Application Instructions for
Non-Compliant Operations Report and Compliance Plan and
Quality Improvement Plan (QIP)
South Coast Air Quality Management District, Form 500-C2 (2014.07)
Title V
Instructions for
Form 500-C2
To complete this application, type or print the information in the appropriate blanks.
Complete this form for any equipment not operating in compliance with federally-enforceable, applicable requirements or will not be in compliance when the Title V permit is issued. A separate Form 500-C2 should be
completed for each process or system that is not in compliance with all applicable requirements. (For initial or Renewal Title V application submittal, attach all completed Forms 500-C2 to Form 500-C1.)
Section I - Operator Information
Facility ID: Complete only if your facility has been issued an identification or ID number by the AQMD. If not, leave these boxes blank. An ID number will be assigned when the application is submitted.
Revision: Check this box if this submittal is a revision to a previous report.
Section II - Non-Compliant Operations Report
Device or Application Number: For RECLAIM facilities, the device number information can be found in the permit under Section D: Facility Description and Equipment Specific Conditions. Non-RECLAIM facilities
shall refer to the existing application number. In the event that there are no numbers assigned to a device because of an addition or modification to a facility, indicate this in the appropriate spaces provided on the
form by inserting the word "new." Upon application approval, the AQMD will assign these numbers and, subsequently, they will be added to the permit for future reference.
Applicable Requirement: Cite the rule number and section and the date of the rule version (e.g., Rule 1130 (b)(5), 08/02/91), or the permit condition with which the device currently is not in compliance.
Federally Enforceable Requirement: For each rule, indicate whether the applicable version is federally enforceable.
Describe Non-Compliant Operations: For each device that is identified as not in compliance according to applicable requirements, describe in detail the circumstances and parameters of the non-compliance.
Attach additional sheets as needed. If one or more Notices of Violation were issued, enter the Notice numbers and the descriptions of the violations here.
Variance or Alternative Operating Condition Case Number: When applicable, provide the case number and attach a copy of any active variance or alternative operating condition granted by the AQMD Hearing
Board for the non-compliant equipment.
Section III - Part 70 Compliance Schedule/Plan and QIP
A compliance plan is required for any device that is expected to not be operating in compliance when the Title V permit is scheduled to be issued. Provide a detailed schedule of compliance including remedial
measures (including an enforceable sequence of actions with milestones) leading to compliance. This compliance schedule should resemble, and is at least as stringent as, that contained in any judicial consent
decree or administrative order to which your facility is subject.
A Quality Improvement Plan (QIP) may be required where the owner or operator has failed to satisfy the general duty to properly operate and maintain an emissions unit or the owner or operator has evidence of
a failure to comply with an applicable requirement. The QIP would include both an initial "problem investigation'' phase and a "corrective action'' phase.
Describe How Compliance Was or Will Be Achieved: Describe in detail all remedial measures that the facility has taken or will take to bring the equipment into compliance. Attach additional sheets as needed.
Compliance Schedule: List each remedial measure and milestone and the date when the action was or will be completed, in chronological order.
Section IV - Progress Report Schedule
Provide a schedule of due dates for progress reports beginning after the scheduled date that the Title V permit will be issued. The frequency of reporting must be at least every six months. Skip this section if
compliance has already been achieved for device(s) listed in Section I.
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