coating Outside of a Spray Booth - Application Method

Portion of Annual Coating Usage Applied Outside of a Booth (percent)

IV. Comments

Use this section to explain any of the above responses or to provide additional information

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Sheet 7: D-1

FORM D-1
CHEMICAL MILLING AND METAL FINISHING OPERATIONS
Complete this form for each processing tank that contains HAP in chemical milling and metal finishing operations. If your facility does not have chemical milling or metal finishing operations, state that in the Comments section.
	Tank 1	Tank 2	Tank 3	Tank 4	Tank 5	Tank 6	Tank 7	Tank 8	Tank 9	Tank 10
I. Processing Tank Description and Location
1. Tank Identification No.
2. Location of Tank (Not required if a control device is listed in Section II, Question 2 below for the tank)
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees to at least five decimal places)
Longitude (decimal degrees to at least five decimal places)
3. Dimensions of Building in Which Tank is Located
Length (ft)
Width (ft)
Height (ft)
4. Purpose of this Tank
5. Average Daily Hours of Operation
Average Days per Year of Operation
II. HAP Emissions and Controls
To avoid double counting, do not report the same HAP emissions under different CAS numbers or as different compounds. For example, do not report both "total chromium" and "hexavalent chromium" for a single chromium compound contained in a coating. The correct reporting method, particularly for chromium compounds, glycol ethers, and polycyclic organic matter, is to report the specific compound (e.g., strontium chromate, ethylene glycol dibutyl ether) rather than the general class of HAP (e.g., chromium compounds, glycol ethers).
1. HAP Emissions
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
2. Control Device Identification No. (must correspond to ID No. of one of the control devices for which a Form J was completed)
3. Type of Control Device
4. Capture Efficiency
5. How was capture efficiency determined?
Testing (specify method)
Manufacturer's Specifications
Engineering Estimate
III. Work Practices
Describe any work practices that you use to reduce emissions from this tank
IV. Comments
Use this section to explain any of the above responses or to provide additional information

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Sheet 8: E-1

FORM E-1
BLAST DEPAINTING/CLEANING OPERATIONS
Complete this form for each depainting or cleaning operation that utilizes a blasting method (plastic beads, metal shot, sodium bicarbonate, carbon dioxide, etc.) to depaint or clean aerospace components. If your facility does not have blast depainting/cleaning operations, state that in the comments section.
	Operation 1	Operation 2	Operation 3
1. Process Identification No.
2. Location of Blasting Operation (Not required if a control device is listed in Section II, Question 2 below for the operation)
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees to at least five decimal places)
Longitude (decimal degrees to at least five decimal places)
3. Identify where blasting occurs (e.g., outside, in a partially enclosed booth, in a fully enclosed booth, etc.)
4. Identify the type of blasting media used (be specific)
5. Dimensions of Building in Which Operation is Located
Length (ft)
Width (ft)
Height (ft)
6. Purpose of this Blasting Operation
7. Average Daily Hours of Operation
Average Days per Year of Operation
II. HAP Emissions and Controls
To avoid double counting, do not report the same HAP emissions under different CAS numbers or as different compounds. For example, do not report both "total chromium" and "hexavalent chromium" for a single chromium compound contained in a coating. The correct reporting method, particularly for chromium compounds, glycol ethers, and polycyclic organic matter, is to report the specific compound (e.g., strontium chromate, ethylene glycol dibutyl ether) rather than the general class of HAP (e.g., chromium compounds, glycol ethers).
1. HAP Emissions
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
2. Control Device Identification No. (must correspond to ID No. of one of the control devices for which a Form J was completed)
3. Type of Control Device
4. Capture Efficiency
5. How was capture efficiency determined?
Testing (specify method)
Manufacturer's Specifications
Engineering Estimate
III. Work Practices
Describe any work practices that you use to reduce emissions from this process
IV. Comments
Use this section to explain any of the above responses or to provide additional information

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Sheet 9: E-2

FORM E-2
SOLVENT DEPAINTING OPERATIONS
Complete this form for each depainting operation that utilizes solvent (liquid) materials to depaint aerospace components. If your facility does not have any solvent depainting operations, state that in the Comments section.
	Operation 1	Operation 2	Operation 3
1. Process Identification No.
2. Location of Depainting Operation (Not required if a control device is listed in Section II, Question 2 below for the operation)
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees to at least five decimal places)
Longitude (decimal degrees to at least five decimal places)
3. Dimensions of Building in Which Operation is Located
Length (ft)
Width (ft)
Height (ft)
4. Purpose of this Depainting Operation
5. Average Daily Hours of Operation
Average Days per Year of Operation
II. HAP Emissions and Controls
Report HAP emissions for organic HAP contained in the solvent depainting materials only. Do not report HAP contained in the coatings removed. To avoid double counting, do not report the same HAP emissions under different CAS numbers or as different compounds. For example, do not report both "total chromium" and "hexavalent chromium" for a single chromium compound contained in a coating. The correct reporting method, particularly for chromium compounds, glycol ethers, and polycyclic organic matter, is to report the specific compound (e.g., strontium chromate, ethylene glycol dibutyl ether) rather than the general class of HAP (e.g., chromium compounds, glycol ethers).
1. HAP Emissions
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
2. Control Device Identification No. (must correspond to ID No. of one of the control devices for which a Form J was completed)
3. Type of Control Device
4. Capture Efficiency
5. How was capture efficiency determined?
Testing (specify method)
Manufacturer's Specifications
Engineering Estimate
III. Work Practices
Describe any work practices that you use to reduce emissions from this process
IV. Comments
Use this section to explain any of the above responses or to provide additional information

