Initial Notification Form - DOC

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					                                               Notification of Compliance Status (NOCS)
                          National Emission Standards for Hazardous Air Pollutants: Area Source Standards
                                      for Nine Metal Fabrication and Finishing Source Categories
                                                      40 CFR 63 Subpart XXXXXX (6X)
This notification ONLY applies to facilities at area sources (less than 10 tons/yr of a single hazardous
air pollutant {HAP} or less than 25 tons/yr of total combination of HAPs) where the primary activity of
the facility is in one of the following nine categories and meets the following criteria:

       Electrical and Electronic Equipment Finishing Operations, including motor and generator manufacture;
        and electrical machinery, equipment, and supplies not elsewhere classified (NEC); (2) Fabricated
        Metal Products NEC; (3) Fabricated Plate Work (Boiler Shops); (4) Fabricated Structural Metal
        Manufacturing; (5) Heating Equipment, except Electric; (6) Industrial Machinery and Equipment
        Finishing Operations, including construction machinery manufacturing; oil and gas field machinery
        manufacturing; and pumps and pumping equipment manufacturing); (7) Iron and Steel Forging; (8)
        Primary Metal Products Manufacturing; and (9) Valves and Pipe Fittings NEC.(For more details on
        applicability, see table on page 8)

        AND -The facility uses or has emissions of the following metal HAPs(MFHAP): cadmium, chromium,
          lead, manganese, and nickel. This does not include processes that use materials with less than 0.1%
          in weight of cadmium (Cd), chromium (Cr), lead (Pb), or nickel (Ni) and less than 1.0% of manganese
          (Mn) as reported on the Material Safety Data Sheet for that material.

Sources that commenced construction of their facility on or after April 3, 2008 are considered to be new
sources and are required to be in full compliance with the requirements of 40 CFR Part 63 subpart XXXXXX by
July 23, 2008 or upon initial startup, whichever is later. Existing sources (commenced construction before April
3, 2008) have until July 25, 2011 to be in compliance. All existing sources subject to this rule must
complete and submit this Notification of Compliance Status by November 22, 2011. New sources must
submit their Notice of Compliance Status by initial startup. Submit this Notification to the following
address: (It is important that you also keep a copy of this notification form for your own records.)

Illinois Environmental Protection Agency
Bureau of Air, Compliance Section MC 40,
1021 North Grand Avenue East, P.O. Box 19276, Springfield, Illinois 62794-9276

Part A – General Information

      Air ID Number (if available)                             Air Permit Number (if available)
A.1     Company Information
Business Name:
Street Address (physical location):
City, State, Zip:

A.2     Owner Information
Name:                                                        Title:
Mailing Address:
City, State, Zip:
Telephone:                                 E-mail (if available):




                                                               1
A.3     Operator Information
Is the Operator the same as the Owner?           Yes       No
If Operator information is different, please provide the following:
Name:                                                                   Title:
Mailing Address:
City, State, Zip:
Telephone:                                            E-mail (if available):

A.4     Certifying Official Information
Is the certifying company official the same as the Owner or Operator?            Yes    No
If certifying official information is different, please provide the following:
Name:                                                                   Title:
Mailing Address:
City, State, Zip:
Telephone:                                            E-mail (if available):


Part B – Initial Notification

B.1     Identification of Regulatory Standard
        I am subject to 40 CFR Part 63 Subpart XXXXXX, National Emissions Standards for Hazardous
                                                                                                                         Yes
        Air Pollutants for Area Source Standards for Nine Metal Fabrication and Finishing Source
                                                                                                               (You must check this box.)
        Categories

B.2     New or Existing Source
        Please check whether the area source is a new or existing source.
                New Source              Startup after 4/3/2008- must be in compliance by July 23, 2008 or upon startup
                Existing Source         Startup on or before 4/3/2008–must be in compliance by July 25, 2011

B.3    The following are the operations at this facility subject to Subpart XXXXXX (check all that apply):

Dry Abrasive Blasting

      (1) Totally enclosed and unvented blast chambers

      (2) Vented enclosures with a filtration control device

    (3) Objects over 8 feet in any dimension without a filtration control device (includes outdoor blasting of objects
    over 8 ft in any dimension)
Dry Machining

Dry Grinding or Dry Polishing with Stationary Machines

Spray Painting

      (1) In a spray booth

      (2) Without a spray booth (for Fabricated Structural Metal facilities or any objects over 15 feet)

Welding

      (1) Use less than 2,000 pounds of MFHAP-containing welding rod or wire annually

      (2) Use 2,000 pounds or more of MFHAP-containing welding rod or welding wire annually




                                                                          2
Part C –Notification of Compliance

C1.       The following table lists each dry abrasive blasting operation at this facility subject to subpart XXXXXX:
                  Do not have any dry abrasive blasting (not applicable)

