5900-391 Part 2: Submit Within 60 Days After Startup of Productio

Prevention of Significant Deterioration and Non-Attainment New Source Review (Renewal)

form5900-391 oil_and_natural_gas_minor_source_registration_part_2_fillable_form

Minor New Source Review for Sources

OMB: 2060-0003

Document [pdf]
Download: pdf | pdf
EPA Form No. 5900-391
EPA ICR No. 1230.27
OMB Control No. 2060-0003
Approval expires 4/30/2017

United States Environmental Protection Agency
https://www.epa.gov/tribal-air/tribal-minor-new-source-review
January 4, 2017

Part 2: Submit Within 60 Days After Startup
of Production -- Emission and Production
Information
FEDERAL IMPLEMENTATION PLAN FOR TRUE MINOR SOURCES IN INDIAN
COUNTRY IN THE OIL AND NATURAL GAS PRODUCTION AND NATURAL
GAS PROCESSING SEGMENTS OF THE OIL AND NATURAL GAS SECTOR
Registration for New True Minor Oil and Natural Gas Sources and Minor
Modifications at Existing True Minor Oil and Natural Gas Sources

Please submit information to:

[Reviewing Authority
Address
Phone]
A. GENERAL SOURCE INFORMATION (See Instructions Below)
1. Company Name
2. Source Name
3. Type of Oil and Natural Gas Operation

4. New Minor Source?

Yes

5. True Source Modification?
6. NAICS Code

No
Yes

No

7. SIC Code

8. U.S. Well ID(s) or API Number(s) [if applicable]
9. Area of Indian Country

10. County

11a. Latitude

11b. Longitude

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EPA Form No. 5900-391
EPA ICR No. 1230.27
OMB Control No. 2060-0003
Approval expires 4/30/2017

B. CONTACT INFORMATION (See Instructions Below)
1. Owner Name

Title

Mailing Address

Email Address

Telephone Number

Facsimile Number

2. Operator Name (if different from owner)

Title

Mailing Address

Email Address

Telephone Number

Facsimile Number

3. Source Contact

Title

Mailing Address

Email Address

Telephone Number

Facsimile Number

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EPA Form No. 5900-391
EPA ICR No. 1230.27
OMB Control No. 2060-0003
Approval expires 4/30/2017

4. Compliance Contact

Title

Mailing Address

Email Address

Telephone Number

Facsimile Number

C. EMISSIONS AND OTHER SOURCE INFORMATION
Include all of the following information in the table below and as attachments to this form:
Note: The emission estimates can be based upon actual test data or, in the absence of such data, upon procedures
acceptable to the Reviewing Authority. The following procedures are generally acceptable for estimating emissions
from air pollution sources: (1) unit-specific emission tests; (2) mass balance calculations; (3) published, verifiable
emission factors that are applicable to the unit (i.e., manufacturer specifications); (4) other engineering calculations;
or (5) other procedures to estimate emissions specifically approved by the Reviewing Authority. Guidance for
estimating emissions can be found at https://www.epa.gov/chief.
Narrative description of the operations.
Identification and description of any air pollution control equipment and compliance monitoring devices or activities.
Type and actual amount (annually) of each fuel that will be used.
Type of raw materials used (e.g., water for hydraulic fracturing).
Actual, annual production rates.
Actual operating schedules.
Any existing limitations on source operations affecting emissions or any work practice standards, where applicable, for
all regulated New Source Review (NSR) pollutants at your source. Indicate all requirements referenced in the Federal
Implementation Plan (FIP) for True Minor Sources in Indian Country in the Oil and Natural Gas Production and
Natural Gas Processing Segments of the Oil and Natural Gas Sector that apply to emissions units and air pollution
generating activities at the source or proposed. Include statements indicating each emissions unit that is an emissions unit
potentially subject to the requirements referenced in the FIP, but does not meet the definition of an affected facility
under the referenced requirement, and therefore, is not subject to those requirements.
For each emissions unit comprising the new source or modification, estimates of the total allowable (potential to
emit) annual emissions at startup of production from the air pollution source for the following air pollutants:
particulate matter, PM10, PM2.5, sulfur oxides ( ), nitrogen oxides (NOx), carbon monoxide (CO), volatile organic
compound (VOC), lead (Pb) and lead compounds, fluorides (gaseous and particulate), sulfuric acid mist (H2SO4),
hydrogen sulfide (H2S), total reduced sulfur (TRS) and reduced sulfur compounds, including all calculations for the
estimates. Allowable annual emissions are defined as: emissions rate of an emissions unit calculated using the
maximum capacity of a stationary source to emit a pollutant under its physical and operational design. Any physical

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EPA Form No. 5900-391
EPA ICR No. 1230.27
OMB Control No. 2060-0003
Approval expires 4/30/2017

or operational limitation on the capacity of the source to emit a pollutant, including air pollution control equipment
and restrictions on hours of operation or on the type or amount of material combusted, stored, or processed, shall be
treated as part of its design if the limitation, or the effect it would have on emissions, is legally and practically
enforceable. You must determine the potential for emissions within 30 days from the startup of production.
For each emissions unit comprising the new source or modification, estimates of the total actual annual emissions
during the upcoming, consecutive 12 months from the air pollution source for the following air pollutants: particulate
matter (PM, PM10, PM2.5), sulfur oxides (SOx), nitrogen oxides (NOx), carbon monoxide (CO), volatile organic
compound (VOC), lead (Pb) and lead compounds, ammonia (NH3), fluorides (gaseous and particulate), sulfuric acid
mist (H2SO4), hydrogen sulfide (H2S), total reduced sulfur (TRS) and reduced sulfur compounds, including all
calculations for the estimates. Estimates of actual emissions must take into account equipment, operating conditions,
and air pollution control measures. You should calculate an estimate of the actual annual emissions using estimated
operating hours, production rates, in-place control equipment, and types of materials processed, stored, or combusted.