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Sheet 10: E-3

FORM E-3
SOLVENT CLEANING OPERATIONS - POINT SOURCES AND FUGITIVE SOURCES
Complete this form for each cleaning operation that utilizes solvent (liquid) materials to clean aerospace components. If your facility does not have any solvent cleaning operations, state that in the Comments section. Do not report solvent cleaning operations that are subject to the Halogenated Solvent Cleaning NESHAP (40 CFR part 63, subpart T) on this form. Use Form E-4 to report halogenated solvent cleaning covered under subpart T. Please see the instructions for further information before completing Forms E-3 and E-4.
PART A - POINT SOURCES. Complete this section for each cleaning operation that occurs within an enclosure that is vented through a stack outside of the building
I. General Information
	Operation 1	Operation 2	Operation 3
1. Process Identification No.
2. Exhaust Stack Location
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees to at least five decimal places)
Longitude (decimal degrees to at least five decimal places)
3. Exhaust Stack Diameter (ft)
4. Exhaust Stack Height (ft)
5. Exhaust Stream Temperature (°F)
6. Exhaust Stream Flow Rate (acfm)
7. (Optional) Dimensions of Building in Which Operation is Located
Length (ft)
Width (ft)
Height (ft)
8. Purpose of this Cleaning Operation
9. Average Daily Hours of Operation
Average Days per Year of Operation
II. HAP Emissions and Controls
To avoid double counting, do not report the same HAP emissions under different CAS numbers or as different compounds. For example, do not report both "total chromium" and "hexavalent chromium" for a single chromium compound contained in a coating. The correct reporting method, particularly for chromium compounds, glycol ethers, and polycyclic organic matter, is to report the specific compound (e.g., strontium chromate, ethylene glycol dibutyl ether) rather than the general class of HAP (e.g., chromium compounds, glycol ethers).
1. HAP Emissions
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
2. Control Device Identification No. (must correspond to ID No. of one of the control devices for which a Form J was completed)
3. Type of Control Device
4. Capture Efficiency
5. How was capture efficiency determined?
Testing (specify method)
Manufacturer's Specifications
Engineering Estimate
III. Work Practices
Describe any work practices that you use to reduce emissions from this process
IV. Comments
Use this section to explain any of the above responses or to provide additional information
B. FUGITIVE SOURCES - Complete this section for cleaning operations that are not vented outside of the building. Combine all fugitive solvent cleaning operations in a building in a single entry.
I. General Information
1. Building Identification
2. Building Location (center of building)
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees to at least five decimal places)
Longitude (decimal degrees to at least five decimal places)
3. Dimensions of Building
Length (ft)
Width (ft)
Height (ft)
4. Purpose of this Cleaning Operation
5. Average Daily Hours of Operation
Average Days per Year of Operation
II. HAP Emissions
To avoid double counting, do not report the same HAP emissions under different CAS numbers or as different compounds. For example, do not report both "total chromium" and "hexavalent chromium" for a single chromium compound contained in a coating. The correct reporting method, particularly for chromium compounds, glycol ethers, and polycyclic organic matter, is to report the specific compound (e.g., strontium chromate, ethylene glycol dibutyl ether) rather than the general class of HAP (e.g., chromium compounds, glycol ethers).
1. HAP Emissions
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
HAP Name
CAS No.
Emissions (lb/yr)
III. Work Practices
Describe any work practices that you use to reduce emissions from this process
IV. Comments
Use this section to explain any of the above responses or to provide additional information