                                                                      HAP
                 Abrasive Blasting                                              b                  Compliance Method
                                                               Emitted or Used
             Process Description / ID No.                                                         (Check all that apply)
                                                              (Cd, Cr, Pb, Mn, Ni)
                                                                                              Totally enclosed, unvented
                                                                                              Vented, with control device;
                                                                                          describe _____________________
                                                                                              Objects over 8 ft (with no control)
                                                                                              Management practices
                                                                                              Totally enclosed, unvented
                                                                                              Vented, with control device;
                                                                                          describe _____________________
                                                                                              Objects over 8 ft (with no control)
                                                                                              Management practices
                                                                                              Totally enclosed, unvented
                                                                                              Vented, with control device;
                                                                                          describe _____________________
                                                                                              Objects over 8 ft (with no control)
                                                                                              Management practices
                                                                                              Totally enclosed, unvented
                                                                                              Vented, with control device;
                                                                                          describe _____________________
                                                                                              Objects over 8 ft (with no control)
                                                                                              Management practices
                                                                                              Totally enclosed, unvented
                                                                                              Vented, with control device;
                                                                                          describe _____________________
                                                                                              Objects over 8 ft (with no control)
                                                                                              Management practices
                                                                                              Totally enclosed, unvented
                                                                                              Vented, with control device;
                                                                                          describe _____________________
                                                                                              Objects over 8 ft (with no control)
                                                                                              Management practices
                                                                                              Totally enclosed, unvented
                                                                                              Vented, with control device;
                                                                                          describe _____________________
                                                                                              Objects over 8 ft (with no control)
                                                                                              Management practices
                                                                                              Totally enclosed, unvented
                                                                                              Vented, with control device;
                                                                                          describe _____________________
                                                                                              Objects over 8 ft (with no control)
                                                                                              Management practices
                                                                                              Totally enclosed, unvented
                                                                                              Vented, with control device;
                                                                                          describe _____________________
                                                                                              Objects over 8 ft (with no control)
                                                                                              Management practices
                                                                                              Totally enclosed, unvented
                                                                                              Vented, with control device;
                                                                                          describe _____________________
                                                                                              Objects over 8 ft (with no control)
                                                                                              Management practices
b
    Important Note: These operations are affected sources under subpart XXXXXX only if/when they use materials that contain or have
          the potential to emit metal fabrication or finishing metal HAP (MFHAP). MFHAP

                                                                 3
C2. The following table lists each dry machining, dry grinding, or dry polishing operation subject to subpart
XXXXXX:
       Do not have any dry machining, dry grinding or dry polishing operations (not applicable)

            Dry Machining, Dry Grinding,                              HAP
                                                                                b                  Compliance Method
                  or Dry Polishing                             Emitted or Used
                                                                                                  (Check all that apply)
            Process Description / ID No.                      (Cd, Cr, Pb, Mn, Ni)
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
                                                                                              Control device;
                                                                                          describe_______________________
                                                                                              Management practices
b
    Important Note: These operations are affected sources under subpart XXXXXX only if/when they use materials that contain or have
          the potential to emit metal fabrication or finishing metal HAP (MFHAP). MFHAP




                                                                 4
C3. The following table lists each spray painting operation subject to subpart XXXXXX
      Do not have any spray painting operations (not applicable)

                                                         HAP
            Spray Painting                                         b                  Compliance Methods Employed
                                                  Emitted or Used
      Process Description / ID No.                                                        (Check all that apply)
                                                 (Cd, Cr, Pb, Mn, Ni)
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
                                                                                 Spray booth, PM filter, HVLP spray guns
                                                                                 HVLP spray guns, only
                                                                                 Management practices
b
    Important Note: These operations are affected sources under subpart XXXXXX only if/when they use materials that contain or have
          the potential to emit metal fabrication or finishing metal HAP (MFHAP). MFHAP




                                                                 5
C4.       The following table lists each welding operation subject to subpart XXXXXX:
                  Do not have any welding operations (not applicable)

                                                                  HAP
         Welding Process Description                                        b               Compliance Methods Employed
                                                           Emitted or Used
                   / ID No.                                                                     (Check all that apply)
                                                          (Cd, Cr, Pb, Mn, Ni)
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
                                                                                            Management practices
                                                                                            Fume capture device;
                                                                                        describe _____________________
b
    Important Note: These operations are affected sources under subpart XXXXXX only if/when they use materials that contain or have
          the potential to emit metal fabrication or finishing metal HAP (MFHAP). MFHAP



                                                                 6
C5.    The following applicable management practices are used at this facility, as practicable (check all that
       apply):

Dry Abrasive Blasting

       Minimize dust generation during emptying of abrasive blasting enclosure to reduce MFHAP emissions, as
       practicable.

       Operate all equipment associated with dry abrasive blasting operations according to the manufacturer's
       instructions.

       Minimize excess dust in the surrounding area to reduce MFHAP emissions, as practicable.

       Enclose dusty abrasive storage areas and holding bins, seal chutes and conveyors that transport abrasive
       materials.

