GSD-10 – Insignificant Activities – INSTRUCTIONS Microsoft Word version of GSD-10 Adobe PDF version of GSD-10 The purpose of GSD-10 (State Form 51596) is to identify all trivial and insignificant activities in operation at the source. GSD-10 is required for all air 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. Indiana's Part 70 permit program regulations require that an applicant list insignificant activities in the application. Insignificant activities are defined in 326 IAC 2-7-1(20). The definition includes the exemption levels specified in 326 IAC 2-1-1 and the following: < 0.6 ton/year or < 3.29 lb/day -- Lead (Pb) < 25 lb/day -- Carbon Monoxide (CO) The exemption levels under 326 IAC 2-1-1 are as follows: < 5 lb/hour or < 25 lb/day -- Particulate Matter (PM) < 10 lb/hour or < 50 lb/day -- Sulfur dioxide (SO2) < 5 lb/hour or < 25 lb/day -- Nitrogen oxides (NOx) < 3 lb/hour or < 15 lb/day -- Volatile organic compounds (VOC) 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: Trivial Activities Part A identifies all trivial activities in operation at the source. Items 1 through 17 are defined as trivial activities in paragraph 40 of Section 1 of Rule 7 from Article 2 of Title 326 of the Indiana Administrative Code (326 IAC 2-7-1(40)). Detailed information concerning the emissions of these activities is not required; however, detailed emissions information must be provided upon request by the department. Indicate which activities are present by checking the appropriate box. Part B: Insignificant Activities Part B identifies all insignificant activities in operation at the source. Items 18 through 47 are defined as insignificant activities in 326 IAC 2-7-1(21). Detailed information concerning the emissions of these activities is not required; however, detailed emissions information must be provided upon request by the department. Indicate which activities are present by checking the appropriate box. Part C: Insignificant Laboratory, Research, and Educational Activities Part C identifies insignificant activities in operation at the source as defined in 326 IAC 2-7-1(21), paragraph (D), (E), or (F). For items 48 through 50, identify any “other activities” in operation at the source, and provide a brief description. Part D: Other Insignificant Activities Part D identifies all other insignificant activities in operation at the source (as defined in 326 IAC 2-7-1(21), paragraphs (A) and (B) as those activities with potential uncontrolled emissions equal to or less than the specified thresholds) that are not identified above in Parts A, B, or C. For item 51, identify any “other activities” in operation at the source, and provide a brief description. Part E: Insignificant Activities with HAP Emissions Part E identifies all trivial and insignificant activities in operation at the source that have the potential to emit hazardous air pollutants (HAP). These activities may or may not be identified above in Parts A, B, or D. Activities listed in Part C above, need not be listed in this section. For items 52 through 53, identify any “Insignificant HAP Activities” in operation at the source, provide a description of the insignificant activity, including identification of the HAPs emitted and any applicable requirements, and provide a brief description. American LegalNet, Inc. www.FormsWorkflow.com For a complete list of HAPs, please refer to the United States Environmental Protection Agency’s (US EPA) Air Toxics Website (ATW) original list of HAPs and list of modifications to the HAPs. You may rely on MSDS sheets, product labels, other manufacturer’s information, or other technical and scientific judgement for identification of HAPs. Insignificant activities that are part of a multi-step process line shall be reported as such and the source shall include a description of the function and components of the process line. Insignificant activities that perform equivalent functions shall be grouped and the function and number of the units shall be included in the application. An applicant may wish to provide the information above on a separate sheet(s) and label GSD-10(a), Insignificant Activities, if additional space is needed. Part F: Specifically Regulated Insignificant Activities Part F identifies all specifically regulated insignificant activities. Examples of specifically regulated activities that may have insignificant emissions include boilers, process heaters, any activity regulated under a federal rule such as MACT or BACT, etc. If you are not sure if an emissions unit would be considered a specifically regulated insignificant activity, contact the PROD for additional guidance. 54. Unit ID: Provide the identification number for each emissions unit that qualifies as a specifically regulated insignificant activity. The identification numbers listed on this form should correspond to the emissions unit identified on the Plant Layout and Process Flow diagrams. 55. Stack / Vent ID: Provide the identification number for each stack or vent that has the potential to emit air pollutants to the atmosphere. The identification numbers listed on this form should correspond to the stacks and vents identified on the Plant Layout and Process Flow diagrams. 