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Sheet 11: E-4

FORM E-4
SOLVENT CLEANING OPERATIONS
Complete this form for each cleaning operation that is subject to the Halogenated Sovent Cleaning NESHAP (40 CFR part 63, subpart T) and NOT subject to the aerospace manufacturing and rework operations NESHAP. If your facility does not have any cleaning operations subject to subpart T, state that in the Comments section. Do not report solvent cleaning operations that are subject to the Aerospace Manufactuing and Rework Operations NESHAP on this form. Use Form E-3 to report solvent cleaning covered under the aeropsace NESHAP. Please see the instructions for further information before completing Forms E-3 and E-4.
	Operation 1	Operation 2	Operation 3
1. Process Identification No.
2. Location of Cleaning Operation (Not required if a control device is listed in Section II, Question 2 below for the operation)
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees to at least five decimal places)
Longitude (decimal degrees to at least five decimal places)
3. Dimensions of Building in Which Operation is Located
Length (ft)
Width (ft)
Height (ft)
4. Purpose of this Cleaning Operation
5. Average Daily Hours of Operation
Average Days per Year of Operation
II. HAP Emissions and Controls
1. HAP Emissions
Methylene Chloride
CAS No. 75-09-02
Emissions (lb/yr)
Perchloroethylene
CAS No. 127-18-4
Emissions (lb/yr)
Trichloroethylene
CAS No. 79-01-6
Emissions (lb/yr)
1,1,1-Trichloroethane
CAS No. 71-55-6
Emissions (lb/yr)
Carbon Tetrachloride
CAS No. 56-23-5
Emissions (lb/yr)
Chloroform
CAS No. 67-66-3
Emissions (lb/yr)
2. Control Device Identification No. (must correspond to ID No. of one of the control devices for which a Form J was completed)
3. Type of Control Device
4. Capture Efficiency
5. How was capture efficiency determined?
Testing (specify method)
Manufacturer's Specifications
Engineering Estimate
III. Work Practices
Describe any work practices that you use to reduce emissions from this process
IV. Comments
Use this section to explain any of the above responses or to provide additional information

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Sheet 12: F-1

FORM F-1
Composite Processing Operations
Use Form F-1 for entering resin information in English units (pounds, gallons, etc.). Use Form F-2 for enterning resin information in metric units (kilograms, liters, etc.). DO NOT complete both Form F-1 and Form F-2.
This form has space for entering data for 10 resins. If you are providing information on more than 10 resins, please add additional columns. If your facility does not have any composite processing operations, state that in the Comments section.
	Resin 1	Resin 2	Resin 3	Resin 4	Resin 5	Resin 6	Resin 7	Resin 8	Resin 9	Resin 10
I. Resin Information
1. Identification No.
2. Manufacturer
3. Product Name
II. Resin Usage and Physical Properties
1. Total Volume Used for the Reporting Year (gals)
2. As-Applied Resin Physical Properties
Resin Density (lb coating/gal coating)
Total Organic HAP Mass Fraction (lb HAP/lb coating)
Total Inorganic HAP Mass Fraction (lb HAP/lb coating)
Solids Mass Fraction (lb solids/lb coating)
Solids Volume Fraction (gal solids/gal coating)
3. Speciated HAP (Organic and Inorganic) Content
To avoid double counting, do not report the same HAP emissions under different CAS numbers or as different compounds. For example, do not report both "total chromium" and "hexavalent chromium" for a single chromium compound contained in a coating. The correct reporting method, particularly for chromium compounds, glycol ethers, and polycyclic organic matter, is to report the specific compound (e.g., strontium chromate, ethylene glycol dibutyl ether) rather than the general class of HAP (e.g., chromium compounds, glycol ethers).
HAP Name
CAS No.
HAP Mass Fraction (lb HAP/lb coating)
HAP Name
CAS No.
HAP Mass Fraction (lb HAP/lb coating)
HAP Name
CAS No.
HAP Mass Fraction (lb HAP/lb coating)
HAP Name
CAS No.
HAP Mass Fraction (lb HAP/lb coating)
HAP Name
CAS No.
HAP Mass Fraction (lb HAP/lb coating)
4. Estimated Percent of Organic HAP Emitted
III. Resin Usage by Spray Booth
Spray Booth Identification No. (from Form B-1)
Portion of Annual Coating Usage in this Booth (percent)
Spray Booth Identification No. (from Form B-1)
Portion of Annual Coating Usage in this Booth (percent)
Spray Booth Identification No. (from Form B-1)
Portion of Annual Coating Usage in this Booth (percent)
Application of Coating Outside of a Spray Booth - Application Method
Portion of Annual Coating Usage Applied Outside of a Booth (percent)
IV. Control Device for Organic Emissions
1. Identification No. (must correspond to ID No. of one of the control devices for which a J Form was completed)
2. Type of Control Device
3. Capture Efficiency
4. How was capture efficiency determined?
Testing (specify method)
Manufacturer's Specifications
Engineering Estimate
V. Comments
Use this section to explain any of the above responses or to provide additional information

