Fill - Free fillable Emission Point Form (Bay Area Air Quality Management District) PDF form

BAY AREA AIR QUALITY MANAGEMENT DISTRICT

EMISSION POINT FORM

All fields are required unless otherwise noted. Please type or print.

Mail to:

BAAQMD

Engineering Division

3 %HDOH St, 6XLWH



San Francisco, CA 9410



 Tel:(415) 749-4990

Page1of2 Anelectronicversionofthisformandinstructionscanbefoundatwww.baaqmd.gov. v0ϱ/201ϲ 



Submittaltype:(Selectone)

 Newemissionpoint(EP) ExistingEPonpermit ExistingEPnotonpermit



1. FacilityInformation



FacilityName BAAQMDFacilityID(Existingfacilitiesonly)



2. GeneralInformation



BAAQMDDeviceID(ifapplicable)

P‐

Device/OperationName Initial/proposeddateofoperation



Device/OperationDescription(Optional)



3. EmissionPointType

Selectone:

 DefinedEmissionPoint(e.g.,Stack) EmissionArea EmissionVolume



4. DefinedEmissionPointCharacteristics–SkipforEmissionAreaorVolumeemissionpointstypes

Doesthedefinedemissionpointstandaloneorisitlocatedontheroofofabuilding?

 Stand‐aloneOntheroof



Whatisthedistancefromground‐leveltothetopstack?

Height

Units

(FeetorMeters)





Stackshape:(Completeoneofthesections;Rectangle/square,RoundorOther)



 InsideLength Insidewidth

Units

(inches,feetorcentimeters)

Rectangle/Square 



 InsideDiameter

Units

(inches,feetorcentimeters)

Round 



 Cross‐sectionarea

Units

(inches

,feet

orcentimeters

)

Describe“other”orifice

Other 



StackOutletOrientation(Selectone.Describeif“Other”)

Horizontal Vertical Other



StackOutlettype(Selectone.Describeif“Other”)

Open Hingedrainflap Raincap Other





BAY AREA AIR QUALITY MANAGEMENT DISTRICT

EMISSION POINT FORM

All fields are required unless otherwise noted. Please type or print.

Mail to:

BAAQMD

Engineering Division

3 %HDOH St, 6XLWH

San Francisco, CA 94105



 Tel:(415) 749-4990

Page2of2 Anelectronicversionofthisformandinstructionscanbefoundatwww.baaqmd.gov. v0ϱ/201ϲ 



Normaloperatingconditions(Use70Fforambientorroomtemperature)

Exhaustflowrate

Units

(acfmorm

/s)

Temperature

Units

(ForC)



Maximumoperatingconditions(Use70Fforambientorroomtemperature)

Exhaustflowrate

Units

(acfmorm

/s)

Temperature

Units

(ForC)





5. EmissionAreaCharacteristics‐SkipforDefinedorEmissionVolumeemissionpointstypes

Whatarethedimensionsoftheareathatemissionsarereleasetotheatmosphere?

Length Width Elevationaboveground

Units

(inches,feet,centimetersormeters)

 



6. EmissionVolumeCharacteristics‐SkipforDefinedorEmissionAreaemissionpointstypes

Wherearetheemissionsgenerated?

 Frominsideabuilding Fromtheoutside

Ifinsideabuilding,doesthebuildinghaveaventilationsystemthatisventedtotheatmosphere?

 Yes No

Ifinsideabuilding,arethebuildingdoorsan

dwindowskeptopenwh

enemissionsaregenerated(operationofthedevices

andequipment)?

 Yes No



7. UpstreamDevices&Operations–ProvideinformationontheoriginoftheemissionsfortheEP.

ListalldeviceswhoseemissionsareemittedtotheatmospherethroughthisEPthatareimmediatelyupstream.



Device/OperationName BAAQMDDeviceID(ifapplicable)



8. Certification/Signatureofpersonresponsiblefortheinformationonthisform.

Thisformcontainsconfidentialinformation. No Yes (IfYes,seeinstructions.)



IherebycertifythatIamauthorizedtocompletethisformforthefacilityandthatallinformationcontainedhereinistrue

andcorrect.

Name Title



Signature Date Phone(xxx‐xxx‐xxxx)

 



BAY AREA AIR QUALITY MANAGEMENT DISTRICT

BAAQMD

Engineering Division

375 Beale St., Suite 600

San Francisco, CA 94105

Page1of2  v05/2016

Instructions:EmissionPointForm



Introduction UsethefollowinginstructionstohelpguideyouthroughtheEmissionPoint(EP)form.



Whoshoulduse

thisform?