56. Pollutant: For each specifically regulated insignificant activity identified, list each criteria pollutant or hazardous air pollutant emitted to the atmosphere during normal operation. If there are multiple pollutants for an activity, use a new row for each pollutant. 57. Actual Emissions: For each emissions unit specific pollutant identified, provide the actual emissions level based on normal operating conditions (i.e., actual hours of operation, using control equipment, etc.) in standard units and also in tons per year (tpy). Since the units will vary depending on the process, appropriate units must be included or the application process may be stopped. The standard units used for this form should correspond to the units used on form CD-01, Facility/Unit Compliance Status. The annual emissions level should be calculated using data from the previous year of operation and should correspond to the emissions reported on the Annual Emission Statement (if required). It is important to provide an estimate of actual emissions so we can compare this number to the potential to emit. 58. Potential Emissions: For each emissions unit specific pollutant identified, provide the total potential to emit in standard units and also in tons per year (tpy) based on the maximum design capacity of the emissions unit and operating at 8760 hours/year. Since the units will vary depending on the process, appropriate units must be included or the application process may be stopped. The standard units used for this form should correspond to the units used on form CD-01, Facility/Unit Compliance Status. NOTE: Indiana Law requires permit emission limits to be based on the potential to emit (PTE) air pollutants as if the process was operating at full capacity 24 hours per day, seven (7) days per week and 365 days per year (i.e., 8760 hours per year). Some sources may opt to take a limit on the potential to emit for the entire source, or individual processes, in order to better reflect the actual operating scenario. Limitations on operations (work practices) or emissions (control equipment) may be included in the calculations only to the extent that the limitations are federally enforceable (required by NSPS, NESHAP, approved SIP requirement, NSR/PSD permit condition, etc.). Limitations that are not federally enforceable cannot be included (state only requirement, local agency permit condition, etc.). 59. Citation: Provide the citation for each federal or state rule that applies to the specifically regulated insignificant activity. American LegalNet, Inc. www.FormsWorkflow.com NOTE: Part 70 and FESOP applicants are not required to provide any emissions information unless an exemption from requirements is being proposed. If you are proposing an exemption, then you must include all requested information. The exclusion of emission information for insignificant activities only applies to the application content requirements and not the determination or imposition of any applicable requirement or the calculation of fees. ***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 OAQ GENERAL SOURCE DATA APPLICATION GSD-10: Insignificant Activities State Form 51596 (R3 / 9-06) INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT IDEM - Office of Air Quality - Permits Branch 100 N. Senate Avenue, 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 • The purpose of this form is to identify all trivial and insignificant activities in operation at the source. This form is required for all air permit applications. • Detailed instructions for this form are available at http://www.in.gov/idem/permits/air/apps/instructions/. . • NOTES: 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 public inspection. Part A: Trivial Activities (Optional) Part A identifies all trivial activities in operation at the source as defined in 326 IAC 2-7-1(40). Please use this table as a checklist. Check each item and sub-item that applies. If applicable, provide the Emissions Unit Identification number that corresponds to the Plant Layout and Process Flow diagrams. Citation Unit ID Description of Trivial Activity 1. (326 IAC) 2-7-1(40)(A) Any activity or emission unit: not regulated by a NESHAP, with potential uncontrolled emissions are equal to or less than one (1) pound per day on an emission unit basis for any single HAP or combination of HAPs; and for which the potential uncontrolled emissions meet the exemption levels specified in the following: For lead and lead compounds measured as elemental lead (Pb), potential uncontrolled emissions that are equal to or less than one (1) pound per day For carbon monoxide (CO), potential uncontrolled emissions that are equal to or less than one (1) pound per day For sulfur dioxide (SO2), potential uncontrolled emissions that are equal to or less than one (1) pound per day For volatile organic compounds (VOC), potential uncontrolled emissions that are equal to or less than one (1) pound per day For nitrogen oxides (NOX), potential uncontrolled emissions that are equal to or less than one (1) pound per day For particulate matter with an aerodynamic diameter less than or equal to ten (10) micrometers (PM10), potential uncontrolled emissions that are equal to or less than one (1) pound per day 2. 