7610-1 Certificate of Representation

		United States Environmental Protection Agency OMB Nos. 2060-0258, 2060-0570, and 2060-NEW Acid Rain, CAIR, and Transport Rule Programs Approval Expires 11/31/2012
		Certificate of Representation For more information, see instructions and 40 CFR 72.24, 96.113, 96.213, 96.313, 97.113, 97.213, 97.313, 97.416, 97.516, 97.616, 97.716, or a comparable state regulation, as applicable. This submission is: □ New □ Revised (revised submissions must be complete; see instructions)
FACILITY (SOURCE) INFORMATION
STEP 1 Provide information for the facility (source).	Facility (Source) Name			State	Plant Code
	County Name
	Latitude		Longitude
STEP 2 Enter requested information for the designated representative.	Name		Title
	Company Name
	Mailing Address
	Phone Number		Fax Number
	E-mail address

STEP 3 Enter requested information for the alternate designated representative.	Name	Title
	Company Name
	Mailing Address
	Phone Number	Fax Number
	E-mail address

Certificate of Representation

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UNIT INFORMATION

STEP 4: Complete a separate page 2 for each unit located at the facility identified in STEP 1 (i.e., for each boiler, simple cycle combustion turbine, or combined cycle combustion turbine) Do not list duct burners. Indicate each program to which the unit is subject, and enter all other unit-specific information. See instructions for more details.

Applicable Program(s):  Acid Rain  CAIR NO_X Annual  CAIR SO₂  CAIR NO_X Ozone Season

 TRNO_x Annual  TRNO_x Ozone Season  TRSO₂ Annual

Unit ID#	Unit Type	Source Category		Generator ID Number (Maximum 8 characters)	Acid Rain Nameplate Capacity (MWe)	CAIR/Transport Rule Nameplate Capacity (MWe)
		NAICS Code
Date unit began (or will begin) serving any generator producing electricity for sale (including test generation) (mm/dd/yyyy): ): Check One: Yes  No 			Is this unit located in Indian Country? Check One: Yes  No 	If this is the first time the unit has been identified on the Certificate of Representation for this facility, was the unit moved from another facility? Check One: Yes  No 
Company Name:					 Owner  Operator
Company Name:					 Owner  Operator
Company Name:					 Owner  Operator
Company Name:					 Owner  Operator
Company Name:					 Owner  Operator

Certificate of Representation

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STEP 5: Read the appropriate certification statements, sign, and date.

Acid Rain Program

I certify that I was selected as the designated representative or alternate designated representative (as applicable) by an agreement binding on the owners and operators of the affected source and each affected unit at the source (i.e., the source and each unit subject to the Acid Rain Program, as indicated in "Applicable Program(s)" in Step 4).

I certify that I have all necessary authority to carry out my duties and responsibilities under the Acid Rain Program on behalf of the owners and operators of the affected source and each affected unit at the source and that each such owner and operator shall be fully bound by my representations, actions, inactions, or submissions.

I certify that the owners and operators of the affected source and each affected unit at the source shall be bound by any order issued to me by the Administrator, the permitting authority, or a court regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, an affected unit, or where a utility or industrial customer purchases power from an affected unit under a life-of-the-unit, firm power contractual arrangement,

I certify that:

I have given a written notice of my selection as the designated representative or alternate designated representative (as applicable) and of the agreement by which I was selected to each owner and operator of the affected source and each affected unit at the source; and

Allowances, and proceeds of transactions involving allowances, will be deemed to be held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual reservation or entitlement, except that, if such multiple holders have expressly provided for a different distribution of allowances, allowances and proceeds of transactions involving allowances will be deemed to be held or distributed in accordance with the contract.

Clean Air Interstate Rule (CAIR) NO_X Annual Trading Program

I certify that I was selected as the CAIR designated representative or alternate CAIR designated representative (as applicable), by an agreement binding on the owners and operators of the CAIR NO_X source and each CAIR NO_X unit at the source (i.e., the source and each unit subject to the CAIR NO_X Annual Trading Program, as indicated in "Applicable Program(s)" in Step 4).

I certify that I have all necessary authority to carry out my duties and responsibilities under the CAIR NO_X Annual Trading Program on behalf of the owners and operators of the CAIR NO_X source and each CAIR NO_X unit at the source and that each such owner and operator shall be fully bound by my representations, actions, inactions, or submissions.

