Indiana Department of Environmental Management Office of Air Quality Air Permit Application Page 1 of 4 PI-04 Instructions 5/2006 PROCESS INFORMATION: Hot or Cold Mix Asphalt Plants – INSTRUCTIONS Microsoft Word version of PI-04 Adobe PDF version of PI-04 The purpose of PI-04 (state form 52544) is to obtain detailed information about the hot or cold asphalt production process. Complete one form for each process unit (or group of identical process units). PI-04 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). Part A: Hot or Cold Mix Asphalt Plant Process Information Part A identifies the asphalt production process. If there are multiple units that are identical in nature, capacity, and use, you may use one form to summarize the data for the identical units. 1. Unit ID: Provide the identification number for the unit. The identification number listed on this form should correspond to the emissions unit identified on the Plant Layout and Process Flow diagrams. 2. Installation Date: Provide the date on which the 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 or reconstructed since the original installation, include the most recent modification/reconstruction date. 3. How many identical units are identified in this form? Indicate whether this form identifies one process unit, or a number of identical process units. Identical units must be of the same type, process capacity, and installation date. If there is more than one identical unit, specify the number of units in the space provided. 4. Type of Asphalt Plant Processing Unit: Place a check on the appropriate box to indicate the type of asphalt plant. Batch: Check "batch" if your plant employs a type of aggregate blending allowing the aggregate to drop from one or more large bins to weigh hoppers. Asphalt is added to the mixture contained in the hoppers. This process enables the operator to control the desired aggregate size. Drum: Check "drum " if your plant employs a type of aggregate blending in which all aggregate proportioning is done on a volumetric basis, along with asphalt, into the rotary drum. This process uses proportioning feed controls in place of hot aggregate storage bins, vibrating screens and the mixer. o Counter flow- Check “counter flow” if the aggregate and the exhaust gases move through the drum in opposite directions. o Parallel- Check “parallel” if the aggregate and the exhaust gases move through the drum in the same direction. Other: If your plant type is different than Batch or Drum-mix, specify the type of asphalt plant you operate. 5. Plant Capacity: Provide the maximum amount of process material which your plant can process in units of tons per hour (tons/hr). 6. Heat Input Rate of Burner: Provide the heat input capacity of the burner in million British thermal units per hour (MMBtu/hr). This should just be the aggregate dryer burner capacity. If you have other combustion units, such as fuel oil heaters, asphalt heaters, or space heater, submit separate PI-02 forms for each unit. American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality Air Permit Application Page 2 of 4 PI-04 Instructions 5/2006 7. Fuel Used: Specify whether natural gas is used as the only process fuel. If a fuel other than natural gas is used, complete the PI02 form for the combustion process and include Form PI-02f to identify all fuels used for the process. Part B: Asphalt Plant Raw Materials Part B identifies all raw materials used in this process. 8. Raw Material: List each type of raw material used in this process. 9. Maximum Throughput: Provide the maximum throughput of each raw material, expressed in tons per hour (tons/hr). Part C: Asphalt Emulsification Information Part C identifies the use of emulsified (cutback) asphalt. 10. Will emulsified (cutback) asphalt be used? Emulsified asphalt is a mixture of asphalt and water that contains a small amount of an emulsifying agent. Check “Yes” if the plant uses, or will use, emulsified (cutback) asphalt. If yes, complete this section and continue to fill out the rest of the form. If no, skip this section and continue to Part D. 11. Emulsifying Agent Components: List all of the emulsifying agent components. 12. Weight Percent VOC: For each emulsifying agent component, provide the volatile organic compound (VOC) content in percent by weight (%). 