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Sheet 13: F-2

FORM F-2
Composite Processing Operations
Use Form F-1 for entering resin information in English units (pounds, gallons, etc.). Use Form F-2 for enterning resin information in metric units (kilograms, liters, etc.). DO NOT complete both Form F-1 and Form F-2. This form has space for entering data for 10 resins. If you are providing information on more than 10 resins, please add additional columns.
This form has space for entering data for 10 resins. If you are providing information on more than 10 resins, please add additional columns. If your facility does not have any composite processing operations, state that in the Comments section.
	Resin 1	Resin 2	Resin 3	Resin 4	Resin 5	Resin 6	Resin 7	Resin 8	Resin 9	Resin 10
I. Resin Information
1. Identification No.
2. Manufacturer
3. Product Name
II. Resin Usage and Physical Properties
1. Total Volume Used for the Reporting Year (liters)
2. As-Applied Resin Physical Properties
Resin Density (kg coating/L coating)
Total Organic HAP Mass Fraction (kg HAP/kg coating)
Total Inorganic HAP Mass Fraction (kg HAP/kg coating)
Solids Mass Fraction (kg solids/kg coating)
Solids Volume Fraction (L solids/L coating)
3. Speciated HAP (Organic and Inorganic) Content
To avoid double counting, do not report the same HAP emissions under different CAS numbers or as different compounds. For example, do not report both "total chromium" and "hexavalent chromium" for a single chromium compound contained in a coating. The correct reporting method, particularly for chromium compounds, glycol ethers, and polycyclic organic matter, is to report the specific compound (e.g., strontium chromate, ethylene glycol dibutyl ether) rather than the general class of HAP (e.g., chromium compounds, glycol ethers).
HAP Name
CAS No.
HAP Mass Fraction (kg HAP/kg coating)
HAP Name
CAS No.
HAP Mass Fraction (kg HAP/kg coating)
HAP Name
CAS No.
HAP Mass Fraction (kg HAP/kg coating)
HAP Name
CAS No.
HAP Mass Fraction (kg HAP/kg coating)
HAP Name
CAS No.
HAP Mass Fraction (kg HAP/kg coating)
4. Estimated Percent of Organic HAP Emitted
III. Resin Usage by Spray Booth
Spray Booth Identification No. (from Form B-1)
Portion of Annual Coating Usage in this Booth (percent)
Spray Booth Identification No. (from Form B-1)
Portion of Annual Coating Usage in this Booth (percent)
Spray Booth Identification No. (from Form B-1)
Portion of Annual Coating Usage in this Booth (percent)
Application of Coating Outside of a Spray Booth - Application Method
Portion of Annual Coating Usage Applied Outside of a Booth (percent)
IV. Control Device for Organic Emissions
1. Identification No. (must correspond to ID No. of one of the control devices for which a Form J was completed)
2. Type of Control Device
3. Capture Efficiency
4. How was capture efficiency determined?
Testing (specify method)
Manufacturer's Specifications
Engineering Estimate
V. Comments
Use this section to explain any of the above responses or to provide additional information

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Sheet 14: G-1

FORM G-1
STORAGE TANKS
Use this form for each stationary storage tank that contains HAP. Do not report tanks that contain fuel for engines, boilers, or other comnustion device. If your facility does not have any storage tanks that contain HAP, state that in the Comments section.
	Tank 1	Tank 2	Tank 3	Tank 4	Tank 5	Tank 6	Tank 7	Tank 8	Tank 9	Tank 10
I. Storage Tank Description and Location
1. Identification No.
2. Tank Type
3. Tank Location (Not required if a control device is listed in Section II, Question 2 below for the tank)
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees to at least five decimal places)
Longitude (decimal degrees to at least five decimal places)
4. Dimensions of Tank
Diameter (ft)
Height (ft)
5. Liquid Stored in Tank
6. Dimensions of Building in Which Tank is Located
Length (ft)
Width (ft)
Height (ft)
II. Throughput and Emissions
Emissions may be calculated using EPA's TANKS Emissions Estimation Software. If you use TANKS, you must provide all input values and model outputs.
1. Annual Throughput (gals)
2. HAP Emissions
To avoid double counting, do not report the same HAP emissions under different CAS numbers or as different compounds. For example, do not report both "total chromium" and "hexavalent chromium" for a single chromium compound contained in a coating. The correct reporting method, particularly for chromium compounds, glycol ethers, and polycyclic organic matter, is to report the specific compound (e.g., strontium chromate, ethylene glycol dibutyl ether) rather than the general class of HAP (e.g., chromium compounds, glycol ethers).
HAP Component in Liquid Stored
Mass Fraction of HAP Component in Liquid (lb HAP/lb liquid)
Emissions (lb/yr)
Emission Estimation Method
HAP Component in Liquid Stored
Mass Fraction of HAP Component in Liquid (lb HAP/lb liquid)
Emissions (lb/yr)
Emission Estimation Method
HAP Component in Liquid Stored
Mass Fraction of HAP Component in Liquid (lb HAP/lb liquid)
Emissions (lb/yr)
Emission Estimation Method
HAP Component in Liquid Stored
Mass Fraction of HAP Component in Liquid (lb HAP/lb liquid)
Emissions (lb/yr)
Emission Estimation Method
HAP Component in Liquid Stored
Mass Fraction of HAP Component in Liquid (lb HAP/lb liquid)
Emissions (lb/yr)
Emission Estimation Method
3. Control Device Identification No. (must correspond to ID No. of one of the control devices for which a Form J was completed)
4. Type of Control Device
5. Capture Efficiency
6. How was capture efficiency determined?
Testing (specify method)
Manufacturer's Specifications
Engineering Estimate
III. Work Practices
Describe any work practices that you use to reduce emissions from this tank
IV. Comments
Use this section to explain any of the above responses or to provide additional information