I certify that the owners and operators of the CAIR NO_X source and each CAIR NO_X unit at the source shall be bound by any order issued to me by the Administrator, the permitting authority, or a court regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a CAIR NO_X unit, or where a utility or industrial customer purchases power from a CAIR NO_X unit under a life-of-the-unit, firm power contractual arrangement,

I certify that:

I have given a written notice of my selection as the CAIR designated representative or alternate CAIR designated representative (as applicable) and of the agreement by which I was selected to each owner and operator of the CAIR NO_X source and each CAIR NO_X unit at the source; and

CAIR NO_X allowances and proceeds of transactions involving CAIR NO_X allowances will be deemed to be held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual reservation or entitlement, except that, if such multiple holders have expressly provided for a different distribution of CAIR NO_X allowances by contract, CAIR NO_X allowances and proceeds of transactions involving CAIR NO_X allowances will be deemed to be held or distributed in accordance with the contract.



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Clean Air Interstate Rule (CAIR) SO₂ Trading Program

I certify that I was selected as the CAIR designated representative or alternate CAIR designated representative (as applicable), by an agreement binding on the owners and operators of the CAIR SO₂ source and each CAIR SO₂ unit at the source (i.e., the source and each unit subject to the SO₂ Trading Program, as indicated in "Applicable Program(s)" in Step 4).

I certify that I have all necessary authority to carry out my duties and responsibilities under the CAIR SO₂ Trading Program, on behalf of the owners and operators of the CAIR SO₂ source and each CAIR SO₂ unit at the source and that each such owner and operator shall be fully bound by my representations, actions, inactions, or submissions.

I certify that the owners and operators of the CAIR SO₂ source and each CAIR SO₂ unit at the source shall be bound by any order issued to me by the Administrator, the permitting authority, or a court regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a CAIR SO₂ unit, or where a utility or industrial customer purchases power from a CAIR SO₂ unit under a life-of-the-unit, firm power contractual arrangement,

I certify that:

I have given a written notice of my selection as the CAIR designated representative or alternate CAIR designated representative (as applicable) and of the agreement by which I was selected to each owner and operator of the CAIR SO₂ source and each CAIR SO₂ unit at the source; and

CAIR SO₂ allowances and proceeds of transactions involving CAIR SO₂ allowances will be deemed to be held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual reservation or entitlement, except that, if such multiple holders have expressly provided for a different distribution of CAIR SO₂ allowances by contract, CAIR SO₂ allowances and proceeds of transactions involving CAIR SO₂ allowances will be deemed to be held or distributed in accordance with the contract.

Clean Air Interstate Rule (CAIR) NO_X Ozone Season Trading Program

I certify that I was selected as the CAIR designated representative or alternate CAIR designated representative (as applicable), by an agreement binding on the owners and operators of the CAIR NO_X Ozone Season source and each CAIR NO_X Ozone Season unit at the source (i.e., the source and each unit subject to the CAIR NO_X Ozone Season Trading Program, as indicated in "Applicable Program(s)" in Step 4).

I certify that I have all necessary authority to carry out my duties and responsibilities under the CAIR NO_X Ozone Season Trading Program on behalf of the owners and operators of the CAIR NO_X Ozone Season source and each CAIR NO_X Ozone Season unit at the source and that each such owner and operator shall be fully bound by my representations, actions, inactions, or submissions.

I certify that the owners and operators of the CAIR NO_X Ozone Season source and each CAIR NO_X Ozone Season unit shall be bound by any order issued to me by the Administrator, the permitting authority, or a court regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a CAIR NO_X Ozone Season unit, or where a utility or industrial customer purchases power from a CAIR NO_X Ozone Season unit under a life-of-the-unit, firm power contractual arrangement, I certify that:

I have given a written notice of my selection as the CAIR designated representative or alternate CAIR designated representative (as applicable) and of the agreement by which I was selected to each owner and operator of the CAIR NO_X Ozone Season source and each CAIR NO_X Ozone Season unit; and

CAIR NO_X Ozone Season allowances and proceeds of transactions involving CAIR NO_X Ozone Season allowances will be deemed to be held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual reservation or entitlement, except that, if such multiple holders have expressly provided for a different distribution of CAIR NO_X Ozone Season allowances by contract, CAIR NO_X Ozone Season allowances and proceeds of transactions involving CAIR NO_X Ozone Season allowances will be deemed to be held or distributed in accordance with the contract.

