Tel: (909) 396-3119
www.aqmd.gov
Mail To:
SCAQMD, RECLAIM Administration - Quarterly Certification
P.O. Box 4830
Diamond Bar, CA 91765-0830
South Coast Air Quality Management District, Form QCER (2014.07)
South Coast Air Quality Management District
Form QCER
Regional Clean Air Incentives Market (RECLAIM)
Quarterly Certification of Emissions Report
Check the appropriate box if this is to correct a previously submitted quarterly certification of emissions
report:
This correction is submitted within the reconciliation period of the reporting period. Corrections to
electronically filed emissions reports have been transmitted to the AQMD Central Station or
corrections to manually filed emissions reports are attached.
This correction is submitted after the end of the reconciliation period of the reporting quarter.
Form C-ERE (for electronic reports) or Form NOx/SOx-1 (for manual reports) is attached to list the
details of and the cause(s) for making the changes. Also attached is the proof to demonstrate
the error was caused by conditions beyond the reasonable control of the permit holder.
Reasons for correction:
(check all applicable boxes)
Missing data procedures were not followed properly.
Excess emissions resulting from breakdowns have been approved by AQMD to be excluded from
determining compliance with the facility’s annual allocations.
Other.
I hereby certify that the emissions reported below are accurate and representative of our facility's emissions
for the quarter beginning on
and ending on . I understand that all records,
including but not limited to, MRR recordkeeping forms (e.g., Forms NOx/SOx-2, NOx/SOx-3, NOx/SOx-4 and
NOx/SOx-5) and other documents necessary for the accurate calculation of these emissions must be
maintained for 3 years at the facility pursuant to Rules 2011(g) and 2012(i). I also understand I am
responsible for providing such documents to substantiate the emissions reported if audited.
Reported by:
Date:
(Signature of Highest Ranking Responsible Official)
Title:
(Type or Print Name) (Type or Print Title) Fa
Facility Name: Facility I.D. #
(If known)
Equipment Category NOx (LBS) SOx (LBS)
Major Sources
Large Sources
Process Units
Equipment Exempt Pursuant to District Rule 219
Equipment with Various Locations Permits
Equipment Operating without an AQMD Permit
Total
Section I - Signature:
Section II - Total Quarterly Emissions:
Section III - For Corrections to a Previously Submitted Quarterly Certification of Emissions Report Only:
