South Coast Air Quality Management District, Form 400-E-9d (2014.07)
Mail To:
SCAQMD
P.O. Box 4944
Diamond Bar, CA 91765-0944
Tel: (909) 396-3385
www.aqmd.gov
South Coast Air Quality Management District
Form 400-E-9d
External Combustion
Burn Off Furnaces/Brake Debonders/Wax Burnoff Furnaces
This form must be accompanied by a completed Application for a Permit to Construct/Operate - Forms 400-A, Form 400-CEQA, and
Form 400-PS.
Page 1 of 2
Blower(s)
Exhaust Quantity:
HP: CFM: for each unit
Circulation Quantity:
HP: CFM: for each unit
Combustion Air Blower Quantity:
HP: CFM: for each unit
Outside
Dimensions
Diameter:
ft. in. Width: ft. in.
Height:
ft. in. Length: ft. in.
Blower(s)
Exhaust Quantity:
HP: CFM: for each unit
Circulation Quantity:
HP: CFM: for each unit
Combustion Air Blower Quantity:
HP: CFM: for each unit
Outside
Dimensions
Diameter:
ft. in. Width: ft. in.
Height:
ft. in. Length: ft. in.
Electric
Total KW Rating:
LPG Natural Gas Other:
Total BTU Rating:
BTU/hr
Number of Burners:
BTU Rating of Each Burner: BTU/hr
Manufacturer:
Model:
Low NOx Type? No Yes If Yes,
ppm @ %O
2
*Provide supporting document.
Section A - Operator Information
Facility Name (Business Name of Operator That Appears On Permit): Valid AQMD Facility ID (Available On Permit Or Invoice Issued By AQMD):
Address where the equipment will be operated (for equipment which will be moved to various location in AQMD’s jurisdiction, please list the initial location site):
Fixed Location Various Locations
*
Electric
Total KW Rating:
LPG Natural Gas Other:
Total BTU Rating:
BTU/hr
Number of Burners:
BTU Rating of Each Burner: BTU/hr
Manufacturer:
Model:
Low NOx Type? No Yes If Yes,
ppm @ %O
2
*Provide supporting document.
*
Section B - Equipment Description
Equipment
Manufacturer: Model: Serial No.:
Type Burn Off Furnace Brake Debonder Wax Burnoff Furnace
Primary Chamber
Secondary Chamber/
Afterburner
South Coast Air Quality Management District, Form 400-E-9d (2014.07)
South Coast Air Quality Management District
Form 400-E-9d
External Combustion
Burn Off Furnaces/Brake Debonders/Wax Burnoff Furnaces
This form must be accompanied by a completed Application for a Permit to Construct/Operate - Forms 400-A, Form 400-CEQA, and Form 400-PS.
Page 2 of 2
THIS IS A PUBLIC DOCUMENT
Pursuant to the California Public Records Act, your permit application and any supplemental documentation are public records and may be disclosed to a third party. If you wish to
claim certain limited information as exempt from disclosure because it qualifies as a trade secret, as defined in the District’s Guidelines for Implementing the California Public Records
Act, you must make such claim at the time of submittal
to the District.
Check here if you claim that this form or its attachments contain confidential trade secret information.
Section B - Equipment Description (cont.)
Design Features
Distance from Secondary Chamber Operating Temperature of
Burner to Temperature Probe:
ft. in. Secondary Chamber: ˚F
Time to Reach Operating Temperature in Primary Chamber:
min.
Time to Reach Operating Temperature in Secondary Chamber:
min.
Is the Secondary Chamber Ignited Prior to the Primary Chamber? No Yes
If Yes, What is the Controlling Factor for Igniting the Primary Chamber?
Temperature in Secondary Chamber Reaching:
˚F Time Delay: min.
Describe the Ignition Procedure:
Section C - Process Description
Brief Description of
Process
Materials Processed:
Please provide a brief description of the process and attach manufacturer’s technical specifications and guarantees:
Operation Batch Continuous
Wax Burnoff
Pounds of Wax Per Pound of Materials Processed:
Instrumentation Attach description of instrumentation for measuring temperature and other operating parameters (attach description).
Operating Schedule
Normal:
hours/day days/week weeks/yr
Maximum:
hours/day days/week weeks/yr
Process Data
Number of Batches Per Day:
Weight of Each Batch of Material Processed (Pounds):
Hours to Process Each Batch:
Weight Percent of Combustible / Volatile in Each Batch:
Brake Debonding
Maximum Weight of Brake Shoes Maximum Weight of Calipers
Processed Per Batch (Pounds):
Processed Per Batch (Pounds):
Weight Percent of Oil on Brake Shoes:
Weight Percent of Oil on Calipers:
Section D - Authorization/Signature
I hereby certify that all information contained herein and information submitted with this application is true and correct.
Preparer
Info
Signature: Date:
Title: Company Name:
Name:
Phone #: Fax #:
Email:
Contact
Info
Name:
Title: Company Name:
Phone #: Fax #:
Email:
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