Fillable Form 400-PS.: Spray Booth/Open Spray (SCAQMD)

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Form 400-PS.: Spray Booth/Open Spray (SCAQMD)

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South Coast Air Quality Management District, Form 400-E-17b (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-17b
Spray Booth/Open Spray
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
Fan Diameter (Inches) Fan Motor Exhaust Flow Rate of Each Fan (CFM)
Fan 1 @ hp
Fan 2 @ hp
Fan 3 @ hp
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 locations in AQMD’s jurisdiction, please list the initial location site):
Fixed Location Various Locations
Type of Filters
No. of
Filters
Width
(in.)
Length
(in.)
Thickness
(in.)
Manometer
Installed?
Pressure Drop ΔP
(in.H2O)
When Clean
Yes No
Yes No
Yes No
Section B - Equipment Description
Equipment Type Open Spray Spray Booth Prep Station Spray Room
Spray Booth /
Prep Station /
Spray Room
Manufacturer: Model:
Type: Automotive: Downdraft Semi-Downdraft Cross Draft
Bench Type
Floor Type
Outside Dimensions: Width:
ft. in. Length: ft. in. Height: ft. in.
Exhaust Fan(s)
Dry Exhaust Filters
(Do not list intake filters)
Waterwash System
Pump:
hp Water Flow Rate: gallons per min
Low NOx Burner? No Yes If Yes, provide:
Burner Mfg:
Model:
ppm NOx
@ 3% O
2
(Provide supporting document)
If air make-up heater (AMU) is certified per Rule 1147, then provide:
AMU Mfg:
Model:
AMU air flow rate @ inlet:
CFM
A separate permit is required if dryer or oven is not built-in.
If already permitted, provide: Permit No.: or Application No.: _
Air Dried Oven Dried or Baked
Oven Heating Method:
Built-in to Spray Booth
Separate Enclosure
Oven Rating (only if built-in) :
Electric kW
Gas-Fired
BTU/hr
Section C - Operation Information
Articles Sprayed /
Operation
Aerospace Plastic/Fiberglass Wood Metal
Motor Vehicle Gel Coat/Resin Mfg Other (specify):
Maximum Article Size
(open spray only)
Width:
ft. in. Length: ft. in. Height: ft. in.
Method of Application
Air Atomization Electrostatic Pressure Atomization (Airless)
HVLP (High Volume Low Pressure) Air Assisted Airless Other (specify):
Gun Cleaning Method
Enclosed Gun Cleaning System Manual Wipe
Open Flush Other (specify):
Drying Method
South Coast Air Quality Management District, Form 400-E-17b (2014.07)
South Coast Air Quality Management District
Form 400-E-17b
Spray Booth/Open Spray
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.
Type of Materials
Material VOC
(lbs VOC/gal material)
Coating VOC
(lbs VOC/gal coating)
Average Amount Used
(gal/day)
Maximum Amount Used
(gal/day)
Enamel
Topcoat
Primer
Sealer
Stain
Resin
Gel Coat
Adhesive
Other Coating
Added Thinner
Clean-up Solvent
Surface Prep. Solution
Other Solvent/Thinner
 
Section C - Operation Information (cont.)
Identify All Materials
Applied
Material Safety Data Sheets
(MSDS) for all coatings and
solvents must be included.
MSDS must include
percentages of all
components of coating(s) and
Volatile Organic Compound
(VOC) contents.
Weight of VOC per
volume of material
Weight of VOC per
volume of material less
water and less except
compounds
Operating Schedule
Normal:
hours/day days/week weeks/yr
Maximum:
hours/day days/week weeks/yr
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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Form 400-PS.: Spray BoothOpen Spray (SCAQMD)

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Completed 12 August 2020

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