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B C\\hpcolor\PHIL_LJ5,,,,0&d9 Z6Times New Roman RegularX($USUS.,ԯd. .Fil\%3|xU0/CEKOU[agmAutoList11.&1.1.1.1.1.1.3#37=CIQYag1.a.i.(1)(a)(i)1)a) i)(;3$2#  0  .3  0  (O;$0  2#  a  .3  0` (#(#pCEIOSW[_cAutoList2&1.&&&&&&)1)a)http://www.osha.gov/oshstats/sicser.html(b$0  0` (#(#2#   .3  0 ` (#` (#(xir$0  0` (#(#0 ` (#` (#2#(  0  )3  0 (# (#($0  0` (#(#0 ` (#` (#0 (# (#2#(  a  )3  0h(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#2#(   )3  0h(#h(#($0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#2#  0  )3  0(#(#({$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#2#  a  )3  0p(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#0p(#(#2#     )3  0p(#p(# http://terraserver.homeadvisor.msn.com/tTABLE ExHGaeimquy}Bullet ListBullets List(hCEKQW]cioAutoList91.1.1.1.1.1.1.1.(O$(.(3($ !USUS.,      0  http://www.epa.gov/ttn/atw/alum2nd/alum2pg.html(#$  0   ddd !USUS.,  _   NotificationofIntenttoConductaPerformanceTest   @  Thisisasamplenotificationformthatyoucanuse,atyourdiscretion,tocomplywith40_CFR_  63.1515(a)(6).See4: 8O  5  http://www.epa.gov/ttn/atw/alum2nd/alum2pg.html6e8Oy  7 Ԁformoreinformation t abouttheSecondaryAluminumProductionrule. `   ApplicableRule:0 40_CFR_ԀPart63Subpart_RRR_ԀNationalEmissionStandardsfor 8  HazardousAirPollutantsforSecondaryAluminumProduction. $ t Notificationofintenttoconductaperformancetestisbeingmadein  ` accordancewith63.1515(a)(6).  L  (# (#  I.0  GENERALINFORMATION $ (#(#  (/03 Printortype thefollowinginformationforeachplantthatproducessecondaryaluminum   (63.9(b)(2)(_i_)(ii)):   Owner/Operator________________________________________________________________   StreetAddress_________________________________________________________________ t MailingAddress________________________________________________________________ ` Website(optional)_______________________________________________________________ L PlantName____________________________________________________________________ 8 PlantContact/Title______________________________________________________________ $t PlantContactPhoneNumber(optional)______________________________________________ ` PlantStreetAddress_____________________________________________________________ L PlantMailingAddress___________________________________________________________ 8 PlantFaxNumber(optional)______________________________________________________ $ PlantEmailAddress(optional)  _____________________________________________________  Plant4digitStandardIndustrialClassification(SIC)Code(s)(optional;forhelpsee  4 8O  5  http://_www.osha.gov_/  _oshstats_/_sicser.html_6 8O$   7 )_____________________________________________ p Plant_UTM_Ԁcoordinates(optional;forhelpsee4 F8O  5  http://terraserver.homeadvisor.msn.com/6S8Og  7 ) \    ______________________________________________________________________ H! PlantPermitNumber(optional)____________________________________________________ 4"   II.0  CERTIFICATION (Note:Youmayeditthetextinthissectionasdeemedappropriate) $\"(#(# 0  Baseduponinformationandbeliefformedafterareasonableinquiry,I,asaresponsible %8!$ officialoftheabovementionedfacility,certifythattheinformationcontainedinthis &$"% notificationisaccurateandtruetothebestofmyknowledge.'#&(#(#   NameofResponsibleOfficial:_____________________________________________ )$(   TitleofResponsibleOfficial:_______________________________________________ *%)    ____________________________________________________________________ \,'+   Signature0 0 (# (#0h(#(#0h(#h(#0(#(#0p(#(#0p(#p(#0 (#(#0x (# (#Date H-(,x(#x(#  III.0  TESTINFORMATION (#(# "3"  352/  1  .3  0    Check theboxthatapplies(63.7(b)(2)):35b݌(#(# Ќ  ";"  ;00  2/&3  0` (#(#  Thisisaninitialnotificationofintenttoconductaperformancetest.;0]݌x` (#` (# Ќ  ";"  ;B0  2/&3  0` (#(#  Myfacilitypreviouslysubmittedanotificationofintenttoconductaperformance d test;however,myfacilityisntabletoconducttheperformancetestatthe P  previouslyscheduledtime.Describethecircumstancesthatrequireyoutochange <  yourscheduledperformancetest(optional): ( x ___________________________________________;Bo݌ d` (#` (# Ќ     ` _________________________________________________________________  P  2.0  Complete thefollowingtableforeachaffectedsourceandtypeofcontrolsystemthat (  willundergoperformancetesting(63.7(b)(1);63.9(f)): (#(# *Yddd Xdd Xdd X(#(#,dd ,Fdd ,Fdd ,Fdd ,edd ,edd +  $   $N XXSource h  ID *  (optional) ' " 'EmissionPoint h  ID(if *  applicable)   (optional) '^" 'TypeofControl h  System *  (optional) ' " 'ControlSystem h  ID(if *  applicable)   (optional) '^" 'TypeofTest h  (Initialor *  periodic) ' " 'Date h  Scheduled *  (mm/dd/_yyy  ! y_) ^"" #XXN P#  #   $   %   &   '   (   4)   4*   4+   4,   4-  4.  3.0  Haveyou preparedasitespecifictestplanforconductingthescheduledtestthatincludes </ atestprogramsummary,thetestschedule,dataqualityobjectives,andbothaninternal ,|0 andexternalqualityassurance(QA)program(63.7(c)(2)(_i_))?[Note:Youdonotneedto h1 submittheplanwiththisnotificationunlesstheAdministratorhasrequestedyoutodo T2 so.]@3(#(#   &Yes ` &No ,4 4.0  Ifyouhavepreparedasitespecifictestplan,doyour dataqualityobjectives include 6 yourpretestexpectationsoftheprecision,accuracy,andcompletenessofthedata 7 (63.7(c)(2)(_i_))? 8(#(#   &Yes ` &No |!9 5.0  Ifyouhavepreparedasitespecifictestplan,doesyour internalQAprogram include,at T#; aminimum,theactivitiesplannedbyroutineoperatorsandanalyststoprovidean D$< assessmentoftestdataprecision(suchassamplingandanalysisofreplicatesamples) 0% = (63.7(c)(2)(ii))?&l!>(#(#   &Yes ` &No 'X"? 6.0  Ifyouhavepreparedasitespecifictestplan,doesyour externalQAprogram include,at (0$A aminimum,plansfortestmethodperformanceaudits(PA)duringtheperformancetest? ) %B AuditactivitiesincludeanopportunityforonsiteevaluationbytheAdministratorof * &C instrumentcalibration,datavalidation,samplelogging,anddocumentationofquality +&D controldataandfieldmaintenanceactivities(63.7(c)(2)(iii)).,'E(#(#   &Yes ` &No