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Sheet 15: H-1

FORM H-1
WASTEWATER TREATMENT OPERATIONS
Use this form to report wastewater treatment operations that treat or use HAP-containing materials. If your facility does not have any wastewater treatment operations that treat or use HAP-contianing materials, then state that in the Comments section.
	Tank/Process 1	Tank/Process 2	Tank/Process 3	Tank/Process 4	Tank/Process 5	Tank/Process 6	Tank/Process 7	Tank/Process 8	Tank/Process 9	Tank/Process 10
I. Processing Tank/Process Description and Location
1. Tank/Process Identification No.
2. Location of Tank/Process (Not required if a control device is listed in Section II, Question 2 below for the tank/process)
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees to at least five decimal places)
Longitude (decimal degrees to at least five decimal places)
3. Dimensions of Building in Which Tank/Process is Located
Length (ft)
Width (ft)
Height (ft)
4. Purpose of this Tank/Process
5. Average Daily Hours of Operation
Average Days per Year of Operation
II. HAP Emissions and Controls
To avoid double counting, do not report the same HAP emissions under different CAS numbers or as different compounds. For example, do not report both "total chromium" and "hexavalent chromium" for a single chromium compound contained in a coating. The correct reporting method, particularly for chromium compounds, glycol ethers, and polycyclic organic matter, is to report the specific compound (e.g., strontium chromate, ethylene glycol dibutyl ether) rather than the general class of HAP (e.g., chromium compounds, glycol ethers).
1. HAP Emissions
HAP Name
CAS No.
Emissions (lb/yr)
Fugitive or Stack Emissions
HAP Name
CAS No.
Emissions (lb/yr)
Fugitive or Stack Emissions
HAP Name
CAS No.
Emissions (lb/yr)
Fugitive or Stack Emissions
HAP Name
CAS No.
Emissions (lb/yr)
Fugitive or Stack Emissions
HAP Name
CAS No.
Emissions (lb/yr)
Fugitive or Stack Emissions
2. Control Device Identification No. (must correspond to ID No. of one of the control devices for which a Form J was completed)
3. Type of Control Device
4. Capture Efficiency
5. How was capture efficiency determined?
Testing (specify method)
Manufacturer's Specifications
Engineering Estimate
III. Work Practices
Describe any work practices that you use to reduce emissions from this tank/process
IV. Comments
Use this section to explain any of the above responses or to provide additional information

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Sheet 16: I-1

FORM I-1
STARTUPS AND SHUTDOWNS
1. For each startup and shutdown event during the reporting year that resulted in excess HAP emissions AND that caused a NESHAP emission limit to be exceeded or caused a deviation of any requirement of the NESHAP, please provide the following information requested in A. through F. Using the definitions provided below, indicate whether the event was a startup or shutdown.
Startup: the setting in operation of an affected source or portion of an affected source for any purpose.
Shutdown: the cessation of operation of an affected source or portion of an affected source for any purpose.
A. A description of each event, including identification of the emissions source or sources associated with the event.
B. What standard was exceeded;
C. The duration of each event;
D. The actions taken to minimize emissions during the event, including the use of any backup control systems;
E. Estimates or measurements, if any, of emissions during the event. If you did not have the ability to quantify emissions during the event, please explain why.
2. Are there any types of startup or shutdown events that you have been able to eliminate; if so, how? Use additional space if necessary.
3. Please submit a copy of any plan you have been required to develop to address startup and shutdown events.
4. Please provide all performance test data collected during periods of startup and shutdown over the last 3 years. Indicate the test method used for each event.
5. Please provide all monitoring data, including control system parameter monitoring, collected during periods of startup or shutdown over the last 3 years.
6. Optional: Do you wish to recommend a standard that would apply during startup or shutdown? If so, please describe the event to which the standard would apply; the recommended standard (this could be an emission limitation, work practice, or operational standard) that would apply during the period; the basis for the recommended standard; why and how the standard would minimize emissions during the event; and how would compliance be determined and/or monitored. Use additional space if necessary.

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Sheet 17: J-1

FORM J-1
AIR POLLUTION CONTROL
I. Electrostatic Precipitator (ESP)
For each ESP:	ESP 1	ESP 2	ESP 3
Process line(s) (identification name/number)
Equipment/process(es) controlled. Include identification number listed on Forms B - F.
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees, five decimal places)
Longitude (decimal degrees, five decimal places)
Stack or vent height (ft)
Stack or vent diameter (ft)
Manufacturer and model
Date of original installation
Number of collection plates and configuration
Gas flow rate to ESP (acfm)
Inlet gas temperature (°F)
Outlet gas temperature (°F)
Inlet grain loading (gr/dscf)
Outlet grain loading (gr/dscf)
Average stack opacity (%)
Pressure drop across ESP (in. H2O gauge)
Plate area (ft2)
Vendor guarantee on ESP efficiency (attach copy)
Method of plate cleaning and frequency
Flow rate of plate wash water to ESP (gpm), if applicable
Temperature of plate wash water to ESP (°F), if applicable
Source of plate wash water used for cleaning, if applicable
Concentration (mg/l) of dissolved and suspended solids in plate wash water, if applicable
Conditioning agents used and amounts (gpm), if applicable
Amount of wastewater generated (gpd), if applicable
Amount of wastewater recycled (gpd), if applicable
Amount of wastewater disposed of (gpd), if applicable
Method of wastewater disposal, if applicable
Quantity of solid waste collected (lbs/yr)
Quantity of solid waste recycled (lbs/yr)
Quantity of solid waste disposed of (lbs/yr)
Method of solid waste disposal
Nature and frequency of routine/preventive maintenance procedures
Problems experienced with control device within the last five years; how were problems solved? For example, periods when the process was shut down or excess emissions resulted because of control device problems.
List all monitoring methods used, including parameters and frequency
Describe any plans to replace or upgrade ESP
Comments

