Fillable Form 400-PS.: Portable/Open Abrasive Blasting Equipment (SCAQMD)

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Form 400-PS.: Portable/Open Abrasive Blasting Equipment (SCAQMD)

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South Coast Air Quality Management District, Form 400-E-4a (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-4a
Portable/Open Abrasive Blasting Equipment
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 3
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 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
Section C - Process Description
Blasting Type
Dry Blasting Wet
% of time Hydro-Blasting % of time
Abrasive Used
Material Type: Sand Grit Shot Plastic Media Other
CARB Certified Abrasives? (see list or check CARB''s website for latest certification) No Yes
Manufacturer:
Material Name:
Density:
lb/ft
3
Material Flow Rate: lbs/hour
Items To Be Blasted
Description:
Dimensions: Length:
ft Width: ft Height: ft
Is the blasted item at its permanent or usual location? No Yes
Is blasted item a stucco surface? No Yes
Operating Schedule
Normal:
hours/day days/week weeks/yr
Maximum:
hours/day days/week weeks/yr
Section B - Equipment Description
Blasting Unit
Manufacturer: Model No.: Capacity of Pot
* (lb):
Nozzles
Number of Nozzles:
Maximum Inner Diameter: inches
Compressor
Driven by Internal Combustion Engine Plant Air
Manufacturer: Model No.: H.P.:
Air Flow Rate:
cfm @ psi
Fuel Type: Gasoline
gals/hr Diesel gals/hr
Is this engine registered with the State of California as a Statewide Portable Engine? No Yes
*If bulk storage equipment is present, a separate permit may be needed for the storage equipment.
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:
Validate/Print
Reset
South Coast Air Quality Management District
Worksheet For Form 400-E-4a
Portable/Open Abrasive Blasting Equipment
South Coast Air Quality Management District, Form 400-E-4a Engineer Evaluation (2014.07)
Gasoline used Diesel used G = gals/hr D = gals/hr
SEE PAGE 3 FOR SAMPLE PERMIT CONDITIONS
Name of Applicant:
A/N:
Facility ID:
Date:
Equipment Location:
By:
Operating Schedule:
hrs/day days/wk wks/yr
Checked:
AQMD USE ONLY
Page 2 of 3
Abrasive Used:
Sand Grit s =
lbs/hr g = lbs/hr
Hydroblasting Wet Abrasive Blasting w =
% of time
Section A: Portable/Open Abrasive Blasting Equipment
Equipment Description
Abrasive-Blasting System Consisting Of:
1. Abrasive-Blasting Pot:
Model lbs. Capacity
2. Compressor With A Maximum Delivery Rate Of:
CFM @ PSIG
3. Plant Air At:
PSIG
4.
Abrasive-Blasting Nozzle(s) With A Maximum Inside Diameter Of:
Given
Compressor
lbs/hr lbs/day
1. RHC = 0.134 (G) + 0.168
= .494 (D)
2. NOx = 0.0958 (G) + 0.494 (D)
3. SOx = 0.0053 (G) + 0.031 (D)
4. CO = 3.96 (G) + 0.0942 (D)
5. PM = [ 0.041 (s) + 0.01 (g) ] 1 - (w / 200)
+ 0.0061 (G) + 0.0301 (D)
For Portable Emissions
Rule 402: This equipment is not expected to cause public nuisance.
Rule 1140: 1. Visible emissions are not expected to exceed 40% opacity for more than 3 minutes in any one-hour period.
2. This operation complies with one of the following:
a. Wet abrasive blasting is used.
b. Dry, unconfined blasting is used and one of the following is met:
i. Steel or iron shot/grit is used.
ii. ARB certified abrasives are used and blasted items meet the requirements of 1140(b)(6)(B) or 1140(b)(6)(C).
Regulation XIII: Exempt by State preemption: Health and Safety Code 41904 (1304(a)(3)).
South Coast Air Quality Management District
Worksheet For Form 400-E-4a
Portable/Open Abrasive Blasting Equipment
South Coast Air Quality Management District, Form 400-E-4a Engineer Evaluation (2014.07)
Sample Permit Conditions
1. OPERATION OF THIS EQUIPMENT SHALL BE CONDUCTED IN ACCORDANCE WITH ALL DATA AND
SPECIFICATIONS SUBMITTED WITH THE APPLICATION UNDER WHICH THIS PERMIT IS ISSUED UNLESS
OTHERWISE NOTED BELOW.
2. THIS EQUIPMENT SHALL BE PROPERLY MAINTAINED AND KEPT IN GOOD OPERATING CONDITION AT ALL
TIMES.
3. THIS EQUIPMENT SHALL COMPLY WITH RULE 1140.
4. ONLY CALIFORNIA AIR RESOURCES BOARD (CARB) CERTIFIED ABRASIVES SHALL BE USED IN THIS
EQUIPMENT.
5. Upon the fifth day after placement of this equipment into operation at a new site, the District shall be notified
via phone at 1-800-CUT SMOG of the exact nature of the project as follows:
1. the permit number of the portable equipment
2. the name and phone number of a contact person
3. the location where the portable equipment will be operated
4. the estimated time the portable equipment will be located at the site
5. description of the project
6. If less than ¼ mile, the distance to the nearest sensitive receptor, defined as: Long-Term Health Care
Facilities, Rehabilitation Centers. Convalescent Centers, Retirement Homes, Residences, Schools,
Playgrounds, Child Care Centers, and Athletic Facilities
6. THIS PORTABLE EQUIPMENT SHALL NOT RESIDE AT THE SAME LOCATION FOR MORE THAN 12
CONSECUTIVE MONTHS. ANY EQUIPMENT THAT REPLACES THE EQUIPMENT AT A SITE AND IS INTENDED TO
PERFORM THE SAME FUNCTION AS THE EQUIPMENT BEING REPLACED SHALL BE INCLUDED IN
CALCULATING THE TIME PERIOD. THE EQUIPMENT SHALL NOT REMAIN OR RESIDE AT A LOCATION FOR A
PERIOD OF LESS THAN 12 CONSECUTIVE MONTHS WHERE SUCH A PERIOD REPRESENTS THE FULL LENGTH
OF NORMAL ANNUAL SOURCE OPERATIONS SUCH AS A SEASONAL SOURCE; OR THE EQUIPMENT IS
REMOVED FROM ONE LOCATION FOR A PERIOD AND THEN IT OR ITS EQUIVALENT IS RETURNED TO THE
SAME LOCATION THEREBY CIRCUMVENTING THE PORTABLE EQUIPMENT RESIDENCE TIME
REQUIREMENTS; OR THE EQUIPMENT IS MOVED AT A SITE WITH NO APPARENT OPERATIONAL REASON
OTHER THAN TO ESTABLISH A NEW OPERATIONAL PERIOD. THE PERIOD DURING WHICH THE EQUIPMENT IS
MAINTAINED AT A DESIGNATED STORAGE FACILITY SHALL BE EXCLUDED FROM THE RESIDENCY TIME
DETERMINATION.
7. THE OPERATOR SHALL KEEP RECORDS TO PROVE COMPLIANCE WITH CONDITION NO. 6. THE RECORDS
SHALL BE KEPT FOR THE MOST RECENT TWO YEAR PERIOD AND BE MADE AVAILABLE TO AQMD
PERSONNEL UPON REQUEST.
Page 3 of 3
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Form 400-PS.: PortableOpen Abrasive Blasting Equipment (SCAQMD)

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Completed 12 August 2020

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