13. Weight Percent HAP: For each emulsifying agent component, provide the hazardous air pollutant (HAP) content in percent by weight (%). If your emulsifying agent contains more HAPs than the provided space allows, continue listing the HAP data on another page. 14. Maximum Usage: For each emulsifying agent component, provide the maximum usage amount in units of pounds per hour (lbs/hr) 15. Duration of Addition: For each batch plant, provide the duration of time, in seconds, that each emulsifying agent component is added. Part D: Emission Factors Part D identifies the emission factors used to calculate air emissions from this process. 16. Air Pollutant: For each process identified, list each air pollutant emitted to the atmosphere during normal operation. If there are multiple pollutants for an process, use a new row for each pollutant. 17. Emission Factor: Provide the relevant emission factor including the appropriate units (e.g., lb/units, lbs/ton, lbs/gal, lbs/cf, etc.). 18. Source of Emission Factor: Provide the source of the emission factors. Common sources include AP-42, stack test data, engineering analysis. The United States Environmental Protection Agency (U.S. EPA) has developed a Clearinghouse for Inventories & Emission Factors containing AP-42 and other emission factors. Appendix A of AP-42 lists several common conversion factors that may be needed to calculate potential to emit. American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality Air Permit Application Page 3 of 4 PI-04 Instructions 5/2006 Part E: Emission Controls and Limitations Part E identifies control technology, control techniques, or other process limitations that impact air emissions. 19. Add-On Control Technology: Identify all control technologies used for this process, if applicable. A Control Equipment (CE) application form will need to be completed for each control device used, and a summary of control equipment should be submitted using form CE-01. 20. Control Techniques: Identify all control techniques used for this process. 21. Process Limitations / Additional Information: Use the space provided to identify any acceptable process limitations or to provide additional information. An example of an acceptable process limitation would be taking a limit on raw material usage. Such a limit would require an additional record keeping and reporting requirements to be enforceable. For some limitations, performance testing may also be required. Any future change to the established limit will require a permit modification. Part F: Federal Rule Applicability Part F identifies any federal rules that apply to the process. 22. Is a New Source Performance Standard (NSPS) applicable to this source? Specify whether a New Source Performance Standard (NSPS) is applicable to the process unit(s). If a New Source Performance Standard (NSPS) applies, list the rule citation and title in the space provided and submit a FED-01 form to identify the applicable portions of the rule. 23. Is a National Emission Standard for Hazardous Air Pollutants (NESHAP) applicable to this source? Specify whether a National Emission Standard for Hazardous Air Pollutants (NESHAP) is applicable to the process unit(s). If a National Emission Standard for Hazardous Air Pollutants (NESHAP) applies, list the rule citation and title in the space provided and submit a FED-01 form to identify the applicable portions of the rule. The United States Environmental Protection Agency (U.S. EPA) provides lists of NESHAP on the Rules and Implementation section of the Air Toxics Website. 24. Non-Applicability Determination: Provide an explanation of non-applicability if the process unit would appear to be subject to a rule (based on the rule title of affected source category), but the rule will not apply to the process. For example, if the process unit is part of the source category subject to a rule, but the process unit in question is not subject to the rule, state the reason why the unit is not subject. ***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-04: www.in.gov/icpr/webfile/formsdiv/52544.doc 2. Adobe PDF version of form PI-04: www.in.gov/icpr/webfile/formsdiv/52544.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 American LegalNet, Inc. www.FormsWorkflow.com Indiana Department of Environmental Management Office of Air Quality Air Permit Application Page 4 of 4 PI-04 Instructions 5/2006 6. U.S. EPA’s Clearinghouse for Inventories & Emission Factors: www.epa.gov/ttn/chief/index.html 7. Appendix A of AP-42: www.epa.gov/ttn/chief/ap42/appendix/appa.pdf 8. United States Environmental Protection Agency (US EPA): www.epa.gov 9. Rules and Implementation section of U.S. EPA’s Air Toxics Website: www.epa.gov/ttn/atw/eparules.html 10. 