Fillable Detailed Emissions Rpt DET-EMIS

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Detailed Emissions Rpt DET-EMIS

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__________________________ Emissions for year ending
Date
Page 1 of 1
H:\pub_data\TitleV\dataform\mfrform\T5-form\Det-Emis.doc
Permit Serv
ices Division
Bay Area Air Quality Management District
375 Beale Street, Suite 600, San Francisco, CA 94105 • 415-749-4990
Major Facility Review
Detailed Emissions
Report
FACILITY NAME: FACILITY #:
LIST OF EQUIPMENT WITH ANNUAL EMISSIONS
In numerical order, list all equipment and/or operations described in Section 2-6-405.6 and their annual emissions in tons per
year. Use one line for each pollutant. If more space is required, use additional forms. Please type or print legibly. If sources or
activities do not have a source number, leave the Source # column blank. Please attach emission calculations to this form or as
an appendix to the application. District calculations may be used if the permittee finds that they are correct. One sample
calculation for a group of identical sources is sufficient.
Source #
Name or
Description
Type of Pollutant
(one line for each)
Annual Emissions,
tons per year
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Completed 19 April 2020

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