7620-16 Account Certificate of Representation

United States Environmental Protection Agency
Acid Rain, CSAPR, and MATS Trading Programs

OMB Nos. 2060-0258, 2060-0667, and 2060-0567

Approval Expires 11/30/2018

Certificate of Representation

For more information, see instructions and 40 CFR 63 subpart UUUUU, 72.24, 97.416, 97.516, 97.616, 97.716, 97.816, or a
comparable state regulation, as applicable.
This submission is:

STEP 1
Provide
information for
the plant.

□

New

□

Revised (revised submissions must be complete; see instructions)

Plant Name 

State 

Plant Code 

County Name 

STEP 2
Enter
requested
information for
the designated
representative.

Latitude 

Longitude 

Name 

Title 

Company Name 

Mailing Address 

City 

Phone Number 

Fax Number 

State 

Zip Code 

State 

Zip Code 

E‐mail Address 

STEP 3
Enter
requested
information for
the alternate
designated
representative.

Name 

Title 

Company Name 

Mailing Address 

City 

Phone Number 

Fax Number 

E‐mail Address 

EPA Form 7610-1 (Revised 12-2016)

Certificate of Representation
Page 2 of 6

UNIT INFORMATION

STEP 4: Complete a separate page 2 for each unit located at the plant 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



CSAPR NOX Annual


CSAPR SO

2



CSAPR NOX Ozone Season


MATS

Acid Rain Nameplate
Capacity (MWe)

Generator
ID Number
(Maximum
8
characters)

CSAPR / MATS Nameplate
Capacity (MWe)

Source Category

Unit ID#

Unit Type

NAICS Code

Enter the date the unit began (or will begin) serving any generator
producing electricity for sale (including test generation)
(mm/dd/yyyy):
Check One:



Company Name:

Is this unit located in Indian
Country?

Has this unit ever operated at another location?

Check One:

Check One:

Actual Date

Yes

Projected Date

No






Yes
No



 Owner
 Operator

Company Name:

 Owner
 Operator

Company Name:

 Owner
 Operator

Company Name:

 Owner
 Operator

EPA Form 7610-1 (Revised 12-2016)

Certificate of Representation
Page 3 of 6

STEP 5: Read the appropriate certification statements that apply, 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.

CSAPR NOx Annual Trading 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 source and each CSAPR NOX Annual unit at the source.
I certify that I have all the necessary authority to carry out my duties and responsibilities under the CSAPR NOX Annual
Trading Program on behalf of the owners and operators of the source and of each CSAPR 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 decision or 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 CSAPR NOX Annual unit, or
where a utility or industrial customer purchases power from a CSAPR 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 CSAPR NOX Annual unit at the source; and CSAPR NOX Annual allowances and
proceeds of transactions involving CSAPR 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 CSAPR NOX Annual allowances by contract, CSAPR NOX Annual
allowances and proceeds of transactions involving CSAPR NOX Annual allowances will be deemed to be held or distributed
in accordance with the contract.

EPA Form 7610-1 (Revised 12-2016)

Certificate of Representation
Page 4 of 6

CSAPR NOX Ozone Season Group 1 Trading 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 source and each CSAPR NOX Ozone Season Group 1 unit at the
source.
I certify that I have all the necessary authority to carry out my duties and responsibilities under the CSAPR NOX Ozone
Season Group 1 Trading Program on behalf of the owners and operators of the source and of each CSAPR NOX Ozone
Season 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 decision or 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 CSAPR NOX Ozone Season
Group 1 unit, or where a utility or industrial customer purchases power from a CSAPR NOX Ozone Season 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 CSAPR NOX Ozone Season Group 1 unit at the source; and
CSAPR NOX Ozone Season Group 1 allowances and proceeds of transactions involving CSAPR NOX Ozone Season 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 CSAPR
NOX Ozone Season Group 1 allowances by contract, CSAPR NOX Ozone Season Group 1 allowances and proceeds of
transactions involving CSAPR NOX Ozone Season Group 1 allowances will be deemed to be held or distributed in
accordance with the contract.
CSAPR NOX Ozone Season Group 2 Trading 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 source and each CSAPR NOX Ozone Season Group 2 unit at the
source.
I certify that I have all the necessary authority to carry out my duties and responsibilities under the CSAPR NOX Ozone
Season Group 2 Trading Program on behalf of the owners and operators of the source and of each CSAPR NOX Ozone
Season 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 decision or 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 CSAPR NOX Ozone Season
Group 2 unit, or where a utility or industrial customer purchases power from a CSAPR NOX Ozone Season 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 CSAPR NOX Ozone Season Group 2 unit at the source; and
CSAPR NOX Ozone Season Group 2 allowances and proceeds of transactions involving CSAPR NOX Ozone Season 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 CSAPR
NOX Ozone Season Group 2 allowances by contract, CSAPR NOX Ozone Season Group 2 allowances and proceeds of
transactions involving CSAPR NOX Ozone Season Group 2 allowances will be deemed to be held or distributed in
accordance with the contract.