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Sheet 18: J-2

FORM J-2
AIR POLLUTION CONTROL
II. Scrubber
For each scrubber:	Scrubber 1	Scrubber 2	Scrubber 3
Process line(s) (identification name/number)
Equipment/process(es) controlled. Include identification number listed on Forms B - F.
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.8949 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees, five decimal places)
Longitude (decimal degrees, five decimal places)
Stack or vent height (ft)
Stack or vent diameter (ft)
Manufacturer and model
Date of original installation
Type (e.g., venturi, orifice)
Gas flow rate to scrubber (acfm)
Inlet gas temperature (°F)
Outlet gas temperature (°F)
Inlet grain loading (gr/dscf)
Outlet grain loading (gr/dscf)
Average stack opacity (%)
Water flow rate to scrubber (gpm)
Percent of scrubber water from recycled wastewater
Source of scrubbing water and type of pretreatment. Substance(s) added as part of pretreatment and amount used (gpm)
HAP composition of wastewater (mg/L)
Concentration (mg/L) of dissolved and suspended solids in scrubbing water
Scrubbing water temperature (°F)
Liquid/gas ratio (gal/103 acfm)
Pressure drop across scrubber (in. H2O gauge)
Amount of wastewater generated (gpd)
Amount of wastewater recycled (gpd)
Amount of wastewater disposed of (gpd)
Method of wastewater disposal
Quantity of solid waste collected (lbs/yr)
Quantity of solid waste recycled (lbs/yr)
Quantity of solid waste disposed of (lbs/yr)
Method of solid waste disposal
Vendor guarantee on scrubber efficiency (attach copy)
Nature and frequency of preventive maintenance procedures
Problems experienced with control device within the last five years; how were problems solved? For example, periods when the process was shut down or excess emissions resulted because of control device problems.
List all monitoring methods used, including parameters and frequency
Plans to replace or upgrade scrubber
Comments

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Sheet 19: J-3

FORM J-3
AIR POLLUTION CONTROL
III. Mechanical Collector (Cyclone)
For each mechanical collector:	Mechanical Collector 1	Mechanical Collector 2	Mechanical Collector 3
Process line(s) (identification name/number)
Equipment/process(es) controlled. Include identification number listed on Forms B - F.
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees, five decimal places)
Longitude (decimal degrees, five decimal places)
Stack or vent height (ft)
Stack or vent diameter (ft)
Manufacturer and model
Date of original installation
Type of mechanical collector
Gas flow rate to collector (acfm)
Inlet gas temperature (°F)
Outlet gas temperature (°F)
Inlet grain loading (gr/dscf)
Outlet grain loading (gr/dscf)
Average stack opacity (%)
Overall pressure drop (in. H2O gauge)
Vendor guarantee on mechanical collector efficiency (attach copy)
Quantity of solid waste collected (lbs/yr)
Quantity of solid waste recycled (lbs/yr)
Quantity of solid waste disposed of (lbs/yr)
Method of solid waste disposal
Nature and frequency of preventive maintenance procedures
Problems experienced with control device within the last five years; how were problems solved? For example, periods when the process was shut down or excess emissions resulted because of control device problems.
List all monitoring methods used, including parameters and frequency
Plans to replace or upgrade mechanical collector
Comments