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Transport Rule NO_x Annual

I certify that I was selected as the designated representative or alternate designated representative, as applicable, by an agreement binding on the owners and operators of the source and each TR NOX Annual unit at the source.

I certify that I have all the necessary authority to carry out my duties and responsibilities under the TR NOX Annual Trading Program on behalf of the owners and operators of the source and of each TR NOX Annual unit at the source and that each such owner and operator shall be fully bound by my representations, actions, inactions, or submissions and by any order issued to me by the Administrator regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a TR NOX Annual unit, or where a utility or industrial customer purchases power from a TR NOX Annual unit under a life‑of‑the‑unit, firm power contractual arrangement, I certify that:

I have given a written notice of my selection as the ‘designated representative’ or ‘alternate designated representative’, as applicable, and of the agreement by which I was selected to each owner and operator of the source and of each TR NOX Annual unit at the source.

TR NOX Annual allowances and proceeds of transactions involving TR NOX Annual allowances will be deemed to be held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual reservation or entitlement, except that, if such multiple holders have expressly provided for a different distribution of TR NOX Annual allowances by contract, TR NOX Annual allowances and proceeds of transactions involving TR NOX Annual allowances will be deemed to be held or distributed in accordance with the contract.

Transport Rule NO_x Ozone Season

I certify that I was selected as the designated representative or alternate designated representative, as applicable, by an agreement binding on the owners and operators of the source and each TR NOX Ozone Season unit at the source.

I certify that I have all the necessary authority to carry out my duties and responsibilities under the TR NOX Ozone Season Trading Program on behalf of the owners and operators of the source and of each TR NOX Ozone Season unit at the source and that each such owner and operator shall be fully bound by my representations, actions, inactions, or submissions and by any order issued to me by the Administrator regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a TR NOX Ozone Season unit, or where a utility or industrial customer purchases power from a TR NOX Ozone Season unit under a life‑of‑the‑unit, firm power contractual arrangement, I certify that:

I have given a written notice of my selection as the ‘designated representative’ or ‘alternate designated representative’, as applicable, and of the agreement by which I was selected to each owner and operator of the source and of each TR NOX Ozone Season unit at the source.

TR NOX Ozone Season allowances and proceeds of transactions involving TR NOX Ozone Season allowances will be deemed to be held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual reservation or entitlement, except that, if such multiple holders have expressly provided for a different distribution of TR NOX Ozone Season allowances by contract, TR NOX Ozone Season allowances and proceeds of transactions involving TR NOX Ozone Season allowances will be deemed to be held or distributed in accordance with the contract.

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Transport Rule SO₂ Annual Group 1

I certify that I was selected as the designated representative or alternate designated representative, as applicable, by an agreement binding on the owners and operators of the source and each TR SO2 Group 1 unit at the source.

I certify that I have all the necessary authority to carry out my duties and responsibilities under the TR SO2 Group 1 Trading Program on behalf of the owners and operators of the source and of each TR SO2 Group 1 unit at the source and that each such owner and operator shall be fully bound by my representations, actions, inactions, or submissions and by any order issued to me by the Administrator regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a TR SO2 Group 1 unit, or where a utility or industrial customer purchases power from a TR SO2 Group 1 unit under a life‑of‑the‑unit, firm power contractual arrangement, I certify that:

I have given a written notice of my selection as the ‘designated representative’ or ‘alternate designated representative’, as applicable, and of the agreement by which I was selected to each owner and operator of the source and of each TR SO2 Group 1 unit at the source.

TR SO2 Group 1 allowances and proceeds of transactions involving TR SO2 Group 1 allowances will be deemed to be held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual reservation or entitlement, except that, if such multiple holders have expressly provided for a different distribution of TR SO2 Group 1 allowances by contract, TR SO2 Group 1 allowances and proceeds of transactions involving TR SO2 Group 1 allowances will be deemed to be held or distributed in accordance with the contract.

Transport Rule SO₂ Annual Group 2

I certify that I was selected as the designated representative or alternate designated representative, as applicable, by an agreement binding on the owners and operators of the source and each TR SO2 Group 2 unit at the source.