EPA Form 7610-1 (Revised 12-2016)

Certificate of Representation
Page 5 of 6

CSAPR SO2 Annual Group 1 Trading 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 source and each CSAPR 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 CSAPR SO2 Group 1
Trading Program on behalf of the owners and operators of the source and of each CSAPR 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 decision or 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 CSAPR SO2 Group 1 unit, or
where a utility or industrial customer purchases power from a CSAPR 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 CSAPR SO2 Group 1 unit at the source; and CSAPR SO2 Group 1 allowances and
proceeds of transactions involving CSAPR 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 CSAPR SO2 Group 1 allowances by contract, CSAPR SO2 Group 1
allowances and proceeds of transactions involving CSAPR SO2 Group 1 allowances will be deemed to be held or distributed
in accordance with the contract.
CSAPR SO2 Annual Group 2 Trading 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 source and each CSAPR 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 CSAPR SO2 Group 2
Trading Program on behalf of the owners and operators of the source and of each CSAPR 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 decision or 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 CSAPR SO2 Group 2 unit, or
where a utility or industrial customer purchases power from a CSAPR 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 CSAPR SO2 Group 2 unit at the source; and CSAPR SO2 Group 2 allowances and
proceeds of transactions involving CSAPR 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 CSAPR SO2 Group 2 allowances by contract, CSAPR SO2 Group 2
allowances and proceeds of transactions involving CSAPR SO2 Group 2 allowances will be deemed to be held or distributed
in accordance with the contract.

EPA Form 7610-1 (Revised 12-2016)

Certificate of Representation
Page 6 of 6

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

EPA Form 7610-1 (Revised 12-2016)

Instructions for the Certificate of Representation
NOTE: The Certificate of Representation information can be submitted online through the CAMD Business
System (CBS), which can be accessed at https://camd.epa.gov/cbs/index.cfm. See the Certificate of
Representation tutorial on the CBS homepage for assistance. If you have questions about CBS, send an email
to [email protected].
You must have a user name and password to access CBS. You can obtain a user name and password if: (1)
you are currently listed in the CAMD database as a designated representative or an agent for a designated
representative, AND (2) CAMD has received and processed a hard copy of the Electronic Subscriber
Agreement form at http://www.epa.gov/airmarkets/business/docs/forms/subscriber_agreement.pdf. Once a
person meets these criteria, he/she may contact one of the following persons to obtain a user name and
password: Karen VanSickle at (202) 343-9220, Kirk Nabors at (202) 343-9171, or Paula Branch at (202) 3439168.
Please type or print. Submit a separate page 2 for each unit at the plant (source) subject to the Acid Rain
Program (ARP), a Cross-State Air Pollution Program (CSAPR), or the MATS Program. Include units for which
a Retired Unit Exemption notice has been submitted. 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, send an email to: [email protected].
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 plants that generate electricity. For older plants, "plant code" is synonymous with
"ORISPL" and "facility" codes. If the plant generates electricity but no plant code has been assigned, or if
there is uncertainty regarding what the plant code is, send an email to the EIA at [email protected]. For plants
that do not produce electricity, use the plant identifier assigned by EPA (beginning with "88"). If the plant does
not produce electricity and has not been assigned a plant identifier, contact Laurel DeSantis at
[email protected].
(ii) Enter the latitude and longitude representing the location of the plant 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.
There may be only one designated representative and one alternate designated representative for a plant.

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STEP 4
(i) Complete one page for each unit subject to theARP, CSAPR, or MATS Program, and indicate the program(s)
that the unit is subject to. Identify each unit at the plant 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

IGC

CB

Cell burner boiler

T

Tangentially-fired
boiler

Integrated
Gasification
Combined Cycle

CFB

Circulating fluidized bed
boiler

OT

Other turbine

Wet bottom wall-fired
boiler

ICE

Wet bottom turbo-fired
boiler

Internal Combustion
engine

KLN

Cement kiln

PRH

Refinery process
heater

DB
DTF
DVF

Dry bottom wall-fired
boiler
Dry bottom turbo-fired
boiler

WBF
WBT
WVF

Wet boiler verticallyfired boiler

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
Bulk Industrial Chemical
Cement Manufacturing
Cogeneration
Electric Utility

Industrial Boiler
Industrial Turbine
Institutional
Iron and Steel
Municipal Waste Combustor

2 

Petroleum Refinery
Portland Cement Plant
Pulp and Paper Mill
Small Power Producer
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 produces electricity for sale. You are strongly encouraged to use the
CAMD Business System to update information regarding the date a unit begins serving a generator
producing electricity for sale. See the Certificate of Representation tutorial on the CBS homepage for
assistance. 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 ARP, CSAPR, or MATS, that, as of the date of submission of this form, serves one
or more generators (whether or not the generator produces electricity for sale), enter the generator ID
number(s) 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 ARP and CSAPR/MATS Programs differ slightly.
Therefore, for a unit subject to the ARP and any CSAPR/MATS Program, the nameplate capacity for the
same generator under the ARP and under the CSAPR/MATS Program may differ in certain limited
circumstances. Specifically, for a unit subject to the ARP, 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 ARP or a CSAPR/MATS 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. For units subject only to MATS, use the nameplate capacity reported for each generator on U.S. EIA
form EIA-860. If the facility does not report to U.S. EIA, use the nameplate capacity displayed on the
nameplate of the generator served by the unit. 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, 97.402, 97.502, 97.602, 97.702 and 97.802, 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. See the Certificate of
Representation tutorial on the CBS homepage for assistance.

3 

(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, 97.702 and 97.802.
(ix) When identifying a unit at a plant for the first time, indicate whether or not the unit ever operated at
another location. If the answer is “yes”, the EPA will contact the owners/operator for more information.
STEP 5
Read the appropriate certification statements that apply (if any), sign, and date.
Mail this form to:
For regular/certified mail:

For overnight mail:

U.S. Environmental Protection Agency
1200 Pennsylvania Ave., NW
Mail Code 6204M
Attention: Designated Representative
Washington, DC 20460

U.S. Environmental Protection Agency
1201 Constitution Ave., NW
7th Floor, Room # 7421M
Attention: Designated Representative
Washington, DC 20004
(202) 343-9191

Submit this form prior to making any other submissions under the ARP, CSAPR or MATS 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. See the Certificate of Representation tutorial on the CBS homepage for
assistance.
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.

4