OAQ AIR PERMIT APPLICATION – FORMS CHECKLIST IDEM - Office of Air Quality - Permits Branch 100 N. Senate Avenue, MC 61-53, Room 1003 Indianapolis, IN 46204-2251 Telephone: (317) 233-0178 or Toll Free: 1-800-451-6027 x30178 (within Indiana) Facsimile Number: (317) 232-6749 www.in.gov/idem/permits/air/index.html State Form 51607 (R4 / 4-08) INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT • The purpose of this checklist is to help the applicant and IDEM, OAQ ensure that the air permit application packet is administratively complete. This checklist is a required form. • Check the appropriate box indicating whether each application form is applicable for the current permit application. The source must submit only those forms pertinent to the current permit application. • NOTES: Place this checklist between the cover sheet and all subsequent forms and attachments that encompass your air permit application packet. Part A: General Source Data Applicable? Form ID Title of Form State Form Number When should this form be included in my application packet? Application Cover Sheet 50639 Include for every application, modification, and renewal, including source specific operating agreements (SSOA). Forms Checklist 51607 Include for every application, modification, and renewal, including SSOA. Y N COVER Y N CHECKLIST Y N GSD-01 Basic Source Level Information 50640 Include for every application, modification, and renewal, including SSOA. Y N GSD-02 Plant Layout Diagram 51605 Include for every new source application, and modification. Y N GSD-03 Process Flow Diagram 51599 Include one for every process covered by the application. Y N GSD-04 Stack / Vent Information 51606 Include for every new source application, and modification. Y N GSD-05 Emissions Unit Information 51610 Include for every process covered by the application. Y N GSD-06 Particulate Emissions Summary 51612 Include if the process has particulate emissions (PM). Y N GSD-07 Criteria Pollutant Emissions Summary 51602 Include if the process has criteria pollutant emissions. Y N GSD-08 HAP Emissions Summary 51604 Include if the process has hazardous air pollutant emissions (HAP). Y N GSD-09 Summary of Additional Information 51611 Include if the additional information is included. Y N GSD-10 Insignificant Activities 51596 Include if there are unpermitted insignificant activities. Y N GSD-11 Alternative Operating Scenario 51601 Include if an AOS is requested. Y N GSD-12 Affidavit of Nonapplicability 51600 Include if the standard notification requirements do not apply. Y N GSD-13 Affidavit of Applicability 51603 Include if the standard notification requirements apply. Y N GSD-14 Owners and Occupants Notified 51609 Include if the standard notification requirements apply. Y N GSD-15 Government Officials Notified 51608 Include if the standard notification requirements apply. Y N RENEWAL Renewal Checklist 51755 Include with every operating permit renewal packet. Continued on Next Page Page 1 of 6 American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51607 (R4 / 4-08) Air Permit Application Forms Checklist Page 2 of 6 Part B: Process Information Applicable? Form ID Title of Form Alternate Emission Factor Request Miscellaneous Processes Y N AEF-01 Y N PI-01 Y N PI-02A Y N PI-02B Y N Y N PI-02D Y N PI-02E PI-02C Combustion Unit Summary Combustion: Boilers, Process Heaters, & Furnaces Combustion: Turbines & Internal Combustion Engines Combustion: Incinerators & Combustors Combustion: Kilns Combustion: Fuel Use State Form Number When should this form be included in my application packet? 51860 Submit if you are requesting to use an emission factor other than AP-42. 52534 Include one form for each process for which there is not a specific PI form. 52535 Include one form to summarize all combustion units (unless SSOA). 52536 Include one form for each boiler, process heater, or furnace (unless SSOA). 52537 Include one form for each turbine or internal combustion engine (unless SSOA). 52538 Include one form for each incinerator or combustor (unless SSOA). 52539 Include one form for each kiln (unless SSOA). 52540 Include one form for each combustion unit (unless SSOA). 52541 Include one form for each combustion unit (unless SSOA). 52542 Include one form for each combustion unit (unless SSOA). Y N PI-02F Y N PI-02G Y N PI-02H Y N PI-03 Combustion: Emission Factors Combustion: Federal Rule Applicability Storage and Handling of Bulk Material 52543 Include if the process involves the storage and handling of bulk materials. 52544 Include for each asphalt plant process (unless general permit). Y N PI-04 Asphalt Plants Y N PI-05 Brick / Clay Products 52545 Include for each brick and/or clay products process. 