I certify that I have all the necessary authority to carry out my duties and responsibilities under the TR SO2 Group 2 Trading Program on behalf of the owners and operators of the source and of each TR SO2 Group 2 unit at the source and that each such owner and operator shall be fully bound by my representations, actions, inactions, or submissions and by any order issued to me by the Administrator regarding the source or unit.

Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a TR SO2 Group 2 unit, or where a utility or industrial customer purchases power from a TR SO2 Group 2 unit under a life‑of‑the‑unit, firm power contractual arrangement, I certify that:

I have given a written notice of my selection as the ‘designated representative’ or ‘alternate designated representative’, as applicable, and of the agreement by which I was selected to each owner and operator of the source and of each TR SO2 Group 2 unit at the source.

TR SO2 Group 2 allowances and proceeds of transactions involving TR SO2 Group 2 allowances will be deemed to be held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual reservation or entitlement, except that, if such multiple holders have expressly provided for a different distribution of TR SO2 Group 2 allowances by contract, TR SO2 Group 2 allowances and proceeds of transactions involving TR SO2 Group 2 allowances will be deemed to be held or distributed in accordance with the contract.

Certificate of Representation

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General

I am authorized to make this submission on behalf of the owners and operators of the source or units for which the submission is made. I certify under penalty of law that I have personally examined, and am familiar with, the statements and information submitted in this document and all its attachments. Based on my inquiry of those individuals with primary responsibility for obtaining the information, I certify that the statements and information are to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant penalties for submitting false statements and information or omitting required statements and information, including the possibility of fine or imprisonment.

Signature (Designated Representative)	Date
Signature (Alternate Designated Representative)	Date

Instructions for the Certificate of Representation

Note: The Certificate of Representation information can be submitted online through the CAMD Business System (CBS) at https://camd.epa.gov/cbs/index.cfm. You must have a user ID and password. If you need a user ID and password, call Karen Van Sickle at (202) 343-9220 or Kirk Nabors at (202) 343-9171 or Paula Branch at (202) 343-9168. If you have questions about CBS, contact Laurel DeSantis at [email protected] or (202) 343-9191, or Alex Salpeter at [email protected] or (202) 343-9157.

Any reference in these instructions to the Designated Representative means the Acid Rain Designated Representative, the CAIR Designated Representative, and/or Transport Rule Designated Representative, as applicable. Any reference to the Alternate Designated Representative means the Alternate Acid Rain Designated Representative, the Alternate CAIR Designated Representative, and/or the Alternate Transport Rule Designated Representative, as applicable. As reflected in this form, the Acid Rain Designated Representative, the CAIR Designated Representative, and the Transport Rule Designated Representative for a facility (source) must be the same individual, and the Alternate Acid Rain Designated Representative, the Alternate CAIR Designated Representative, and the Alternate Transport Rule Designated Representative for a facility (source) must be the same individual.

Please type or print. Submit a separate page 2 for each unit subject to the Acid Rain Program, a CAIR Trading Program, or a Transport Rule Program at the facility (source), and indicate the page order and total number of pages (e.g., 1 of 4, 2 of 4, etc.) in the boxes in the upper right hand corner of page 2. A Certificate of Representation amending an earlier submission supersedes the earlier submission in its entirety and must therefore always be complete. Submit one Certificate of Representation form with original signature(s). NO FIELDS SHOULD BE LEFT BLANK. For assistance, contact Laurel DeSantis at [email protected] or (202) 343-9191.

STEP 1

(i) A Plant Code is a 4 or 5 digit number assigned by the Department of Energy=s (DOE) Energy Information Administration (EIA) to facilities that generate electricity. For older facilities, "Plant Code" is synonymous with "ORISPL" and "Facility" codes. If the facility generates electricity but no Plant Code has been assigned, or if there is uncertainty regarding what the Plant Code is, contact EIA at (202) 586-1029. For facilities that do not produce electricity, use the facility identifier assigned by EPA (beginning with "88"). If the facility does not produce electricity and has not been assigned a facility identifier, contact Laurel DeSantis at [email protected] or (202) 343-9191.

(ii) Enter the latitude and longitude representing the location of the facility in degree decimal format.

