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BACT 01A Background Search Existing BACT Determinations Form. This is a Indiana form and can be use in Department Of Enviromental Management Statewide.
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Tags: BACT 01A Background Search Existing BACT Determinations, 49554, Indiana Statewide, Department Of Enviromental Management
Indiana Department of Environmental Management
Office of Air Management
Permit Application
State Form 49554 (11/99)
FORM BACT-01a
Background Search - Existing BACT Determinations
1/2000
BACKGROUND SEARCH - EXISTING BACT DETERMINATIONS
Facility:
Unit ID:
Pollutant:
Complete all five tables of this form to provide more detailed information regarding the five
determinations listed on Table C of FORM BACT-01 ANALYSIS OF BEST AVAILABLE CONTROL TECHNOLOGY.
A.
SOURCE 1
Source
City
State
Regulatory Authority
Permit
Date Issued
Facility
Capacity (specify units)
BACT Determination
Compliance Achieved? (Yes/No)
Method of Compliance Determination
Actions Taken for Noncompliance
Baseline Emissions Rate (specify units)
Post-BACT Emissions Rate (specify units)
Emissions Reduction Potential (%)
Cost Effectiveness ($/ton removed)
Reference
Refer to Chapter B of the ANew Source Review (NSR) Workshop Manual@ (Draft edition, October 1990).
BACT-01a
Page 1 of 5
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Indiana Department of Environmental Management
Office of Air Management
Permit Application
State Form 49554 (11/99)
FORM BACT-01a
Background Search - Existing BACT Determinations
1/2000
Background Search - Existing BACT Determinations (continued)
Facility:
Unit ID:
B.
Pollutant:
SOURCE 2
Source
City
State
Regulatory Authority
Permit
Date Issued
Facility
Capacity (specify units)
BACT Determination
Compliance Achieved? (Yes/No)
Method of Compliance Determination
Actions Taken for Noncompliance
Baseline Emissions Rate (specify units)
Post-BACT Emissions Rate (specify units)
Emissions Reduction Potential (%)
Cost Effectiveness ($/ton removed)
Reference
Refer to Chapter B of the ANew Source Review (NSR) Workshop Manual@ (Draft edition, October 1990).
BACT-01a
Page 2 of 5
American LegalNet, Inc.
www.FormsWorkflow.com
Indiana Department of Environmental Management
Office of Air Management
Permit Application
State Form 49554 (11/99)
FORM BACT-01a
Background Search - Existing BACT Determinations
1/2000
Background Search - Existing BACT Determinations (continued)
Facility:
Unit ID:
C.
Pollutant:
SOURCE 3
Source
City
State
Regulatory Authority
Permit
Date Issued
Facility
Capacity (specify units)
BACT Determination
Compliance Achieved? (Yes/No)
Method of Compliance Determination
Actions Taken for Noncompliance
Baseline Emissions Rate (specify units)
Post-BACT Emissions Rate (specify units)
Emissions Reduction Potential (%)
Cost Effectiveness ($/ton removed)
Reference
Refer to Chapter B of the ANew Source Review (NSR) Workshop Manual@ (Draft edition, October 1990).
BACT-01a
Page 3 of 5
American LegalNet, Inc.
www.FormsWorkflow.com
Indiana Department of Environmental Management
Office of Air Management
Permit Application
State Form 49554 (11/99)
FORM BACT-01a
Background Search - Existing BACT Determinations
1/2000
Background Search - Existing BACT Determinations (continued)
Facility:
Unit ID:
D.
Pollutant:
SOURCE 4
Source
City
State
Regulatory Authority
Permit
Date Issued
Facility
Capacity (specify units)
BACT Determination
Compliance Achieved? (Yes/No)
Method of Compliance Determination
Actions Taken for Noncompliance
Baseline Emissions Rate (specify units)
Post-BACT Emissions Rate (specify units)
Emissions Reduction Potential (%)
Cost Effectiveness ($/ton removed)
Reference
Refer to Chapter B of the ANew Source Review (NSR) Workshop Manual@ (Draft edition, October 1990).
BACT-01a
Page 4 of 5
American LegalNet, Inc.
www.FormsWorkflow.com
Indiana Department of Environmental Management
Office of Air Management
Permit Application
State Form 49554 (11/99)
FORM BACT-01a
Background Search - Existing BACT Determinations
1/2000
Background Search - Existing BACT Determinations (continued)
Facility:
Unit ID:
E.
Pollutant:
SOURCE 5
Source
City
State
Regulatory Authority
Permit
Date Issued
Facility
Capacity (specify units)
BACT Determination
Compliance Achieved? (Yes/No)
Method of Compliance Determination
Actions Taken for Noncompliance
Baseline Emissions Rate (specify units)
Post-BACT Emissions Rate (specify units)
Emissions Reduction Potential (%)
Cost Effectiveness ($/ton removed)
Reference
Refer to Chapter B of the ANew Source Review (NSR) Workshop Manual@ (Draft edition, October 1990).
BACT-01a
Page 5 of 5
American LegalNet, Inc.
www.FormsWorkflow.com