2-7-1(40)(B) Water related activities including: Production of hot water for on-site personal use not related to any industrial or production process Water treatment activities used to provide potable and process water for the plant, excluding any activities associated with wastewater treatment Steam traps, vents, leaks and safety relief valves Cooling ponds Laundry operations using only water solutions of bleach or detergents Demineralized water tanks and demineralizer vents Boiler water treatment operations, not including cooling towers Oxygen scavenging (de-aeration) of water Steam cleaning operations and steam sterilizers Pressure washing of equipment Water jet cutting operations Continued on Next Page Page 1 of 13 American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51596 (R3 / 9-06) Air Permit Application FORM GSD-10 Page 2 of 13 Part A: Trivial Activities (continued) Part A identifies all trivial activities in operation at the source as defined in 326 IAC 2-7-1(40). Please use this table as a checklist. Check each item and sub-item that applies. If applicable, provide the Emissions Unit Identification number that corresponds to the Plant Layout and Process Flow diagrams. Citation Unit ID Description of Trivial Activity 3. (326 IAC) 2-7-1(40)(C) Combustion activities including the following: Portable electrical generators that can be moved by hand from one location to another. "Moved by hand" means that it can be moved without the assistance of any motorized or non-motorized vehicle, conveyance, or device Combustion emissions from propulsion of mobile sources Fuel use related to food preparation for on-site consumption Tobacco smoking rooms and areas Blacksmith forges Indoor and outdoor kerosene heaters 4. 2-7-1(40)(D) Activities related to ventilation, venting equipment and refrigeration, including the following: Ventilation exhaust, central chiller water systems, refrigeration and air conditioning equipment, not related to any industrial or production process, including natural draft hoods or ventilating systems that do not remove air pollutants Stack and vents from plumbing traps used to prevent the discharge of sewer gases, handling domestic sewage only, excluding those at wastewater treatment plants or those handling any industrial waste Vents from continuous emissions monitors and other analyzers Natural gas pressure regulator vents, excluding venting at oil and gas production facilities Air vents from air compressors Vents for air cooling of electric motors provided the air does not commingle with regulated air pollutants Vents from equipment used to air blow water from cooled plastics strands or sheets 5. 2-7-1(40)(E) Activities related to routine fabrication, maintenance and repair of buildings, structures, equipment or vehicles at the source where air emissions from those activities would not be associated with any commercial production process including the following: Activities associated with the repair and maintenance of paved and unpaved roads, including paving or sealing, or both, of parking lots and roadways Painting, including interior and exterior painting of buildings, and solvent use, excluding degreasing operations utilizing halogenated organic solvents Brazing, soldering, or welding operations and associated equipment Portable blast-cleaning equipment with enclosures Blast-cleaning equipment using water as the suspension agent and associated equipment Batteries and battery charging stations, except at battery manufacturing plants Lubrication, including hand-held spray can lubrication, dipping metal parts into lubricating oil, and manual or automated addition of cutting oil in machining operations Non-asbestos insulation installation or removal Tarring, retarring and repair of building roofs Bead blasting of heater tubes Instrument air dryer and filter maintenance Manual tank gauging Open tumblers associated with deburring operations in maintenance shops Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51596 (R3 / 9-06) Air Permit Application FORM GSD-10 Page 3 of 13 Part A: Trivial Activities (continued) Part A is intended to identify all trivial activities in operation at the source as defined in 326 IAC 2-7-1(40). Please use this table as a checklist. Check each item and sub-item that applies. If applicable, provide the Emissions Unit Identification number that corresponds to the Plant Layout and Process Flow diagrams. Citation Unit ID Description of Trivial Activity 6. (326 IAC) 2-7-1(40)(F) Activities performed using hand-held equipment including the following: Application of hot melt adhesives with no VOC in the adhesive formulation Cutting, excluding cutting torches Grinding Sanding Machining wood, metal, or plastic Carving Polishing Sawing Turning wood, metal, or plastic 7. Buffing Drilling Routing Surface grinding 2-7-1(40)(G) Housekeeping and janitorial activities and supplies including the following: Vacuum cleaning systems used exclusively for housekeeping or custodial activities, or both Steam cleaning activities Rest rooms and associated cleanup operations and supplies Alkaline or phosphate cleaners and associated equipment Mobile floor sweepers and floor scrubbers Pest control fumigation 8. 