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AIR POLLUTANT EMISSION NOTICE (APEN) & Application for Construction Permit — Generali <br />Permit Number: 09GU1382 Emission Source AIRS ID: 051 / 0015 / 011 <br />Section 05 — Emission Release Information (Attach a separate sheet with relevant information in the event of multiple releases; provide datum & either Lat/Long or UTM) <br />Operator <br />Base <br />Discharge Height <br />Temp. <br />Flow Rale <br />velocity <br />Moisture <br />Honzonlal Datum <br />UTM <br />UTM Easting or UTM Northing or <br />Method of Collection for Location <br />Stack <br />Elevation <br />Above Ground <br />("F) <br />(ACFK <br />(ft/sec)r'0) <br />(NAD27,NAD83, <br />Zone <br />Longitude Latitude <br />Data (e.g. map' GPS, GoogleEarth) <br />M No. <br />(feet) <br />Level (Feet) <br />NO, <br />WGS84) <br />(12 or 13) <br />(metas or degrees) (meters or degrees) <br />NA <br />CO <br />Please use the APCD Non -Criteria Reportable Air Pollutant Addendum form to re ort ollutants not listed above. <br />Direction of outlet (check one): ❑ Vertical ❑ Vertical with obstructing raincap <br />Exhaust Opening Shape & Size (check one): ❑ Circular: Inner Diameter (inches) <br />Section 06 — Combustion Equipment & Fuel Consumption Information <br />Company equipment Identification No.: <br />Manufacturer. <br />❑ Horizontal ❑ Down <br />❑ Other. Length (inches) = <br />❑ Other (Describe). <br />Width (inches) = <br />Model: Sepal No.: <br />Fuel Type <br />Design Input Rate <br />(10 Btu/hr) <br />Actual Level Annual Requested Permitted Level' <br />(For Data Year) (Specify Units) <br />Fuel Heating Value (indicate- <br />BwAb, Btu/gid, BnilSCF) <br />Perish by Weight Seasonal Fuel Use (°/a of Annual Use) <br />Sulfur I Ash Dec -Feb Mar -Ma Jun -Au Sep -Nov <br />NA <br />Enclosures <br />0.0015 Ibstton 62 <br />PM 1, <br />1 Enclosures <br />0.0010 Ibslton 4,2 <br />PM,, <br />'Requested values will become permit limitations. Requested levet should consider process growth over the rxxt live years <br />Renewal Only of 051/0015/011 <br />Section 07 — Emissions Inventory Information & Emission Control Information No C hinge from 0=enatPawlit - 09GUlM <br />Atiach any emission calculations and emis.;ion factor documentation to this APEN form. <br />M F.m tTnn Fartnr Documentation ntttrhe t Data veer rnr actual eslendar vr_ emissions helow & tlkrouQhnut above te.e. 70071: <br />Pollutant <br />Control Device Description Overall <br />Efficiency <br />Primary Secondary Efficiency <br />Control <br />Efficiency <br />(% Reduction) <br />Calendar Year <br />Emission Factor Emissions` Requested Permitted Emissions <br />on <br />Est oratiControlon <br />Method or <br />Emission Factor <br />Source <br />Uncontrolled Units Uncontrolled Controlled Uncontrolled Controlled <br />Bass ons/Year) ons/Year ons/Year onsrYear <br />TSP <br />Enclosures <br />0.0015 Ibstton 62 <br />PM 1, <br />1 Enclosures <br />0.0010 Ibslton 4,2 <br />PM,, <br />sox <br />NO, <br />VOC <br />CO <br />Please use the APCD Non -Criteria Reportable Air Pollutant Addendum form to re ort ollutants not listed above. <br />'You will be charged as additional AMEN fee it AY1;N is tilled out Incorrectly or information is missing and requires re-5ubmlttal. <br />'Annual emission fees will be based on actual emissions reposed here <br />ee ' S —Anplicant Certification - I hereby certify that all information contained herein and information submitted with this application is complete, true and correct <br />,r,.,Z�/111,1exZ1L_4„C, 11/10/2014 Jessica Loveland Environmental Engineer <br />Sionfire of Person Legally Authorized to Supply Data Date Name of Legally Authorized Person (Please print) Title <br />Page 2 of 2 Form APCD-200 — OencralAPEN — Ver.02.10.2014.docx <br />