PARTICULATE CONTROL EQUIPMENT: Cyclone – INSTRUCTIONS Microsoft Word version of CE-03 Adobe PDF version of CE-03 The purpose of CE-03 (state form 52620) is to summarize all of the physical and operational parameters of a cyclone used to control particulate emissions. Complete this form once for each control device (or once for each set of identical control devices). CE-03 is a required form for submitting information about a cyclone 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. 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 and Description of Control Equipment Part A identifies the particulate control device and to describe its physical properties. 1. Control Equipment ID: Provide the identification number for each device used to control or limit air pollutant emissions. The identification numbers listed on this form should correspond to the emissions unit identified on the Plant Layout diagram and Process Flow diagram. 2. Installation Date: Specify when the control equipment was installed. At a minimum, the month and year of installation is required. 3. Number of Tubes: Specify the number of tubes for the cyclone. For multiple tubes, specify whether the tubes are arranged in parallel or in series. 4. Is an Alarm / Detector Installed on this devices? Specify whether or not an alarm or detection system is installed on the control device. If such a system is present, briefly describe the system. Part B: Operational Parameters Part B provides the operational parameters of the control device and the pollutant laden gas stream. Appropriate units must be included if the standard units are not used. 5. Gas Stream Flow Rate: Provide the volumetric flow rate of the gas stream prior to entering the control device, after leaving the control device, and include the calculation of the difference in flow rate between the inlet and outlet of the device. You must also include the units for flow rate. Air flow rates are typically provided in actual cubic feet per minute (acfm). 6. Gas Stream Temperature: Provide the average temperature of the gas stream prior to entering the control device, after leaving the control device, and include the calculation of the difference in temperature between the inlet and outlet of the device. You must also indicate the temperature scale used. Air stream temperatures are typically provided in degrees Fahrenheit (°F). 7. Gas Stream Pressure: Provide the pressure applied to the gas stream prior to entering the control device, after leaving the control device, and include the calculation of the difference in pressure between the inlet and outlet of the device. You must also include the units of pressure. Air pressure is typically provided in inches of water (in H2O) or pounds per square inch (psi) or millimeters of mercury (mm Hg). 8. Moisture Content: Provide the moisture content of the gas stream prior to entering the control device, after leaving the control device, and include the calculation of the difference in moisture content between the inlet and outlet of the device. Moisture content is typically provided as a percent (%). 9. Average Particle Size Range: Provide the average size range of the particulates in the gas stream prior to entering the control device, after leaving the control device, and include the calculation of the difference in size range of particulates between the inlet and outlet of the device. Particulate size range is typically provided in micrometers (μm). 10. Other: Specify any other parameter of the control device, and provide the appropriate value for the parameter prior to American LegalNet, Inc. www.FormsWorkflow.com entering the control device, after leaving the control device, and include the calculation of the difference between the inlet and outlet of the device. Specify the units of measure used for the control device parameter. Part C: Pollutant Concentrations Part C provides the operational parameters of the particulate control device and the pollutant laden gas stream. Appropriate units must be included if the standard units are not used. 11. Units: For each pollutant controlled, provide the units of measure for each concentration. Pollutant concentrations are typically provided in pounds per hour (lb/hr), tons per year (tpy), parts per million by volume (ppmv) or in milligrams per liter (mg/L), or in grains per dry standard cubic foot (gr/dscf). 12. Inlet: For each pollutant controlled, provide the concentration of the pollutant in the gas stream prior to entering the control device. 13. Outlet: For each pollutant controlled, provide the concentration of the pollutant in the gas stream after leaving the control device. 14. Efficiency: Provide a capture and control efficiency for each pollutant controlled by the control device. Capture The capture efficiency of the control device is the amount of the contaminated gas stream that is collected by the control device. Provide the particulate capture efficiency for the control device. Efficiency is typically provided as a percent (%). Control The control efficiency of the control device is the amount of contaminant that is removed from the captured gas stream by the control device. Provide the particulate control efficiency for the control device. Efficiency is typically provided as a percent (%). Part D: Monitoring, Record Keeping, & Testing Procedures Part D identifies any existing or proposed monitoring, record keeping, & testing procedures that may need to be included in the permit. 15. Items Monitored: Specify what is or will be monitored for each control device. For example, “pressure drop across the baghouse”. 16. Monitoring Frequency: Specify the frequency for each monitored item (e.g., “once per shift”). 17. Items Recorded: List what records are or will be kept for each listed control device (e.g., “raw material usage”). 18. Record Keeping Frequency: Specify the record keeping frequency for each recorded item (e.g., “daily log of material usage”). 19. 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”. 20. Test Methods: If the applicable requirement requires the use of a specific test method, identify the test method. Standard testing methods are provided by the American Society for Testing and Materials (ASTM). If no specific test method is required, describe the methods used to for the performance test. 21. Testing Frequency: Specify the testing frequency for each performance test (e.g., “annually”). Part E: Preventive Maintenance Plan Part E verifies that a complete Preventive Maintenance Plan (PMP) has been prepared for the control device, if applicable. Use this table as a checklist to ensure that the PMP is complete. American LegalNet, Inc. www.FormsWorkflow.com 22. Do you have a Preventive Maintenance Plan (PMP)? Specify whether or not a Preventive Maintenance Plan (PMP) is needed for the control device. If the PMP is needed, use the checklist items A-D to verify that the PMP is complete. A. Identification of the individual(s) responsible for inspecting, maintaining and repairing emission control devices. Identify the individual(s) responsible for inspecting, maintaining and repairing emission control devices. B. Description of the items or conditions that will be inspected. Describe the items or conditions that will be inspected. C. Schedule for inspection of items or conditions described above. Specify the schedule for inspection of items or conditions described above. D. Identification and quantification of the replacement parts that will be maintained in inventory for quick replacement. Identify and quantify the replacement parts that will be maintained in inventory for quick replacement. Part F: Determination of Integral Control Part F provides explanation to determine whether the control device should be considered integral to the process. 23. Has IDEM already made an integral control determination for this device? Specify whether or not IDEM has previously made an integral control determination for this device. If IDEM has previously made an integral control determination, provide the Permit Number, the Issuance Date, and whether or not the device was determined to be Integral to the process. 24. Is this device integral to the process? Indicate whether or not the device should be considered integral to the process, and if applicable, provide the reason(s) why the device is integral. ***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-03 – COMPLIANCE PLAN REQUIREMENTS PER EMISSIONS UNIT State Form 51863 (R / 9-04) INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT NOTES: The purpose of CD-03 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. 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/air/permits/index.html FOR OFFICE USE ONLY PERMIT NUMBER: CD-03 focuses on specific applicable requirements that may apply to a single emission unit or group of emission units. 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/air/permits/apps/instructions/cd03instructions.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. PART A: Identification of Source and Applicable Requirement Part A is intended to identify the source and the emissions unit. Use one form for each emissions unit. 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. Emissions Unit Description: 4. Unit ID: 5. Limitations: List each operational and/or emission limit for this emissions unit. 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 Emissions Unit (CD03) Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT OFFICE OF AIR QUALITY State Form 51863 (R / 9-04) Compliance Plan Requirements Per Emissions Unit FORM CD-03 PART B: Compliance Plan Components Part B is intended to identify the main components of each required compliance plan. 7. Rule Cite 8. Control Equipment 9. Parameters Monitored Compliance Plan Requirements Per Emissions Unit (CD-03) 10. Monitoring Frequency 11. Item Recorded 12. Record Keeping Frequency 13. Pollutants Tested 14. Test Method 15. Testing Frequency Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com