Tel: (909) 396-3385
www.aqmd.gov
Mail To:
SCAQMD
P.O. Box 4944
Diamond Bar, CA 91765-0944
South Coast Air Quality Management District, Form 500-C1 (2014.07)
South Coast Air Quality Management District
Form 500-C1
Title V Compliance Status Report
To provide the compliance status of your facility with applicable federally enforceable requirements and identify other local-only requirements, complete this form and
attach it to a completed compliance certification Form 500-A2. As appropriate, all submittals of Form 500-C2 as appropriate should also be attached to this form.
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PROCEDURES FOR DETERMINING COMPLIANCE STATUS
1. Equipment verification: Review the list of pending applications, and either the preliminary Title V facility permit or the list of current permits to operate that the AQMD provided you, to
determine if they completely and accurately describe all equipment operating at the facility. Attach a statement to describe any discrepancies.
2. Identify applicable requirements
*: Use the checklist in Section II to identify all applicable and federally-enforceable local, state, and federal rules and regulations, test methods, and
monitoring, recordkeeping and reporting (MRR) requirements that apply to any equipment or process (including equipment exempt from a permit by Rule 219) at your facility.
The potential applicable requirements, test methods and MRR requirements are identified and listed adjacent to each given equipment/process description. Check off each box adjacent to the
corresponding requirement as it applies to your particular equipment/process.
Note: Even if there is only one piece of equipment that is subject to a particular requirement, the appropriate box should be checked.
3. Identify additional applicable requirements
*: Use Section III to identify any additional requirements not found in Section II. Section II is not a complete list of all applicable requirements. It
does not include recently adopted NESHAP regulations by EPA or recent amendments to AQMD rules. Do not add rules listed in Section V here.
4. Identify any requirements that do not apply to a specific piece of equipment or process: Also use Section III to identify any requirements that are listed in Section II but that do not
apply
to a specific piece of equipment or process. Fill out Section III of this form and attach a separate sheet to explain the reason(s) why the identified rules do not apply. Note: Listing any
requirement that does not apply to a specific piece of equipment will not provide the facility with a permit shield unless one is specifically requested by completing Form 500-D and is approved
by AQMD.
5. Identify SIP-approved rules that are not current AQMD rules: Use Section IV to identify older versions of current AQMD rules that are the EPA-approved versions in the State
Implementation Plan (SIP), and that are still applicable requirements as defined by EPA. The facility is not
required to certify compliance with the items checked in Section IV provided that the
non-SIP approved rule in Section II is at least as stringent as the older SIP-approved version in Section IV.
**
6. Identify Local-Only Enforceable Regulatory Requirements: Use Section V to identify AQMD rules that are not SIP-approved and are not federally enforceable.
7. Determine compliance: Determine if all equipment and processes are complying with all requirements identified in Sections II and III. If each piece of equipment complies with all applicable
requirements, complete and attach Form 500-A2 to certify the compliance status of the facility. If any piece of equipment is not
in compliance with any of the applicable requirements, complete
and attach Form 500-C2 in addition to Form 500-A2.
1. Facility Name (Business Name of Operator That Appears On Permit): 2. Valid AQMD Facility ID (Available On Permit Or Invoice
Issued By AQMD):
Section I - Operator Information
* The following AQMD rules and regulations are not required to be included in Section II and do not have to be added to Section III: Regulation I, List and Criteria in Regulation II, Rule 201, Rule
201.1, Rule 202, Rule 203, Rule 205, Rule 206, Rule 207, Rule 208, Rule 209, Rule 210, Rule 212, Rule 214, Rule 215, Rule 216, Rule 217, Rule 219, Rule 220, Rule 221, Regulation III,
Regulation V, Regulation VIII, Regulation XII, Regulation XV, Regulation XVI, Regulation XIX, Regulation XXI, Regulation XXII, and Regulation XXX.
** Emission units adversely affected by the gap between current and SIP-approved versions of rules may initially be placed in a non-Title V portion of the permit
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