5900-83 IE, Insignificant Emissions

OMB No. 2060-0336, Approval Expires 04/30/2012

Federal Operating Permit Program (40 CFR Part 71)
INSIGNIFICANT EMISSIONS (IE)
On this page list each insignificant activity or emission unit. In the "number" column, indicate the number
of units in this category. Descriptions should be brief but unique. Indicate which emissions criterion of
part 71 is the basis for the exemption.
HAP
Number
Description of Activities or Emissions Units
RAP,
except
HAP

EPA Form 5900-83

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INSTRUCTIONS FOR IE
INSIGNIFICANT ACTIVITIES
Use this form only if you have any equipment, emissions units, or emitting activities at your facility that
qualify for insignificant treatment due to insignificant emissions levels (defined in the part 71 rule) and
you desire such treatment.
Generally identify the source of emissions.
The "number" column is provided to indicate the total number or units or activities grouped together
under one description, for example, equipment such as valves and flanges. However, units or
activities that are similar should be listed separately in the form when the descriptions differ in a
meaningful way, such as when capacities or sizes differ and this information is relevant, for example,
to an applicability determination.
Check one of the columns provided to indicate which emission level criteria of part 71 is met for these
units or activities that warrant such treatment. The rule provides 2 emission criteria:
 emissions of 2 tons per year or less or any regulated pollutants except HAP (RAP, except
HAP) from any emission unit, or
 1000 pounds per year or less of any HAP from any emission unit.
Note that part 71 does not exempt any insignificant units from major source applicability
determinations.
In addition, attach to this form information concerning equipment, activities, or emissions units that are
exempted from an otherwise applicable requirement (e.g., grandfathered emissions units. Please cite
the basis for the exemption (e.g., State administrative code or Federal regulation).

EPA Form 5900-83