CD-02 – Compliance Plan Requirements Per Applicable Requirement – INSTRUCTIONS Microsoft Word version of CD-02 Adobe PDF version of CD-02 The purpose of CD-02 (state form 51862) is to identify existing compliance monitoring activities (monitoring, testing, record keeping and/or reporting) required in an applicable requirement or to provide compliance monitoring activities for applicable requirements where there is no or inadequate compliance monitoring requirements. CD-02 focuses on generally applicable requirements that apply to many or all emission units at the source. CD-02 is a required form for all Title V permit applications submitted to IDEM, OAQ. For the purposes of this form, the term “source” refers to the plant as a whole and NOT to the individual emissions units. NOTE: The Compliance Determination forms, CD-01 through CD-04, are required for a "complete" application under the Part 70 Permitting Program (Title V) per 326 IAC 2-7-4(c), paragraphs (4), (11), (12), and (14). These forms must be completed for each initial Title V permit application as well as each modification and every renewal. If you have any questions, contact the Air Permit Reviewer of the Day (PROD) at (317) 233-0178 or 1-800-451-6027 extension 3-0178 (toll free call within Indiana). Part A: Identification of Source and Applicable Requirement Part A identifies the source and the applicable requirement. Use one form for each applicable requirement. For the purposes of this form, the term “source” refers to the plant site as a whole and NOT to individual emissions units. 1. Source Name: Provide the legal name of the company that will be used to conduct official business with this source. 2. Source ID: The source identification (ID) number consists of a three (3) digit county code and a five (5) digit source code separated by a dash (-). Sources that have been previously permitted with the OAQ should have received a source ID from our office. If you are planning to construct an entirely new source, you will not yet have a source ID, so you will need to put the words “Not Applicable” on this line. If you think you have a source ID, but you are not sure, contact the Air Permit Reviewer of the Day (PROD) at (317) 233-0178 or 1-800-451-6027 extension 3-0178 (toll free call within Indiana). 3. Applicable Requirement: Provide the name of the applicable requirement. 4. Rule Cite: Provide the citation of the applicable requirement. 5. Limitations: List each operational and/or emission limit specified in the applicable requirement. 6. Reporting Schedule: Provide a description of the reporting schedule to be used. The schedule should include what will be reported and how often the reports will be submitted. Part B: Regulatory Compliance Status Part B identifies the main components of each required compliance plan. 7. Unit ID: Provide the identification number for each emissions unit. The identification numbers listed on this form should correspond to the emissions unit identified on the Plant Layout diagram and Process Flow diagram. 8. Stack / Vent ID: Provide the identification number for each stack or vent to which this emissions unit exhausts. The identification numbers listed on this form should correspond to the stacks and vents identified on the Plant Layout and Process Flow diagrams. 9. Control Equipment: List the pollution control equipment that will be monitored for each listed emissions unit. American LegalNet, Inc. www.FormsWorkflow.com 10. Parameters Monitored: Specify what will be monitored for each listed emissions unit. For example, “pressure drop across the baghouse”. 11. Monitoring Frequency: Specify the monitoring frequency for each monitored item. For example, “once per operating day”. 12. Item Recorded: List what records will be kept for each listed emissions unit. 13. Record Keeping Frequency: Specify the record keeping frequency for each recorded item. 14. Pollutants tested: For each listed emissions unit, list the performance tests conducted. For the pressure drop example, the performance test would be for “particulate matter”. 15. Test Method: If the applicable requirement requires the use of a specific test method, provide the test method. If no test method is required, place "N/A" here. 16. Testing Frequency: Specify the testing frequency for each performance test. ***SUBMISSION OF CONFIDENTIAL RECORDS*** All information submitted to IDEM will be made available to the public unless it is submitted under a claim of confidentiality. Claim of confidentiality must be made at the time the information is submitted to IDEM, and must follow the requirements set out in 326 IAC 17.1-4-1. Failure to follow these requirements exactly will result in your confidential information becoming a public record, available for public inspection. To ensure that your information remains confidential, refer to the IDEM, OAQ information regarding submittal of confidential business information. For more information on confidentiality for certain types of business information, please review IDEM’s Nonrule Policy Document Air-031-NPD regarding Emission Data. American LegalNet, Inc. www.FormsWorkflow.com CD-02 – COMPLIANCE PLAN REQUIREMENTS PER APPLICABLE REQUIREMENT IDEM - Office of Air Quality - Permits Branch 100 N. Senate Avenue Indianapolis, IN 46204 Telephone: (317) 233-0178 or Toll Free: 1-800-451-6027 x30178 (within Indiana) Facsimile Number: (317) 232-6749 http://www.IN.gov/idem/permits/air State Form 51862 (R / 9-04) INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT NOTES: • • • • • The purpose of CD-02 is to identify existing compliance monitoring activities (monitoring, testing, record keeping and/or reporting) required in an applicable requirement or to provide compliance monitoring activities for applicable requirements where there is no or inadequate compliance monitoring requirements. CD-02 focuses on generally applicable requirements that apply to many or all emission units at the source. This is required form for each initial Title V permit application as well as each modification and every renewal. Detailed instructions for this form are available online at http://www.in.gov/idem/permits/air/apps/instructions/cd02instructions.html. All information submitted to IDEM will be made available to the public unless it is submitted under a claim of confidentiality. Claims of confidentiality must be made at the time the information is submitted to IDEM, and must follow the requirements set out in 326 IAC 17.1-4-1. Failure to follow these requirements exactly will result in your information becoming a public record, available for any one to inspect and photocopy. FOR OFFICE USE ONLY PERMIT NUMBER: ____ ______ – _________ – ____________ PART A: Identification of Source and Applicable Requirement Part A is intended to identify the source and the applicable requirement. Use one form for each applicable requirement. For the purposes of this form, the term “source” refers to the plant site as a whole and NOT to individual emissions units. 1. Source Name: 2. Source ID: __ __ __ - __ __ __ __ __ 3. Applicable Requirement: 4. Rule Cite: 5. Limitations: List each operational and/or emission limit specified in the applicable requirement. 6. Reporting Schedule: Provide a description of the reporting schedule to be used. The schedule should include what will be reported and how often the reports will be submitted. Compliance Plan Requirements Per Applicable Requirement (CD-02) Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT OFFICE OF AIR QUALITY State Form 51862 (R / 9-04) Compliance Plan Requirements Per Applicable Requirement FORM CD-02 PART B: Compliance Plan Components Part B is intended to identify the main components of each required compliance plan. 7. Unit ID 8. Stack / Vent ID 9. Control Equipment 10. Parameters Monitored Compliance Plan Requirements Per Applicable Requirement (CD-02) 11. Monitoring Frequency 12. Item Recorded 13. Record Keeping Frequency 14. Pollutants Tested 15. Test Method 16. Testing Frequency Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com