52546 Include for each electroplating process. Y N PI-06 Electroplating Operations Y N PI-07 Welding Operations 52547 Include for each welding process. Y N PI-08 Concrete Batchers 52548 Include for each concrete batcher (unless SSOA). Y N PI-09 Degreasing 52549 Include for each degreasing process (unless SSOA). Y N PI-10 Dry Cleaners 52550 Include for each dry cleaning process 52551 Include for each foundry process Y N PI-11 Foundry Operations Y N PI-12 Grain Elevators 52552 Include for each grain elevator (unless SSOA). 52553 Include for each lime manufacturing process. Y N PI-13 Lime Manufacturing Y N PI-14 Liquid Organic Compound Storage 52554 (doc) Include if the process involves the storage of liquid organic compounds. Y N PI-14ALT Alternate version of Liquid Organic Compound Storage 52555 (xls) Include if the process involves the storage of liquid organic compounds and there are several storage vessels. Y N PI-15 Portland Cement Manufacturing 52556 Include for each Portland cement manufacturing process. Y N PI-16 Reinforced Plastics & Composites 52557 Include for each reinforced plastics and composites process. Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51607 (R4 / 4-08) Air Permit Application Forms Checklist Page 3 of 6 Part B: Process Information Applicable? Y N Form ID Title of Form State Form Number When should this form be included in my application packet? PI-17 Blasting Operations 52558 Include for each blasting process (unless SSOA). 52559 Include if the process involves mineral processing (unless SSOA). Y N PI-18 Mineral Processing Y N PI-19 Surface Coating & Printing Operations 52560 Include for each surface coating or printing process (unless SSOA). 52561 Include for each woodworking or plastic machining process (unless SSOA). Y N PI-20 Woodworking / Plastic Machining Y N PI-21 Site Remediation 52570 Include for each soil remediation process. Y N PI-22 Ethanol Plants (Under Development) None Include for each ethanol plant. Part C: Control Equipment Applicable? Form ID Title of Form State Form Number When should this form be included in my application packet? Y N CE-01 Control Equipment Summary 51904 Include if add-on control equipment will be used for the process. Y N CE-02 Particulates – Baghouse / Fabric Filter 51953 Include for each baghouse or fabric filter. Y N CE-03 Particulates – Cyclone 52620 Include for each cyclone. Y N CE-04 Particulates – Electrostatic Precipitator 52621 Include for each electrostatic precipitator. Y N CE-05 Particulates – Wet Collector / Scrubber / Absorber 52622 Include for each wet collector, scrubber, or absorber. Y N CE-06 Organics – Flare / Oxidizer / Incinerator 52623 Include for each flare, oxidizer, or incinerator. Y N CE-07 Organics – Adsorbers 52624 Include for each adsorber. Y N CE-08 Organics – Condenser 52625 Include for each condenser. Y N CE-09 Reduction Technology 52626 Include for each control device using reduction technology (e.g., SCR, SNCR). Y N CE-10 Miscellaneous Control Equipment 52436 Include one form for equipment for which there is not a specific CE form. Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51607 (R4 / 4-08) Air Permit Application Forms Checklist Page 4 of 6 Part D: Compliance Determination for Part 70 Sources Applicable? Form ID Title of Form State Form Number When should this form be included in my application packet? Y N CD-01 Emissions Unit Compliance Status 51861 Include for every Title V application, including modifications. Y N CD-02 Compliance Plan by Applicable Requirement 51862 Include for every Title V application, including modifications. Y N CD-03 Compliance Plan by Emissions Unit 51863 Include for every Title V application, including modifications. Y N CD-04 Compliance Schedule and Certification 51864 Include for every Title V application, including modifications and renewal. Y N FED-03 Compliance Assurance Monitoring 53377 Include for every Title V application, including modifications. Part E: Best Available Control Technology Applicable? Form ID Title of Form State Form Number When should this form be included in my application packet? Y N BACT-01 Analysis of Best Available Control Technology None Include for every BACT application. Y N BACT-01a Background Search: Existing BACT Determinations None Include for every BACT application. Y N BACT-01b Cost/Economic Impact Analysis None Include for every BACT application. Y N BACT-02 Summary of Best Available Control Technology None Include for every BACT application. Y N PSD / EO-01 PSD / Emission Offset Checklist None Include for every PSD application and every NSR application that requires emission offsets. Part F: Emission Credit Registry Applicable? Form ID Title of Form State Form Number When should this form be included in my application packet? Y N EC-01 Generation of Emission Credits 51783 Include if the modification results in emission reductions. Y N EC-02 Transfer of Emission Credits 51784 Submit whenever registered emission credits are transferred. Y N EC-03 Use of Emission Credits 51785 Include if the modification requires the use of emission credits for offsets. Y N EC-04 Emission Credit Request 51906 Submit if you are looking for emission credits for offsets. Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51607 (R4 / 4-08) Air Permit Application Forms Checklist Page 5 of 6 Part G: Plantwide Applicability Limits Applicable? Form ID Title of Form State Form Number When should this form be included in my application packet? Y N PAL-01 Actuals Plantwide Applicability Limit 52451 Include if the modification results in emission reductions. Y N PAL-02 Revised Plantwide Applicability Limit 52452 Submit whenever registered emission credits are transferred. Y N PAL-03 Plantwide Applicability Limit Renewal 52453 Include if the modification requires the use of emission credits for offsets. Y N PAL-04 Request for Termination of Plantwide Applicability Limit 52454 Submit if you are looking for emission credits for offsets. Part H: Air Toxics Applicable? Form ID Title of Form State Form Number When should this form be included in my application packet? Y N FED-01 Summary of Federal Requirements – NSPS & NESHAP 53512 Include for each 40 CFR Part 60 NSPS, 40 CFR Part 61 NESHAP, and 40 CFR Part 63 NESHAP applicable to the process. Y N FED-02 MACT Pre-Construction Review 51905 Include if constructing or modifying a process subject to a Part 63 NESHAP. Y N No Form ID MACT Initial Notification None This form is available on the U.S. EPA website. Completed notifications should be submitted to the IDEM Compliance Branch. Part I: Special Permits Applicable? Form ID Title of Form State Form Number When should this form be included in my application packet? Y N INTERIM Interim Approval None Submit if you are applying for interim operating approval. Y N ASPHALT Asphalt General Permit None Submit if you are applying for or modifying an asphalt plant general permit. Y N NOXBTP NOX Budget Permit None Submit if you are a power plant or if you have opted in to the NOX budget trading program. Y N ACIDRAIN Phase 2 Acid Rain Permit None Submit if you are applying for, modifying, or renewing a Phase 2 Acid Rain permit. Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51607 (R4 / 4-08) Air Permit Application Forms Checklist Page 6 of 6 Part J: Source Specific Operating Agreements (SSOA) Applicable? Form ID Title of Form State Form Number When should this form be included in my application packet? Y N OA-01 Summary of Application and Existing Agreements 53438 Submit if you are applying for or modifying a Source Specific Operating Agreement. Y N OA-02 Industrial / Commercial Surface Coating Operations -OR- Graphic Arts Operations (326 IAC 2-9-2.5) 53439 Submit if you are applying for or modifying a SSOA for industrial or commercial surface coating operations not subject to 326 IAC 8-2; or graphic arts operations not subject to 326 IAC 8-5-5. Y N OA-03 Surface Coating or Graphic Arts Operations (326 IAC 2-9-3) 53440 Submit if you are applying for or modifying a SSOA for surface coating or graphic arts operations. Y N OA-04 Woodworking Operations (326 IAC 2-9-4) 53441 Submit if you are applying for or modifying a SSOA for woodworking operations. Y N OA-05 Abrasive Cleaning Operations (326 IAC 53442 Submit if you are applying for or modifying a SSOA for abrasive cleaning operations. 2-9-5) Y N OA-06 Grain Elevators (326 IAC 2-9-6) 53443 Submit if you are applying for or modifying a SSOA for grain elevators. Y N OA-07 Sand And Gravel Plants (326 IAC 2-9-7) 53444 Submit if you are applying for or modifying a SSOA for sand and gravel plants. Y N OA-08 Crushed Stone Processing Plants (326 53445 Submit if you are applying for or modifying a SSOA for crushed stone processing plants. 53446 Submit if you are applying for or modifying a SSOA for ready-mix concrete batch plants. 53447 Submit if you are applying for or modifying a SSOA for coal mines and coal preparation plants. 53448 Submit if you are applying for or modifying a SSOA for automobile refinishing operations. IAC 2-9-8) Y N OA-09 Ready-Mix Concrete Batch Plants (326 IAC 2-9-9) Y N OA-10 Coal Mines And Coal Preparation Plants (326 IAC 2-9-10) Y N OA-11 Automobile Refinishing Operations (326 IAC 2-9-11) Y N OA-12 Degreasing Operations (326 IAC 2-9-12) 53449 Submit if you are applying for or modifying a SSOA for degreasing operations. Y N OA-13 External Combustion Sources (326 IAC 53450 Submit if you are applying for or modifying a SSOA for external combustion sources. 53451 Submit if you are applying for or modifying a SSOA for internal combustion sources. 2-9-13) Y N OA-14 Internal Combustion Sources (326 IAC 2-9-14) American LegalNet, Inc. www.FormsWorkflow.com