2-7-1(40)(H) Office related activities including the following: Office supplies and equipment Photocopying equipment and associated supplies Paper shredding Blueprint machines, photographic equipment, and associated supplies 9. 2-7-1(40)(I) Lawn care and landscape maintenance activities and equipment, including the storage, spraying or application of insecticides, pesticides and herbicides 2-7-1(40)(J) 10. Storage equipment and activities including: Pressurized storage tanks and associated piping for the following: Acetylene Inorganic compounds Natural gas Anhydrous ammonia Liquid petroleum gas (LPG) Nitrogen dioxide Carbon Monoxide Liquid natural gas (LNG) (propane) Sulfur dioxide Chlorine Storage tanks, vessels, and containers holding or storing liquid substances that do not contain any VOC or HAP Storage tanks, reservoirs, and pumping and handling equipment of any size containing soap, wax, vegetable oil, grease, animal fat, and nonvolatile aqueous salt solutions, provided appropriate lids and covers are utilized Storage of drums containing maintenance raw materials Storage of the following: Castings Lance rods Any non-HAP containing material in solid form stored in a sealed or covered container Portable containers used for the collection, storage, or disposal of materials provided the container capacity is equal to or less than forty-six hundredths (0.46) cubic meters and the container is closed except when the material is added or removed Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51596 (R3 / 9-06) Air Permit Application FORM GSD-10 Page 4 of 13 Part A: Trivial Activities (continued) Part A identifies to identify all trivial activities in operation at the source as defined in 326 IAC 2-7-1(40). Please use this table as a checklist. Check each item and sub-item that applies. If applicable, provide the Emissions Unit Identification number that corresponds to the Plant Layout and Process Flow diagrams. Citation Unit ID Description of Trivial Activity (326 IAC) 2-7-1(40)(K) 11. Emergency and standby equipment including: Emergency (backup) electrical generators at residential locations, such as dormitories, prisons and hospitals. Safety and emergency equipment, except engine driven fire pumps, including fire suppression systems and emergency road flares. Process safety relief devices installed solely for the purpose of minimizing injury to persons or damage to equipment which could result from abnormal process operating conditions, including the following: Explosion relief vents, diaphragms or panels Rupture discs Safety relief valves Activities and equipment associated with on-site medical care not otherwise specifically regulated Vacuum producing devices for the purpose of removing potential accidental releases 2-7-1(40)(L) 12. Sampling and testing equipment and activities including the following: Equipment used for quality control/assurance or inspection purposes, including sampling equipment used to withdraw materials for analysis Hydraulic and hydrostatic testing equipment Ground water monitoring wells and associated sample collection equipment Environmental chambers not using hazardous air pollutant (HAP) gases Shock chambers Humidity chambers Solar simulators Sampling activities including Sampling of waste Glove box sampling, charging, and packaging Instrument air dryers and distribution 13. Use of consumer products and equipment where the product or equipment is used at a source in the same manner as normal consumer use and is not associated with any production process 2-7-1(40)(M) 14. Equipment and activities related to the handling, treating, and processing of animals including: 2-7-1(40)(N) Equipment used exclusively to slaughter animals, but not including the following: Rendering cookers, Boilers, Heating plants, Incinerators, and/or Electrical power generating equipment Veterinary operating rooms 2-7-1(40)(O) 15. Activities generating limited amounts of fugitive dust including: Fugitive emissions related to movement of passenger vehicles, provided the emissions are not counted for applicability purposes under 326 IAC 2-7-1(22)(B), and any required fugitive dust control plan or its equivalent is submitted Soil boring Road salting and sanding Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51596 (R3 / 9-06) Air Permit Application FORM GSD-10 Page 5 of 13 Part A: Trivial Activities (continued) Part A identifies all trivial activities in operation at the source as defined in 326 IAC 2-7-1(40). Please use this table as a checklist. Check each item and sub-item that applies. If applicable, provide the Emissions Unit Identification number that corresponds to the Plant Layout and Process Flow diagrams. Citation Unit ID Description of Trivial Activity (326 IAC) 16. Activities associated