D. TABLE OF ESTIMATED EMISSIONS
Provide in the table below estimates of the total allowable annual emissions in tons per year (tpy) and total actual annual
emissions (tpy) for the following pollutants for all emissions units comprising the new source or modification.
POLLUTANT

TOTAL ALLOWABLE ANNUAL
EMISSIONS (TPY)

TOTAL ACTUAL ANNUAL
EMISSIONS (TPY)

PM

PM10

PM2.5

SOx

NOx

CO

VOC

Pb

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EPA Form No. 5900-391
EPA ICR No. 1230.27
OMB Control No. 2060-0003
Approval expires 4/30/2017

POLLUTANT

TOTAL ALLOWABLE ANNUAL
EMISSIONS (TPY)

TOTAL ACTUAL ANNUAL
EMISSIONS (TPY)

NH3

Fluorides

H2SO4

H2S

TRS

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EPA Form No. 5900-391
EPA ICR No. 1230.27
OMB Control No. 2060-0003
Approval expires 4/30/2017

Instructions for Part 2
Please answer all questions. If the item does not apply to the source and its operations write “n/a”. If the answer is not
known write "unknown".
A. General Source Information
1. Company Name: Provide the complete company name. For corporations, include divisions or subsidiary name, if
any.
2. Source Name: Provide the source name. Please note that a source is a site, place, or location that may contain one
or more air pollution emitting units.
3. Type of Operation: Indicate the generally accepted name for the oil and natural gas production or natural gas
processing segment operation (e.g., oil and gas well site, tank battery, compressor station, natural gas
processing plant).
4. New True Minor Source: [Per Federal Indian Country Minor New Source Review Rule, 40 CFR 49.153].
5. True Minor Source Modification: [Per Federal Indian Country Minor New Source Review Rule, 40 CFR 49.153].
6. North American Industry Classification System (NAICS): The NAICS Code for your oil and natural gas source
can be found at the following link for North American Industry Classification System:
http://www.census.gov/eos/www/naics/.
7. Standard Industrial Classification Code (SIC Code): Although the new NAICS code has replaced the SIC
codes, much of the Clean Air Act permitting processes continue to use these codes. The SIC Code for your oil
and natural gas source can be found at the following link for Standard Industrial Classification Codes:
http://www.osha.gov/pls/imis/sic_manual.html.
8. U.S. Well ID or API Number: Unique well identifier as assigned by the Federal or State oil and gas regulatory
agency with primacy, using the American Petroleum Institute (API) Standard for number format (pre-2014) or the
Professional Petroleum Data Management (PPDM) Association US Well Number Standard (2014-present).
Provide IDs for all oil and natural gas production wells associated with the facility, if applicable. May not be
applicable for downstream production sources, such as compressor stations.
9. Area of Indian Country: Provide the name of the Indian reservation within which the source is operating.
10. County: Provide the County within which the source is operating.
11. Latitude & Longitude (11a. and 11b.): Provide latitude and longitude location(s) in decimal degrees, indicating
the datum used in parentheses. These are GPS (global positioning system) coordinates. This information should
be provided in decimal degrees with 6 digits to the right of the decimal point, indicating the datum used in
parentheses (i.e., NAD 27, NAD 83, WGS 84 – WGS 84 is preferred over NAD 27).
B. Contact Information
Please provide the information requested in full.
1. Owners: List the full name (last, middle initial, first) of all owners of the source.
2. Operator: Provide the name of the operator of the source if it is different from the owner(s).
3. Source Contact: The source contact must be the local contact authorized to receive requests for data and
information.
4. Compliance Contact: The compliance contact must be the local contact responsible for the source’s compliance
with this rule. If this is the same as the Source Contact please note this on the form.
C. Attachments
The information requested in the attachments will enable the U.S. Environmental Protection Agency (EPA) to understand
the type of oil and natural gas source being registered and the nature and extent of the air pollutants to be emitted.

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EPA Form No. 5900-391
EPA ICR No. 1230.27
OMB Control No. 2060-0003
Approval expires 4/30/2017

Disclaimers:
The public reporting and recordkeeping burden for this collection of information is estimated to average 6 hours per
response. 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.
Information in these forms submitted in compliance with the final Federal Indian Country Minor NSR rule may be claimed
as confidential. A company may assert a claim of confidentiality for information submitted by clearly marking that
information as confidential. Such information shall be treated in accordance with EPA’s procedures for information claimed
as confidential at 40 CFR part 2, subpart B, and will only be disclosed by the means set forth in the subpart. If no claim of
confidentiality accompanies the report when it is received by EPA, it may be made public without further notice to the
company (40 CFR 2.203).

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File Typeapplication/pdf
File TitleAPI Comments Tribal Lands 12042015 1
AuthorDenise.Grubert
File Modified2017-01-11
File Created2017-01-04

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