ISSUED TO:

<Company Legal Name>

<Mailing Address>

<City, State, Zip>

INFORMATION RELIED UPON:

Application No.:  0     

Date Received:  <mm/dd/yy>

PLANT SITE LOCATION:

<Street Address>

<City, County, Zip Code>

LAND USE COMPATABILITY STATEMENT:

Approving Authority:  <Name>

Approval Date:  <mm/dd/yy>

PERMIT PREVIOUSLY ISSUED TO:

<Company legal name>

Table 1 Code

Source Description

SIC

Part A, 2

Natural gas and propane fired boilers (with or without #2 diesel back up) of 10 or more but less than 30 million Btu per hour heat input, constructed after June 9, 1989.

4961

1.1  1

Permitted Activities

The permittee is allowed to discharge air contaminants from processes and activities related to the air contaminant source(s) listed on the first page of this permit until this permit expires, is modified, revoked or rescinded as long as the permittee complies with the conditions of this permit.

2.1  Visible emission limits

Emissions from any air contaminant source must not equal or exceed 20% opacity for as a six-minute block average. “Opacity” means the degree to which an emission reduces transmission of light and obscures the view of an object in the background.

2.2  Fugitive Emissions

The permittee must take reasonable precautions for preventing fugitive dust emissions.

2.3  Particulate Matter Fallout

The permittee must not cause or permit the emission of any particulate matter larger than 250 microns in size at sufficient duration or quantity, as to create an observable deposition upon the real property of another person.

2.4  Nuisance and Odors

The permittee must not cause or allow air contaminants from any source to cause a nuisance. Nuisance conditions will be verified by DEQ personnel.

2.5  Other Regulations

In addition to the specific requirements listed in this permit, the permittee must comply with all other legal requirements enforceable by DEQ.

3.1  Sulfur Limits

The sulfur content of fuel oil burned in the boiler must not exceed 0.5% by weight.

3.2  Fuel sulfur monitoring

Unless an approved alternate monitoring frequency is obtained from the EPA Administrator, the permittee must record and maintain records of the amounts of each fuel combusted during each day in each subject boiler.

a.  If oil is burned, the permittee must maintain records of the sulfur content of the fuel oil by either obtaining fuel supplier certifications or sampling and analyzing the fuel oil in accordance with ASTM procedures.

b.  If relying on fuel samples for demonstrating compliance with the fuel sulfur content limits, a sample must be collected and analyzed after each shipment of fuel is added to the storage tank.

3.3  NSPS boiler Reporting Requirement

Unless an approved alternate monitoring frequency is obtained from the EPA Administrator, the permittee must submit semi-annual reports to the DEQ and EPA for periods during which oil was burned that include the following information:

a.  The calendar dates covered in the reporting period;

b.  Each 30-day average sulfur content (weight percent), calculated during the reporting period, ending with the last 30-day period in the quarter; including:

i.  reasons for any noncompliance with the emission standards; and

ii.  a description of corrective actions taken.

c.  If fuel supplier certifications are used for distillate oil to demonstrate compliance, records of fuel supplier certifications that include:

iii.  The name of the oil supplier; and

iv.  A statement from the oil supplier that the oil complies with the specifications under the definition of distillate oil in 40 CFR §61.41c.

d.  The initial semi-annual report must be postmarked by the 30^th day of the third month following the actual date of startup. Each subsequent semi-annual report must be postmarked by the 30^th day following the end of the reporting period.

3.4  EPA Submittal Address

All submittals to the EPA must be sent to the following address:

Director

Air and Waste Management Division

EPA Region X

Mail Stop OAQ-107

1200 Sixth Avenue

Seattle, WA 98101-3123

4.1  Records

The permittee must maintain records of the information identified in Condition 4.2 for at least five years from the date of the record.

4.2  Reports

The permittee is required to report to DEQ by February 15^th of each year the amount of natural gas (cubic feet) and distillate oil (gallons) burned in the boiler(s) during the previous calendar year.

4.3  Permit Renewal

An application to renew the permit is due <date>.

4.4  Construction or Modification Notices

The permittee must notify DEQ before adding new or modifying existing equipment to the extent that process equipment is substantially changed or added to, or emissions are significantly changed or increased.

4.5  Notice of Change of Ownership or Company Name

The permittee must promptly notify DEQ of any change of mailing address, company name, or plant ownership. The permit will expire 60 days after a change in the legal entity owning/operating the facility unless application, with appropriate fees, is made to transfer the permit to the new entity.

4.6  Where to Send Reports and Notices

The reports and notices, with the permit number prominently displayed, must be sent to the regional office identified on the cover page of the permit.

5.1  Fees

The Annual Fee specified in OAR 340-216-8020, Table 2, Part 2 for a Basic ACDP is due on December 1 of each year this permit is in effect. An invoice indicating the amount, as determined by DEQ regulations, will be mailed prior to the above date.

6.1  Masking of Emissions

The permittee must not cause or permit the installation of any device or use any means designed to mask the emissions of an air contaminant that causes or is likely to cause detriment to health, safety, or welfare of any person or otherwise violate any other regulation or requirement.

6.2  Open Burning

The permittee may not conduct any open burning except as allowed by Division 264 of OAR Chapter 340.

6.3  Asbestos

All activities involving asbestos-containing materials, including, but not limited to, demolition, renovation, repair, construction, and maintenance must be performed by persons certified for asbestos abatement projects. Accumulation of asbestos containing material is prohibited. If you have asbestos questions, contact the regional DEQ office identified below.

6.4  Permit Availability

The permittee must have a copy of the permit available at all times.

6.5  DEQ Inspections

The permittee must allow DEQ’s representatives access to the plant site and pertinent records at all reasonable times for the purposes of performing inspections, surveys, collecting samples, obtaining data, reviewing and copying air contaminant emissions discharge records and conducting all necessary functions related to this permit in accordance with ORS 468.095.

6.6  Legal Disclaimers

The issuance of this permit does not convey any property rights in either real or personal property, or any exclusive privileges, nor does it authorize any injury to private property or any invasion of personal rights, nor any infringement of federal, state, or local laws or regulations.

6.7  Permit Revocation

This permit is subject to revocation for cause as provided in OAR 340-216-0082.

6.8  DEQ Contact

Call the Air Quality Section of the regional office in at .