Althoughalldevices,equipmentandoperationsthatemitairpollutionhaveanEPof

sometype,BAAQMDdoesnotrequirethisforminallcases.Currently,EPinformationis

requiredwhenemissionsmustbemodeled.SubmitthisformforeachEPcontainedin

yourpermitapplication,ifyourpermitapplicationrequiresoneofthefollowing:

 Ahealthriskscreeninganalysis

 Anabatementdevice

 EmissionsmodelingifyourprojectrequiresevaluationunderCalifornia

EnvironmentalQualityAct(CEQA)orPreventionofSignificantDeterioration

(PSD)evaluation.



CommonPermit

Applications

thatRequireEP

Form



PermitapplicationsthatcommonlyrequireanEPformare:

 Newgasdispensingfacilities(GDFs)orthoserequestingathroughputincrease

 Dieselengines

 Abatementdevices



SpecialNotes

forGas

Dispensing

Facilities



HerearespecialinstructionsforGDFs:

 GDFstypicallydonothaveabatementdevices.

 GDFstypicallydonotrequireCEQAorPSDanalysis.

 GDFshavevolumeemissionpointswithemissiongeneratedfromtheoutside.



TheupstreamdevicefortheemissionpointistypicallytheGDF.



Submittaltype NewEP–Thismeansanemissionpointthatcurrentlydoesnotexist.TheEPwouldnot

existunlessthedevice/operationassociatedwiththisEPisnotconstructed/operated.

ExistingEPonpermit–Thismeansanexistingemissionpointthatisalreadylistedon

yourBAAQMDpermit.

ExistingEPnotonpermit‐Thismeansanexistingemissionpointthatisnotlistedon

yourBAAQMDpermit.



Facility

Information

BAAQMDFacilityID ‐ Ifyouareanexistingfacility,filloutthisfieldsothatBAAQMD

canassociateyourchangestoyourfacility.ThefacilityIDisavailableonyourpermitor

invoiceissuedbyBAAQMD.



General

Information

BAAQMDDeviceID – Foranexistingpermitted EP,youremissionpointdeviceIDis

availableonyourpermit.EPsareidentifiedwith“P‐“followedbyanumber.

Device/OperationName–ThisisthenameyouassociatetotheEP.

Initial/proposeddateofoperation–Fornewconstruction,enterthedatethatyou

proposewillbetheinitialdateofoperation.ForamodificationofanEP,enterthedate

BAY AREA AIR QUALITY MANAGEMENT DISTRICT

BAAQMD

Engineering Division

375 Beale St., Suite 600

San Francisco, CA 94105

Page2of2  v05/2016

thatyouproposethechangestooccur.ForanexistingEPwherethereisnophysical

change,enterdatetheEPwasinitiallyoperated(approximateifexactdateisunknown).

DeviceorOperationDescription–Thisisyourdescriptionofthedeviceoroperation.

Thisfieldcanbeusedtodistinguishitwithothersimilardevices(e.g.IDnumbers,

location),make,modelandothersimilarinformation.



EmissionPoint

Type

DefinedEmissionPoint – Adeviceoroperationhasdefinedemissionpointwhenthe

emissionsarereleasedthoughawell‐definedorificesuchasventpipes,stacksor

exhaustducts.

EmissionArea–Adeviceoroperationhasanemissionareawhenfugitiveemissions

arenotcapturedbyacollectionsystemnordirectlyemittedthroughadefinedemission

pointnordirectedbyanotherrestrictionsuchasanemissionvolume.Examplesof

operationsthathaveemissionareasarelandfills,quarries.

EmissionVolume–Adeviceoroperationhasanemissionareawhenfugitive

emissionsarenotcapturedbyacollectionsystemnordirectlyemittedthrougha

definedemissionpoint,butcanbedirectedbysomeotherrestrictionsuchasabuilding,

definedspaceorcanopy.Examplesofvolumesourcesarecoatingoperationswithin

buildings,drycleanersandgasolinedispensingfacilities.



Defined

EmissionPoint

Characteristics

Theheightisthedistancefromground‐leveltotheoutlet oftheEP.

Forexample,

Ifthestackislocated... Theheightis...

Ontheground Thedistancebetweenthegroundtoend

ofthestackoutlet.

Ontopofaroof Theheightofthebuildingplustheheight

ofthestack.



EmissionArea

Characteristics

TypicaldevicesoroperationsthathaveareaEPsare:

 Landfills

 Wastewatertreatment

 Quarries



Emission

Volume

Characteristics

TypicaldevicesoroperationsthathavevolumeEPsare:

 GDFs

 Emissionsthataretypicallyventedthroughopendoorways



Upstream

Devices&

Operations

EmissionsareroutedtotheEPfromotherdevices/operations.Enterthe

devices/operations,thatareimmediatelyupstream(thatimmediatelyfeedintotheEP).



Stillneedhelp? CalltheEngineeringDivisionat(415)749‐4990.



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Emission Point Form (Bay Area Air Quality Management District)

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