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Title V Permit Writer's Tips - Title V Permit Application Checklist Form

EPA Region 3's "Title V Permit Application Checklist" Form

TITLE V PERMIT REVIEW
PERMIT APPLICATION CHECKLIST

STATE: ______ SOURCE NAME: ______________________________________

AFS Plant ID#_____________________(<16 characters)

SOURCE TYPE: ______________________ PERMIT# ___________(<16 characters)

SIC# ___________

SOURCE LOCATION (COUNTY ): __________________________

I. Is this a general permit? If yes, which one?_______________________ (Go to part III) If no, go to part II.

 

II. PROGRAM IMPLEMENTATION

 

Does this permit contain "streamlined limits" (per White Paper #2)
YES   NO
Does this permit contain requirements/provisions for:
1. Periodic Monitoring YES  NO
2. NESHAP/MACT (If so, please list subpart(s)) _________________  YES  NO
3. Case-by-case MACT YES  NO
4. NSPS (If so, please list subpart(s))____________________ YES  NO
5. PSD/NSR YES  NO
6. Acid rain Phase II permit YES  NO
7. Potential-to-emit limits YES  NO
8. Consent order or agreement YES  NO
9. NOx RACT YES  NO
10. VOC RACT YES  NO
11. Does permit application contain confidential information YES  NO
 

III. COMPLIANCE STATUS

 

Is the source subject to a compliance schedule? YES  NO
 

IV. EPA REVIEW

 

1. Do you want EPA to review all or part of this permit? YES  NO
2. Are there other issues you would like to call to EPA's
attention? Please explain.
YES  NO

STATE CONTACT: ____________________________ DATE:___________
PHONE: ______________________
(for EPA use only) date entered _________ init ______ action ______ ver: 13sep96 cklst.app

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