with production including the following: 2-7-1(40)(P) Closed, non-vented, tumblers used for cleaning or deburring metal products without abrasive blasting Electrical resistance welding CO2 lasers, used only on metals and other materials which do not emit HAPs in the process Laser trimmers which do not produce fugitive emissions and are equipped with dust collection devices such as bag filter, cyclone, or equivalent device Application equipment for hot melt adhesives with no VOC in the adhesive formulation Drop hammers or hydraulic presses for forging or metalworking Air compressors and pneumatically operated equipment, including hand tools Compressor or pump lubrication and seal oil systems Equipment used to mix and package soaps, vegetable oil, grease, animal fat, and nonvolatile aqueous salt solutions, provided appropriate lids and covers are utilized Equipment for washing or drying fabricated glass or metal products, if no VOCs or HAPs are used in the process, and no gas, oil or solid fuel is burned Handling of solid steel, including coils and slabs, excluding scrap burning, scarfing, and charging into steel making furnaces and vessels 17. Miscellaneous equipment, but not emissions associated with the process for which the equipment is used, and activities including the following: 2-7-1(40)(Q) Equipment used for surface coating, painting, dipping or spraying operation, except those that will emit VOCs or HAPs Condensate drains for natural gas and landfill gas Electric or steam heated drying ovens and autoclaves, including only the heating emissions and not any associated process emissions Salt baths using nonvolatile salts including caustic solutions that do not result in emissions of any regulated air pollutants Ozone generators Portable dust collectors Scrubber systems circulating water based solutions of inorganic salts or bases which are installed to be available for response to emergency situations Soil borrow pits Manual loading and unloading operations Purging of refrigeration devices using a combination of nitrogen and CFC-22 (R-22) as pressure test media Construction and demolition operations Mechanical equipment gear boxes and vents which are isolated from process materials Non-volatile mold release waxes and agents Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51596 (R3 / 9-06) Air Permit Application FORM GSD-10 Page 6 of 13 Part B: Insignificant Activities Part B identifies all insignificant activities in operation at the source as defined in 326 IAC 2-7-1(21)(G). Please use this table as a checklist. Indicate which activities are present by checking the appropriate box. If applicable, provide the Emissions Unit Identification number that corresponds to the Plant Layout and Process Flow diagrams. Citation Unit ID Description of Insignificant Activity (326 IAC) 2-7-1(21)(G)(i) 18. Combustion related activities, including the following: Space heaters, process heaters, or boilers using the following fuels Natural gas-fired combustion sources with heat input equal to or less than ten million (10,000,000) Btu per hour Propane or liquified petroleum gas, or butane-fired combustion sources with heat input equal to or less than six million (6,000,000) Btu per hour Fuel oil-fired combustion sources with heat input equal to or less than two million (2,000,000) Btu per hour and firing fuel containing less than five-tenths percent (0.5%) sulfur by weight Wood-fired combustion sources with heat input equal to or less than one million (1,000,000) Btu per hour and not burning wood refuse, treated wood or chemically contaminated wood Equipment powered by diesel fuel fired or natural gas fired internal combustion engines of capacity equal to or less than five hundred thousand (500,000) Btu/hour, except where total capacity of equipment operated by one stationary source exceeds two million (2,000,000) Btu/hour Combustion source flame safety purging on startup 2-7-1(21)(G)(ii) 19. Fuel dispensing activities, including the following: A gasoline fuel transfer dispensing operation handling less than or equal to one thousand three hundred (1,300) gallons per day and filling storage tanks having a capacity equal to or less than ten thousand five hundred (10,500) gallons. Such storage tanks may be in a fixed location or on mobile equipment A petroleum fuel, other than gasoline, dispensing facility, having a storage tank capacity less than or equal to ten thousand five hundred (10,500) gallons, and dispensing three thousand five hundred (3,500) gallons per day or less 2-7-1(21)(G)(iii) 20. The following VOC and HAP storage containers: Storage tanks with capacity less than or equal to one thousand (1,000) gallons and annual throughputs less than twelve thousand (12,000) gallons Vessels storing the following: Hydraulic oils Lubricating oils Machining oils Machining fluids 21. Refractory storage not requiring air pollution control equipment 2-7-1(21)(G)(iv) 22. Equipment used exclusively for the following 2-7-1(21)(G)(v) Packaging the following: Greases Lubricants Filling drums, pails or other packaging containers with the following: Greases Lubricating oils Waxes This space is intentionally left blank. Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51596 (R3 / 9-06) Air Permit Application FORM GSD-10 Page 7 of 13 Part B: Insignificant Activities (continued) Part B identifies all insignificant activities in operation at the source as defined in 326 IAC 2-7-1(21)(G). Please use this table as a checklist. Indicate which activities are present by checking the appropriate box. If applicable, provide the Emissions Unit Identification number that corresponds to the Plant Layout and Process Flow diagrams. Citation Unit ID Description of Insignificant Activity (326 IAC) 2-7-1(21)(G)(vi) 23. Production related activities, including the following: Application of the following as temporary protective coatings: Greases Lubricants Nonvolatile materials Oils Machining where an aqueous cutting coolant continuously floods the machining interface Degreasing operations that do not exceed one hundred forty-five (145) gallons per twelve (12) months, except if subject to 326 IAC 20-6 Cleaners and solvents characterized as follows where the use of which, for all cleaners and solvents combined, does not exceed one hundred forty-five (145) gallons per twelve (12) months Having a vapor pressure equal to or less than two kilo Pascals (2.0 kPa) (fifteen millimeters of mercury (15 mm Hg) or three-tenths pound per square inch (0.3 psi)) measured at thirty-eight degrees Centigrade (38°C) (one hundred degrees Fahrenheit (100°F)) Having a vapor pressure equal to or less than seven-tenths kilo Pascals (0.7 kPa) (five millimeters of mercury (5 mm Hg) or one-tenth pound per square inch (0.1 psi)) measured at twenty degrees Centigrade (20°C) (sixty-eight degrees Fahrenheit (68°F)) The following equipment related to manufacturing activities not resulting in the emission of HAPs: Brazing equipment Cutting torches Soldering equipment Welding equipment Closed loop heating and cooling systems Infared cure equipment Exposure chambers (towers or columns) for curing of ultraviolet inks and ultra-violet coatings where heat is the intended discharge Any of the following structural steel and bridge fabrication activities: Cutting two hundred thousand (200,000) linear feet or less of one (1) inch plate or equivalent Using eighty (80) tons or less of welding consumables 24. Activities associated with the following recovery systems: 2-7-1(21)(G)(vii) Rolling oil recovery systems Groundwater oil recovery wells 25. Solvent recycling systems with batch capacity less than or equal to one hundred (100) gallons 2-7-1(21)(G)(viii) This space is intentionally left blank. Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51596 (R3 / 9-06) Air Permit Application FORM GSD-10 Page 8 of 13 Part B: Insignificant Activities (continued) Part B is intended to identify all insignificant activities in operation at the source as defined in 326 IAC 2-7-1(21)(G). Please use this table as a checklist. Indicate which activities are present by checking the appropriate box. If applicable, provide the Emissions Unit Identification number that corresponds to the Plant Layout and Process Flow diagrams. Citation Unit ID Description of Insignificant Activity (326 IAC) 26. Water-based activities, including the following: 2-7-1(21)(G)(ix) Activities associated with the treatment of wastewater streams with an oil and grease content less than or equal to one percent (1%) by volume Water runoff ponds for petroleum coke-cutting and coke storage piles Activities associated with the transportation and treatment of sanitary sewage, provided discharge to the treatment plant is under the control of the owner/operator, that is, an onsite sewage treatment facility Any operation using aqueous solutions containing less than one percent (1%) by weight of VOCs excluding HAPs Water based adhesives that are less than or equal to five percent (5%) by volume of VOCs excluding HAPs Noncontact cooling tower systems with either of the following: Natural draft cooling towers not regulated under a NESHAP Forced and induced draft cooling tower systems not regulated under a NESHAP Quenching operations used with heat treating processes 27. Repair activities, including the following: 2-7-1(21)(G)(x) Replacement or repair of electrostatic precipitators, bags in baghouses and filters in other air filtration equipment Heat exchanger cleaning and repair Process vessel degassing and cleaning to prepare for internal repairs 28. Trimmers that do not produce fugitive emissions and that are equipped with a dust collection or trim material recovery device, such as a bag filter or cyclone 2-7-1(21)(G)(xi) 29. Stockpiled soils from soil remediation activities that are covered and waiting transport for disposal 2-7-1(21)(G)(xii) 30. Paved and unpaved roads and parking lots with public access 2-7-1(21)(G)(xiii) 31. Conveyors as follows: 2-7-1(21)(G)(xiv) Covered conveyors for solid raw material, including the following: Coal or coke conveying of less than or equal to three hundred sixty (360) tons per day Limestone conveying of less than or equal to seven thousand two hundred (7,200) tons per day for sources other than mineral processing plants constructed after August 31, 1983 Uncovered coal or coke conveying of less than or equal to one hundred twenty (120) tons per day Underground conveyors Enclosed systems for conveying plastic raw materials and plastic finished goods 32. Coal bunker and coal scale exhausts and associated dust collector vents 2-7-1(21)(G)(xv) 33. Asbestos abatement projects regulated by 326 IAC 14-10 2-7-1(21)(G)(xvi) This space is intentionally left blank. Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51596 (R3 / 9-06) Air Permit Application FORM GSD-10 Page 9 of 13 Part B: Insignificant Activities (continued) Part B is intended to identify all insignificant activities in operation at the source as defined in 326 IAC 2-7-1(21)(G). Please use this table as a checklist. Indicate which activities are present by checking the appropriate box. If applicable, provide the Emissions Unit Identification number that corresponds to the Plant Layout and Process Flow diagrams. Citation Unit ID Description of Insignificant Activity (326 IAC) 34. Routine maintenance and repair of buildings, structures, or vehicles at the source where air emissions from those activities would not be associated with any production process, including the following: Purging of gas lines Purging of vessels 35. Flue gas conditioning systems and associated chemicals such as the following: Sodium sulfate Ammonia Temporary liquid separators Tanks 2-7-1(21)(G)(xix) Fluid handling equipment 2-7-1(21)(G)(xx) 37. Blowdown for the following: Sight glass 2-7-1(21)(G)(xviii) Sulfur trioxide. 36. Equipment used to collect any material that might be released during a malfunction, process upset, or spill cleanup, including the following: Catch tanks 2-7-1(21)(G)(xvii) Boiler Compressors Pumps Cooling tower 38. Furnaces used for melting metals other than beryllium with a brim full capacity of less than or equal to four hundred fifty (450) cubic inches by volume 2-7-1(21)(G)(xxi) 39. Activities associated with emergencies, including the following: 2-7-1(21)(G)(xxii) On-site fire training approved by the IDEM Emergency generators as follows: Gasoline generators not exceeding one hundred ten (110) horsepower Diesel generators not exceeding one thousand six hundred (1,600) horsepower Natural gas turbines or reciprocating engines not exceeding sixteen thousand (16,000) horsepower Stationary fire pump engines 40. Grinding and machining operations controlled with fabric filters, scrubbers, mist collectors, wet collectors and electrostatic precipitators with a design grain loading of less than or equal to three one-hundredths grains per actual cubic foot (0.03 gr/acf) and a gas flow rate less than or equal to four thousand actual cubic feet per minute (4,000 acf/min), including the following: Deburring Polishing Pneumatic conveying Buffing Abrasive blasting 2-7-1(21)(G)(xxiii) Woodworking operations 41. Purge double block and bleed valves 2-7-1(21)(G)(xxiv) 42. Filter or coalescer media changeout 2-7-1(21)(G)(xxv) 43. Vents from ash transport systems not operated at positive pressure 2-7-1(21)(G)(xxvi) 44. Mold release agents using low volatile products (vapor pressure less than or equal to two kilo Pascals (2kPa) measured at thirty-eight degrees Centigrade (38°C) 2-7-1(21)(G)(xxvii) 45. Farm operations 2-7-1(21)(G)(xviii) This space is intentionally left blank. Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51596 (R3 / 9-06) Air Permit Application FORM GSD-10 Page 10 of 13 Part B: Insignificant Activities (continued) Part B identifies all insignificant activities in operation at the source as defined in 326 IAC 2-7-1(21)(G). Please use this table as a checklist. Indicate which activities are present by checking the appropriate box. If applicable, provide the Emissions Unit Identification number that corresponds to the Plant Layout and Process Flow diagrams. Citation Unit ID Description of Insignificant Activity (326 IAC) 46. Woodworking equipment controlled by a baghouse provided that the following criteria are met: 2-7-1(21)(G)(xxix) The baghouse does not exhaust to the atmosphere greater than one hundred twenty-five thousand (125,000) cubic feet per minute The baghouse does not emit particulate matter with a diameter less than ten (10) microns in excess of three-thousandths grains per dry standard cubic feet (0.003 gr/dscf) of outlet air Opacity from the baghouse does not exceed ten percent (10%) The baghouse is in operation at all times the woodworking equipment is in use Visible emissions from the baghouse are observed daily using procedures in accordance with 40 CFR 60, Appendix A, Method 22 and normal or abnormal emissions are recorded. In the event abnormal emissions are observed for greater than six (6) minutes in duration, the following shall occur: The baghouse shall be inspected Corrective actions, such as replacing or reseating bags, are initiated, when necessary The baghouse is inspected quarterly when vented to the atmosphere The owner or operator keeps the following records: Records documenting the date when the baghouse redirected indoors or to the