Note that coordinates MUST be submitted in decimal degree format; in this format minutes and seconds are represented as a decimal fraction of one degree. Therefore, coordinates containing degrees, minutes, and seconds must first be converted using the formula:

decimal degrees = degrees + (minutes / 60) + (seconds / 3600)

Example:

39 degrees, 15 minutes, 25 seconds = 39 + (15 / 60) + (25 / 3600) = 39.2569 degrees

STEPS 2 & 3

The Designated Representative and the Alternate Designated Representative must be individuals (i.e., natural persons) and cannot be a company. Enter the company name and address of the representative as it should appear on all correspondence. If an email address is provided, most correspondence will be emailed. Although not required, EPA strongly encourages owners and operators to designate an Alternate Designated Representative to act on behalf of the Designated Representative.

STEP 4

(i) Complete one page for each unit subject to the Acid Rain Program, a CAIR Trading Program, or a Transport Rule Program, and indicate the program(s) to which the unit is subject. Identify each unit at the facility by providing the appropriate unit identification number, consistent with the identifiers used in previously submitted Certificates of Representation (if applicable) and with submissions made to DOE and/or EIA. Do not list duct burners. For new units without identification numbers, owners and operators must assign identifiers consistent with EIA and DOE requirements. Each submission to EPA that includes the unit identification number(s) (e.g., monitoring plans and quarterly reports) should reference those unit identification numbers in exactly the same way that they are referenced on the Certificate of Representation. Do not identify units that are not subject to the above-listed programs but are part of a common monitoring configuration with a unit that is subject to any of these programs. To identify units in a common monitoring configuration that are not subject to any of these programs, call the CAMD Hotline at (202) 343-9620, and leave a message under the “Continuous Emissions Monitoring” submenu.

(ii) Identify the type of unit using one of the following abbreviations:

Boilers		Boilers		Turbines
AF	Arch-fired boiler	OB	Other boiler	CC	Combined cycle
BFB	Bubbling fluidized bed boiler	PFB	Pressurized fluidized bed boiler	CT	Combustion turbine
C	Cyclone boiler	S	Stoker	OT	Other turbine
CB	Cell burner boiler	T	Tangentially-fired boiler	Others
CFB	Circulating fluidized bed boiler	WBF	Wet bottom wall-fired boiler	ICE	Internal combustion engine
DB	Dry bottom wall-fired boiler	WBT	Wet bottom turbo-fired boiler	KLN	Cement kiln
DTF	Dry bottom turbo-fired boiler	WVF	Wet bottom vertically-fired boiler	PRH	Refinery process heater
DVF	Dry bottom vertically-fired boiler

If there is uncertainty about how a unit should be characterized, contact Robert Miller at [email protected] or (202) 343-9077.

(iii) Indicate the source category description that most accurately describes the purpose for which the unit is operated by entering one of the following terms. If none of these descriptions applies to your unit, contact Robert Miller at [email protected] or (202) 343-9077.

Automotive Stampings Industrial Boiler Petroleum Refinery

Bulk Industrial Chemical Industrial Turbine Portland Cement Plant

Cement Manufacturing Institutional Pulp and Paper Mill

Cogeneration Iron and Steel Small Power Producer

Electric Utility Municipal Waste Combustor Theme Park

(iv) Provide the primary North American Industrial Classification System (NAICS) code that most accurately describes the business type for which the unit is operated. If unknown, go to http://www.census.gov for guidance on how to determine the proper NAICS code for the unit.

(v) Enter the date the unit began (or will begin) serving any generator producing electricity for sale, including test generation. Enter this date and check the "actual" box for any unit that has begun to serve a generator producing electricity for sale as of the date of submission of this form. (This information should be provided even if the unit does not currently serve a generator producing electricity for sale.) For any unit that will begin, but has not begun as of the date of submission of this form, to serve a generator producing electricity for sale, estimate the future date on which the unit will begin to produce electricity for sale and check the "projected" box. When the actual date is established, revise the form accordingly by entering the actual date and checking the "actual" box. Enter "NA" if the unit has not ever served, is not currently serving, and is not projected to serve, a generator that producing electricity for sale. You are strongly encouraged to use the CAMD Business System to update information regarding when a unit begins serving a generator producing electricity for sale.

If you have questions regarding this portion of the form, contact Robert Miller at [email protected] or (202) 343-9077.