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 11. IDEM, OAQ’s information regarding submittal of confidential business information: www.in.gov/idem/permits/air/apps/cbi.html 12. 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-04: Hot or Cold Mix Asphalt Plants 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 State Form 52544 (R / 1-07) INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT • The purpose of this form is to obtain detailed information about the hot or cold asphalt production process. Complete one form for each process unit (or group of identical process units). This is a required form. • NOTES: Detailed instructions for this form are available online at www.idem.IN.gov/permits/air/apps/instructions/pi04instructions.doc . • 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. PART A: Hot or Cold Mix Asphalt Plant Process Information Part A identifies the asphalt production process. If there are multiple units that are identical in nature, capacity, use, and installation date, you may use one form to summarize the data for the identical process units. 2. 1. Unit ID: Installation Date: (actual or anticipated) 3. How many (identical) units are identified in this form? One More than one 4. Type of Asphalt Processing Unit: Batch Drum (specify): (check all that apply) (specify number) : Other (specify): Counter-flow Parallel 5. Plant Capacity: tons/hour 6. Heat Input Rate of Burner: MMBtu/hour 7. Fuel Used: Natural Gas Only Other – Attach completed PI-02F form. PART B: Raw Materials Part B identifies all raw materials used in this process. 8. Raw Material 9. Maximum Throughput (tons/hr) Continued on Next Page Page 1 of 3 American LegalNet, Inc. www.FormsWorkflow.com Indiana Department Of Environmental Management Office Of Air Quality State Form 52544 (R / 1-07) Process Information – Asphalt Plants FORM PI-04 Page 2 of 3 PART C: Emulsified (Cutback) Asphalt Information Part C identifies the use of emulsified (cutback) asphalt. 10. Will emulsified (cutback) asphalt be used? Yes: Complete this section. 11. Emulsifying Agent Components: No: Proceed to the next section. 12. Weight % VOC 13. Weight % HAP 14. Maximum Usage: Attach MSDS for each. 15. Duration of Addition: BATCH PLANTS ONLY lb/hr seconds lb/hr seconds lb/hr seconds lb/hr seconds lb/hr seconds lb/hr seconds PART D: Emission Factors Part D identifies all emission factors used to calculate air emissions from this process. 16. Air Pollutant 17. Emission Factor value units 18. Source of Emission Factor (if not using AP-42, include calculations) Carbon Monoxide (CO) AP-42 Other Lead (Pb) AP-42 Other Nitrogen Oxides (NOX) AP-42 Other Particulate Matter (PM) AP-42 Other Particulate Matter less than 10μm (PM10) AP-42 Other Particulate Matter less than 2.5μm (PM2.5) AP-42 Other Sulfur Dioxide (SO2) AP-42 Other Volatile Organic Compounds (VOC) AP-42 Other Hazardous Air Pollutant (HAP) (specify): AP-42 Other Other (specify): AP-42 Other Other (specify): AP-42 Other Continued on Next Page American LegalNet, Inc. www.FormsWorkflow.com Indiana Department Of Environmental Management Office Of Air Quality State Form 52544 (R / 1-07) Process Information – Asphalt Plants FORM PI-04 Page 3 of 3 PART E: Control Technology Part E identifies the methods used to control emissions from this process. 19. Add-On Control Technology: Identify all control technologies used for this unit, and attach completed CE-01 (unless “none”). None Baghouse / Fabric Filter – Attach CE-02. Cyclone – Attach CE-03. Other (specify): – Attach CE-10. 20. Control Techniques: Identify all control techniques used for this process. 21. Process Limitations / Additional Information: Identify any acceptable process limitations. Attach additional information if necessary. PART F: Federal Rule Applicability Part F identifies any federal rules that apply to the process. 22. Is a New Source Performance Standard (NSPS) applicable to this process unit? Attach a completed FED-01 for each rule that applies. 40 CFR Part 60, Subpart I No Yes No Hot Mix Asphalt Facilities 40 CFR Part 60, Subpart Yes (Specify): 23. Is a National Emission Standard for Hazardous Air Pollutants (NESHAP) applicable to this process unit? Attach a completed FED-01 for each rule that applies. 40 CFR Part 61, Subpart (Specify): 40 CFR Part 63, Subpart (Specify): 24. Non-Applicability Determination: Provide an explanation if the process unit appears subject to a rule (based on the rule title or the source category), but the rule will not apply. American LegalNet, Inc. www.FormsWorkflow.com