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Sheet 20: J-4

FORM J-4
AIR POLLUTION CONTROL
IV. Fabric/Cartridge Filter
NOTE: Do not complete this form for particulate filters on paint spray booths. Spray booth filters should be reported on Form B-1, Section II, Particulate Filters.
For each fabric/cartridge filter (some of these questions apply only to fabric filters and not to cartridge filters; complete as appropriate for your situation):	Fabric Filter 1	Fabric Filter 2	Fabric Filter 3
Process line(s) (identification name/number)
Equipment/process(es) controlled. Include identification number listed on Forms B - F.
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees, five decimal places)
Longitude (decimal degrees, five decimal places)
Stack or vent height (ft)
Stack or vent diameter (ft)
Manufacturer and model
Date of original installation
Number of compartments
Number of bags/cartridges per compartment
Filter material and coatings applied (if any)
Fabric weight (oz/yd2)
Filter surface area (ft2)
Gas flow rate to filter (acfm)
Inlet gas temperature (°F)
Outlet gas temperature (°F)
Inlet grain loading (gr/dscf)
Outlet grain loading (gr/dscf)
Average stack opacity (%)
Overall pressure drop (in. H2O gauge)
Method of bag cleaning
Frequency of bag cleaning
Vendor guarantee on fabric filter/cartridge efficiency (attach copy)
Quantity of solid waste collected (lbs/yr)
Quantity of solid waste recycled (lbs/yr)
Quantity of solid waste disposed (lbs/yr)
Method of solid waste disposal
Nature and frequency of preventive maintenance procedures
Problems experienced with control device within the last five years; how were problems solved? For example, periods when the process was shut down or excess emissions resulted because of control device problems.
List all monitoring methods used, including parameters and frequency
Plans to replace or upgrade fabric filter
Comments

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Sheet 21: J-5

FORM J-5
AIR POLLUTION CONTROL
V. Thermal Incinerator
For each thermal incinerator	Thermal Incinerator 1	Thermal Incinerator 2	Thermal Incinerator 3
Process line(s) (identification name/number)
Equipment/process(es) controlled. Include identification number listed on Forms B - F.
Incinerator type
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees, five decimal places)
Longitude (decimal degrees, five decimal places)
Stack or vent height (ft)
Stack or vent diameter (ft)
Manufacturer and model
Date of original installation
Fuel type: gas or oil
Fuel consumption rate (BTU/hr)
Inlet gas flow rate (acfm)
Inlet gas temperature (°F)
Chemical composition of combustibles in inlet gas
Combustion chamber gas temperature (°F)
Outlet gas temperature (°F)
Inlet grain loading (gr/dscf)
Outlet grain loading (gr/dscf)
Average stack opacity (%)
Excess air (%)
Residence time (sec) at temperature (°F)
Percent heat recovery
Vendor guarantee on incinerator efficiency (attach copy)
Nature and frequency of preventive maintenance procedures
Problems experienced with control device within the last five years; how were problems solved? For example, periods when the process was shut down or excess emissions resulted because of control device problems.
List all monitoring methods used, including parameters and frequency
Plans to replace or upgrade thermal incinerator
Comments

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Sheet 22: J-6

FORM J-6
AIR POLLUTION CONTROL
VI. Condenser
For each condenser:	Condenser 1	Condenser 2	Condenser 3
Process line(s) (identification name/number)
Equipment/process(es) controlled. Include identification number listed on Forms B - F.
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees, five decimal places)
Longitude (decimal degrees, five decimal places)
Stack or vent height (ft)
Stack or vent diameter (ft)
Manufacturer and model
Date of original installation
Gas flow rate to condenser (acfm)
Inlet gas temperature (°F)
Organic compounds in inlet gas stream
Name of organic compound
Volume fraction
Name of organic compond
Volume fraction
Name of organic compound
Volume fraction
Name of organic compound
Volume fraction
Name of organic compound
Volume fraction
Vendor guarantee on condenser efficiency (attach copy)
Nature and frequency of preventive maintenance procedures
Problems experienced with control device within the last five years; how were problems solved? For example, periods when the process was shut down or excess emissions resulted because of control device problems.
List all monitoring methods used, including parameters and frequency
Plans to replace or upgrade condenser
Comments

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Sheet 23: J-7

FORM J-7
AIR POLLUTION CONTROL
VII. Carbon Adsorber
For each carbon adsorber:	Carbon Adsorber 1	Carbon Adsorber 2	Carbon Adsorber 3
Process line(s) (identification name/number)
Equipment/process(es) controlled. Include identification number listed on Forms B - F.
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees, five decimal places)
Longitude (decimal degrees, five decimal places)
Stack or vent height (ft)
Stack or vent diameter (ft)
Manufacturer and model
Date of original installation
Gas flow rate to condenser (acfm)
Inlet gas temperature (°F)
Organic compounds in inlet gas stream
Name of organic compound
Volume fraction
Name of organic compond
Volume fraction
Name of organic compound
Volume fraction
Name of organic compound
Volume fraction
Name of organic compound
Volume fraction
Number of carbon beds
Vendor guarantee on adsorber efficiency (attach copy)
Nature and frequency of preventive maintenance procedures
Problems experienced with control device within the last five years; how were problems solved? For example, periods when the process was shut down or excess emissions resulted because of control device problems.
List all monitoring methods used, including parameters and frequency
Plans to replace or upgrade adsorber
Comments

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Sheet 24: J-8

FORM J-8
AIR POLLUTION CONTROL
VIII. High Velocity Air Filter (HVAF)
For each HVAF:	HVAF 1	HVAF 2	HVAF 3
Process line(s) (identification name/number)
Equipment/process(es) controlled. Include identification number listed on Forms B - F.
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees, five decimal places)
Longitude (decimal degrees, five decimal places)
Stack or vent height (ft)
Stack or vent diameter (ft)
Manufacturer and model
Date of original installation
Inlet gas flow rate (acfm)
Inlet gas temperature (°F)
Outlet gas temperature (°F)
Inlet grain loading (gr/dscf)
Outlet grain loading (gr/dscf)
Average stack opacity (%)
Water spray pressure (psig), if applicable
Water spray rate (gpm), if applicable
Filter face velocity (acfm/ft2)
Maximum pressure drop across mat (in. H2O gauge)
Vendor guarantee on HVAF efficiency (attach copy)
Method and frequency of filter mat advancement
Amount of wastewater generated (gpd)
Amount of wastewater recycled (gpd)
Amount of wastewater disposed (gpd)
Method of wastewater disposal
Quantity of solid waste collected (lbs/yr)
Quantity of solid waste recycled (lbs/yr)
Quantity of solid waste disposed (lbs/yr)
Method of solid waste disposal
Nature and frequency of preventive maintenance procedures
Problems experienced with control device within the last five years; how were problems solved? For example, periods when the process was shut down or excess emissions resulted because of control device problems.
List all monitoring methods used, including parameters and frequency
Plans to replace or upgrade HVAF
Comments

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Sheet 25: J-9

FORM J-9
AIR POLLUTION CONTROL
IX. Mist Eliminator
For each mist eliminator:	Mist Eliminator 1	Mist Eliminator 2	Mist Eliminator 3
Process line(s) (identification name/number)
Equipment/process(es) controlled. Include identification number listed on Forms B - F.
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees, five decimal places)
Longitude (decimal degrees, five decimal places)
Stack or vent height (feet)
Stack or vent diameter (feet)
Manufacturer and model
Date of original installation
Type of mist eliminator
Gas flow rate to mist eliminator (acfm)
Inlet gas temperature (°F)
Outlet gas temperature (°F)
Inlet grain loading (gr/dscf)
Outlet grain loading (gr/dscf)
Average stack opacity (%)
Velocity in mist eliminator (ft/sec)
Pressure drop (in. H2O gauge)
For chevron blade mist eliminators:
Spacing between blades (in.)
Washing frequency of blades
For mesh pad mist eliminators:
Number of pads or elements
Thickness of pad (in.) or element dimensions
Density of pad, (lb/ft3)
Washing frequency of pad
Vendor guarantee on mist eliminator efficiency (attach copy)
Amount of wastewater generated (gpd)
Amount of wastewater recycled (gpd)
Amount of wastewater disposed (gpd)
Method of wastewater disposal
Quantity of solid waste collected (lbs/yr)
Quantity of solid waste recycled (lbs/yr)
Quantity of solid waste disposed (lbs/yr)
Method of solid waste disposal
Nature and frequency of preventive maintenance procedures
Problems experienced with control device within the last five years; how were problems solved? For example, periods when the process was shut down or excess emissions resulted because of control device problems.
List all monitoring methods used, including parameters and frequency
Plans to replace or upgrade mist eliminator
Comments

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Sheet 26: J-10

FORM J-10
AIR POLLUTION CONTROL
XI. Other
For each other air pollution control devide (APCD):	Other APCD 1	Other APCD 2	Other APCD 3
Process line(s) (identification name/number)
Equipment/process(es) controlled. Include identification number listed on Forms B - F.
Latitude and longitude must be reported in decimal degrees to five decimal places. For example, EPA Headquarters at 1200 Pennsylvania Ave, NW in Washington, D.C. is 38.89491 latitude and -77.02862 longitude at the front door. You may use the Satellite function of Google Maps to identify latitude/longitude information at http://www.gorissen.info/Pierre/maps/googleMapLocationv3.php
Latitude (decimal degrees, five decimal places)
Longitude (decimal degrees, five decimal places)
Stack or vent height (ft)
Stack or vent diameter (ft)
Description
Vendor guarantee on control efficiency
List all monitoring methods used, including parameters and frequency
Problems experienced with control device within the last five years; how were problems solved? For example, periods when the process was shut down or excess emissions resulted because of control device problems.
Comments

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Sheet 27: K-1

FORM K-1
COST
Complete this form as completely as possible using readily available information for each air pollution control device for which you completed Form J.
I. Air Pollution Control Device (APCD)
For each APCD:	APCD 1	APCD 2	APCD 3
APCD ID
Process Line ID
II. Capital Costs
Base year
APCD equipment purchase cost (list what equipment is included in this cost in Comments)
List the cost for each piece of auxiliary equipment for each APCD not included above
Installation cost
Land purchase cost
Total capital cost
Method of financing APCD
Retrofit installation
Field erected or modular
III. Annual Operating Costs
Base year
Annual cost of maintenance materials and replacement parts
Raw materials costs
Labor
($/yr) for each labor class
(hr/hr) for each labor class
Utilities
Waste treatment and/or disposal
Savings associated with heat recovery and wastewater and/or solid waste returned to process from APCD (or sold to another user)
Indirect costs
Other (specify in Comments)
Total annual operating cost
Comments