(vi) For a unit subject to the Acid Rain Program, a CAIR Trading Program, or a Transport Rule Program, that, as of the date of submission of this form, serves one or more generators (whether or not the generator produces electricity for sale), indicate the generator ID number and the nameplate capacity (in MWe) of each generator served by the unit. A unit serves a generator if it produces, or is able to produce, steam, gas, or other heated medium for generating electricity at that generator. For combined cycle units, report separately the nameplate capacities of the generators associated with the combustion turbine and the steam turbine. Please ensure that the generator ID numbers entered are consistent with those reported to the EIA.

The definitions of "nameplate capacity" under the Acid Rain Program and under the CAIR/Transport Rule Programs differ slightly. Therefore, for a unit subject to the Acid Rain Program and any CAIR/Transport Rule Program, the nameplate capacity for the same generator under the Acid Rain Program and under the CAIR/Transport Rule Program may differ in certain limited circumstances. Specifically, for a unit subject to the Acid Rain Program, the nameplate capacity of a generator, if listed in the National Allowance Database ("NADB"), is not affected by physical changes to the generator after initial installation that result in an increase in the maximum electrical generating output that the generator is capable of producing. Otherwise, for a unit subject to the Acid Rain Program or a CAIR/Transport Rule Program, the nameplate capacity of a generator is affected by physical changes to the generator after initial installation that result in an increase in the maximum electrical generating output that the generator is capable of producing. In such a case, the higher maximum electrical generating output number in MWe should be reported in the nameplate capacity column. Enter "NA" if, as of the date of submission of this form, the unit does not serve a generator.

See the definition of "nameplate capacity" at 40 CFR 72.2, 96.102, 97.102, 96.202, 97.202, 96.302, 97.302, 97.402, 97.502, 97.602, and 97.702, as applicable. The NADB is located at the CAMD website at http://www.epa.gov/airmarkets/trading/allocations.html. If you have questions regarding nameplate capacity, contact Robert Miller at [email protected] or (202) 343-9077; if you have questions regarding the NADB, contact Craig Hillock at [email protected] or (202) 343-9105.

(vii) Enter the company name of each owner and operator in the "Company Name" field. Indicate whether the company is the owner, operator, or both. For new units, if the operator of a unit has not yet been chosen, indicate that the owner is both the owner and operator and submit a revised form when the operator has been selected within 30 days of the effective date of the selection. EPA must be notified of changes to owners and operators within 30 days of the effective date of the change. You are strongly encouraged to use the CAMD Business System to provide updated information on owners and operators.

(viii) Indicate whether or not the unit is located in Indian Country. For more information see the definition of “Indian Country” at 40 CFR 97.402, 97.502, 97.602 and 97.702.

(ix) When identifying a unit at a facility for the first time, indicate whether or not the unit was moved from another facility. If the answer is “yes”, the EPA will contact the owners/operator for more information.

STEP 5

Read the appropriate certification statements, sign, and date.

Mail this form to:

For regular/certified mail: For overnight mail:

U.S. Environmental Protection Agency U.S. Environmental Protection Agency

Clean Air Markets Division (6204J) Clean Air Markets Division (6204J)

Attention: Designated Representative Attention: Designated Representative

1200 Pennsylvania Avenue, NW 1310 L Street, NW

Washington, DC 20460 Second Floor

Washington, DC 20005

(202) 343-9191

Submit this form prior to making any other submissions under the Acid Rain Program, CAIR Programs, or Transport Rule Programs. Submit a revised Certificate of Representation when any information in the existing Certificate of Representation changes. You are strongly encouraged to use the CAMD Business System to provide updated information.

Paperwork Burden Estimate

The public reporting and record keeping burden for this collection of information is estimated to average 15 hours per response annually. Burden means the total time, effort, or financial resources expended by persons to generate, maintain, retain, or disclose or provide information to or for a Federal agency. This includes the time needed to review instructions; develop, acquire, install, and utilize technology and systems for the purposes of collecting, validating, and verifying information, processing and maintaining information, and disclosing and providing information; adjust the existing ways to comply with any previously applicable instructions and requirements; train personnel to be able to respond to a collection of information; search data sources; complete and review the collection of information; and transmit or otherwise disclose the information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

Send comments on the Agency's need for this 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 form to this address.