atmosphere Quarterly inspection reports, when vented to the atmosphere Visible observation reports Records of corrective actions 47. Woodworking equipment controlled by a baghouse provided that the following criteria are met: 2-7-1(21)(G)(xxx) The baghouse does not exhaust to the atmosphere greater than forty thousand (40,000) cubic feet per minute The baghouse does not emit particulate matter with a diameter less than ten (10) microns in excess of one-hundredth grains per dry standard cubic feet (0.01 gr/dscf) of outlet air Opacity from the baghouse does not exceed ten percent (10%) The baghouse is in operation at all times the woodworking equipment is in use Visible emissions from the baghouse are observed daily using procedures in accordance with 40 CFR 60, Appendix A, Method 22 and normal or abnormal emissions are recorded. In the event abnormal emissions are observed for greater than six (6) minutes in duration, the following shall occur: The baghouse shall be inspected Corrective actions, such as replacing or reseating bags, are initiated, when necessary The baghouse is inspected quarterly when vented to the atmosphere The owner or operator keeps the following records: Records documenting the date when the baghouse redirected indoors or to the atmosphere Quarterly inspection reports, when vented to the atmosphere Visible observation reports Records of corrective actions Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51596 (R3 / 9-06) Air Permit Application FORM GSD-10 Page 11 of 13 Part C: Insignificant Laboratory, Research, and Educational Activities Part C identifies insignificant activities in operation at the source as defined in 326 IAC 2-7-1(21), paragraph (D), (E), or (F). Please use this table as a checklist. Indicate which activities are present by checking the appropriate box. If applicable, provide the Emissions Unit Identification number that corresponds to the Plant Layout and Process Flow diagrams. Unit ID Description of Insignificant Activity 48. Emissions from a laboratory as defined in 2-7-1(21)(D). 49. Emissions from research and development activities as defined in 2-7-1(21)(E). 50. Emissions from educational and teaching activities as defined in 2-7-1(21)(F). Part D: Other Insignificant Activities Part D identifies all other insignificant activities in operation at the source (as defined in 326 IAC 2-7-1(21), paragraphs (A) and (B) as those activities with potential uncontrolled emissions equal to or less than the thresholds listed below) that are not identified above in Parts A, B, or C. If applicable, provide the Emissions Unit Identification number that corresponds to the Plant Layout and Process Flow diagrams. Carbon Monoxide (CO) ≤ 25 lb/day Particulate Matter with aerodynamic diameter ≤ 10μm (PM10) ≤ 5 lbs/hr or 25 lb/day Lead (Pb) ≤ 0.6 ton/yr or 3.29 lb/day Sulfur Dioxide (SO2) ≤ 5 lbs/hr or 25 lb/day Nitrogen Oxides (NOx) ≤ 5 lbs/hr or 25 lb/day Volatile Organic Compounds (VOC) ≤ 3 lbs/hr or 15 lb/day 51. Other Insignificant Activities: Identify any “other activities”, and provide a brief description. Unit ID Description of Other Activity Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51596 (R3 / 9-06) Air Permit Application FORM GSD-10 Page 12 of 13 Part E: Insignificant Activities with HAP Emissions Part D identifies all insignificant activities in operation at the source (as defined in 326 IAC 2-7-1(21)(C)) that have the potential to emit hazardous air pollutants (HAP). These activities may or may not be identified above in Parts A, B, or D. Activities listed in Part C above, need not be listed in this section. Indicate which type of “Insignificant HAP Activities” are present by checking the appropriate box, and provide a brief description. 52. Individual HAP Emissions: Identify any emissions unit, not regulated by a NESHAP, emitting greater than 1 pound per day but less than 5 pounds per day or 1 ton per year of a single HAP. Emissions Unit HAP Brief Description Applicable Requirements 53. Combination HAP Emissions: Identify any emissions unit, not regulated by a NESHAP, emitting greater than 1 pound per day but less than 12.5 pounds per day or 2.5 ton per year of a combination of HAPs. Emissions Unit HAPs Brief Description Continued on Next Page Applicable Requirements American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality State Form 51596 (R3 / 9-06) Air Permit Application FORM GSD-10 Page 13 of 13 Part E: Specifically Regulated Insignificant Activities Part E identifies all specifically regulated insignificant activities. Examples of specifically regulated activities that may have insignificant emissions include boilers, process heaters, any activity regulated under a federal rule such as MACT or BACT, etc. If you are not sure if an emissions unit would be considered a specifically regulated insignificant activity, contact the Air Permit Reviewer of the Day for additional guidance. 54. Unit ID 55. Stack / Vent ID 56. Pollutant 57. Actual Emissions 58. Potential to Emit Standard Units Standard Units Tons Per Year 59. Citation Tons Per Year American LegalNet, Inc. www.FormsWorkflow.com