Indiana Department of Environmental Management Office of Air Quality Air Permit Application Page 1 of 2 PI-02A Instructions 4/2006 PROCESS INFORMATION: Combustion Unit Summary – INSTRUCTIONS Microsoft Word version of PI-02A Adobe PDF version of PI-02A The purpose of PI-02A (state form 52535) is to summarize all of the combustion process units. Complete one row for each combustion unit (or group of identical combustion units). PI-02A is a required form 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. If you do not provide the enough information to adequately describe the process, the application process may be stopped. 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). Summary of Combustion Related Application Forms Form ID PI-02A PI-02B PI-02C PI-02D PI-02E PI-02F Form Title Combustion Unit Summary Boilers & Process Heaters Turbines & Internal Combustion Engines Incinerators & Combustors Kilns Fuel Use PI-02G PI-02H Emission Factors Federal Rule Applicability Guidance on when to submit the form Complete once for each application. Complete once for each boiler or process heater. Complete once for each turbine or internal combustion engine. Complete once for each incinerator or combustor. Complete once for each kiln. Complete once for each emissions unit that burns fuel other than natural gas. Complete once for each emissions unit. Complete once for each emissions unit. Summary of Combustion Units This table identifies all the combustion processes at the source, and some of the basic information about each combustion process. 1. Combustion Unit Type: Specify the type of combustion process. 2. Number of Identical Units: Specify the number of identical units in the space provided. Identical units must be of the same type, capacity, and installation date. 3. Unit ID(s): Provide the identification number for the unit. The identification numbers listed on this form should correspond to the emissions unit identified on the Plant Layout and Process Flow diagrams. If there are multiple combustion units that are identical in nature, capacity, and use, you may use one row to summarize the data for the identical combustion units. 4. Date of Installation or Modification: Provide the date on which the process unit was installed. If the exact date is not known, provide the month and year of the installation. If the unit has not yet been installed, provide the anticipated installation date. If the unit has been modified since the original installation, include the most recent modification date. 5. Heat Input Rate: Provide the heat input capacity of the unit in million British thermal units per hour (MMBtu/hr). American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality Air Permit Application Page 2 of 2 PI-02A Instructions 4/2006 6. Is this an emergency use or back-up unit? Place a check in the appropriate box to indicate whether the unit will be used as an emergency or back-up unit. ***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. Summary of Websites 1. Microsoft Word version of form PI-02A: www.in.gov/icpr/webfile/formsdiv/52535.doc 2. Adobe PDF version of form PI-02A: www.in.gov/icpr/webfile/formsdiv/52535.pdf 3. Air Permit Reviewer of the Day (PROD) online form: www.in.gov/idem/permits/air/prodform.html 4. Plant Layout Diagram: www.in.gov/idem/permits/air/apps/instructions/pldexample.pdf 5. Example Process Flow Diagram: www.in.gov/idem/permits/air/apps/instructions/pfdexample.pdf 6. Article 17.1, Rule 4, Section 1 of the Indiana Administrative Code (326 IAC 17.1-4-1): www.in.gov/legislative/iac/T03260/A00171.PDF 7. IDEM, OAQ’s information regarding submittal of confidential business information: www.in.gov/idem/permits/air/apps/cbi.html 8. IDEM’s Nonrule Policy Document regarding Emission Data (Air-031-NPD): www.in.gov/idem/rules/policies/index.html American LegalNet, Inc. www.FormsWorkflow.com OAQ PROCESS INFORMATION APPLICATION PI-02A: Combustion Unit Summary State Form 52535 (R / 1-07) INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT IDEM – Office of Air Quality – Permits Branch 100 N. Senate Ave., MC 61-53 Indianapolis, IN 46204-2251 Telephone: (317) 233-0178, or Toll Free: 1-800-451-6027 x30178 (within Indiana) Facsimile Number: (317) 232-6749 www.idem.IN.gov/permits/air/index.html • The purpose of this form is to summarize all of the combustion process units. • Detailed instructions for this form are available online at www.idem.IN.gov/permits/air/apps/instructions/pi02Ainstructions.doc . • 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 anyone to inspect and photocopy. Form ID PI-02A PI-02B PI-02C PI-02D PI-02E PI-02F Form Title Combustion Unit Summary Boilers & Process Heaters Turbines & Internal Combustion Engines Incinerators & Combustors Kilns Fuel Use PI-02G PI-02H Emission Factors Federal Rule Applicability Guidance on when to submit the form Complete once for each application. Complete once for each boiler or process heater. Complete once for each turbine or internal combustion engine. Complete once for each incinerator or combustor. Complete once for each kiln. Complete once for each emissions unit that burns fuel other than natural gas. Complete once for each emissions unit. Complete once for each emissions unit. Summary of Combustion Units This table summarizes all the combustion units at the source. If there are multiple combustion units that are identical in nature, capacity, and use, you may use one row to summarize the identical units. 1. Combustion Unit Type 2. Number of Identical Units 3. Unit ID(s) 4. Date of Installation or Modification 5. Heat Input Rate of each unit (actual or anticipated) (MMBtu/hr) 6. Emergency / Back-Up Unit? Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Page 1 of 1 American LegalNet, Inc. www.FormsWorkflow.com