South Coast Air Quality Management District, Form 400-E-1a (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-1a
Particulate Matter Control
Fabric Filter (Baghouse)/Cartridge Collector
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
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):
Addr
ess 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
Section B - Equipment Description (Complete Part I or Part II)
Equipment
Manufacturer: Model No.:
Part I: For Fabric Filters
Bag Material
Nomex® Nylon Polyester Acryli
cs
Fiber Glass Cotton Teflon®
PFTE Membrane Laminated Textratex® Other
Bag Dimensions
Number of Bags:
Bag Length: ft. Bag Diameter: ft.
Total Filter Area:
sq. ft. Designed Air to Filter Ratio: : 1
Part II: For Cartridge Filters
Number of Cartridges:
Total Filter Area: sq. ft. Designed Air to Filter Ratio: : 1
Size of Each Cartridge: Diameter
ft. Length ft.
Material:
Cartridge Dimensions
Section C - Device And Method
Dust Collection Device
Pneumatic Drag Conveyor Closed Container
Rotary Airlock Values Double Dump
Screw Conveyors Manual Discharge Device: Slide Gate Hinged Doors or Drawers
Cleaning Method
Pulse Jet Reverse Air (If Reverse Air, Is it: Online or Offline)
Mechanical Shaker Other
Blower
Blower Horsepower:
H.P. Design Flow Rate: SCFM
Draft: Forced Induced
Design Criteria
Baghouse Configuration: Positive Pressure Negative Pressure
Pre-Treatment Device
Cyclone Precooler
Pr
eheater
Knock-Out
Chamber
HEPA None
Post-Treatment Device
HEPA Af
terburner Other:
South Coast Air Quality Management District, Form 400-E-1a (2014.07)
South Coast Air Quality Management District
Form 400-E-1a
Particulate Matter Control
Fabric Filter (Baghouse)/Cartridge Collector
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.
Micron Range
Particle Size Distribution
(Wt%)
Manufacturer’s Guaranteed Removal
Efficiency For Each Micron Range
(%)
0.5 - 1.0
1.0 - 5.0
5 - 10
10 - 20
Over 20
Brief Description Of
Process
Please include a process flow diagram and engineering drawing of the filter system and material processed. In the space provided, indicate what
equipment is vented to the baghouse and how waste material is handled and disposed.
Particulate Size Distribution
Data
Flow Data
Gas Stream Temperature:
˚F
Pressure Drop Range: High
in. H
2
O Low in. H
2
O
Inlet Flow Rate:
ACFM
Moisture Content:
grams of water/cubic feet (ft
3
) of dry air
Dew Point Temperature of Process Stream:
˚F
Section D - Process Stream Characteristics
Operating Schedule
Normal:
hours/day days/week weeks/yr
Maximum:
hours/day days/week weeks/yr
Section E - 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:
Validate/Print
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