       Minimize excess dust in the surrounding area to reduce MFHAP emissions, as practicable

       Do not re-use dry abrasive blasting media unless contaminants (i.e., any material other than the base metal, such
       as paint residue) have been removed by filtration or screening, and the abrasive material conforms to its original
       size.

       When practicable, switch from high particulate matter (PM)-emitting blast media (e.g., sand) to low PM-emitting
       blast media (e.g., crushed glass, specular hematite, steel shot, aluminum oxide).

Dry Machining, Dry Grinding, Dry Polishing

       Minimize excess dust in the surrounding area to reduce MFHAP emissions, as practicable

       Operate equipment according to manufacturer's instructions.

Spray Painting

       Proper cleaning and storage of spray guns, if applicable.

       Training for employees using HVLP spray equipment, with certification as having completed classroom or hands-
       on training in the proper selection, mixing, and application of coatings, with refresher training repeated at least
       once every 5 years.

Welding

       Operate equipment according to manufacturer's instructions.

       Use welding processes with reduced fume generation capabilities, if practicable. (e.g., gas metal arc welding
       (GMAW)—also called metal inert gas welding (MIG))

       Use welding process variations (e.g., pulsed current GMAW), which can reduce fume generation rates, if
       practicable.

       Use welding filler metals, shielding gases, carrier gases, or other process materials which are capable of reduced
       welding fume generation, if practicable.

       Optimize welding process variables (e.g., electrode diameter, voltage, amperage, welding angle, shield     gas
       flow rate, travel speed) to reduce the amount of welding fume generated, if practicable.

       Use a welding fume capture and control system, operated according to the manufacturer’s specifications, if
       practicable.


                                                            7
Part D – Compliance Verification Statement

           Yes, the facility referenced below IS operating in compliance with all of the relevant standards
           and other requirements of 40 CFR Part 63 subpart XXXXXX, National Emission Standards
           for Hazardous Air Pollutants: Area Source Standards for Nine Metal Fabrication and Finishing
           Source Categories

           No, the facility referenced below is NOT operating in compliance with the relevant standards
           And/or other requirements of 40 CFR Part 63 subpart XXXXXX, National Emission Standards
           for Hazardous Air Pollutants: Area Source Standards for Nine Metal Fabrication and Finishing
           Source Categories

           Reason for noncompliance: _________________________________________________________________

           ________________________________________________________________________________________

Name
(print):                                                                            Title:

Signature:                                                                         Date:
     Owner        Operator          Certifying official

The Illinois EPA is authorized to require, and you shall disclose, the information requested on this form pursuant to the Illinois Environmental
Protection Act (Act), 415 ILCS 5/9. This information shall be provided using this form or by alternative means at your discretion. Failure to
disclose the requisite information may result in your application being denied, and/or penalties being imposed as provided for in the Act, 415 ILCS
5/42-45.

Any person who knowingly makes a false, fictitious, or fraudulent material statement, orally or in writing, to the Illinois EPA commits a Class 4
felony. A second or subsequent offense after conviction is a Class 3 felony. (415 ILCS 5/44(h))


6X METAL FABRICATION APPLICABILITY – Must fall under both NAICS and SIC Code to be subject

       NAICS            NAICS Description                                                    EPA Source Category and (SIC Code)
       Codes
1      332111           Iron and Steel Forging                                               Iron and Steel Forging (3462)
2      332117           Powder Metallurgy Part Manufacturing                                 Fabricated Metal Products, NEC (3499)
3      332312           Fabricated Structural Metal Manufacturing                            Fabricated Structural Metal Manufacturing (3441)
4      332313           Plate Work Manufacturing                                             Fabricated Plate Work (Boiler Shops) (3443)
5      332410           Power Boiler and Heat Exchanger Manufacturing                        Fabricated Plate Work (Boiler Shops) (3443)
6      332420           Metal Tank (Heavy Gauge)                                             Manufacturing Fabricated Plate Work (Boiler
                                                                                             Shops) (3443)
7      332618           Other Fabricated Wire Product Manufacturing                          Primary Metals Products Manufacturing (3399)
8      332919           Other Metal Valve and Pipe Fitting Manufacturing                     Valves and Pipe Fittings, NEC (3494)
9      332999           All Other Miscellaneous Fabricated Metal Product                     Fabricated Metal Products, NEC (3499)
                        Manufacturing
10     333120           Construction Machinery Manufacturing                                 Industrial Machinery and Equipment: Finishing
                                                                                             Ops (3531)
11     333132           Oil and Gas Field Machinery and Equipment                            Industrial Machinery and Equipment: Finishing
                        Manufacturing                                                        Ops (3533)
12     333414           Heating Equipment (Except Warm Air Furnaces)                         Heating Equipment, Except Electric (3433)
                        Manufacturing
13     333911           Pump and Pumping Equipment Manufacturing                             Industrial Machinery and Equipment: Finishing
                                                                                             Ops (3561)
14     335312           Motor and Generator Manufacturing                                    Electrical and Electronic Equipment Finishing
                                                                                             Ops (3621)
15     335999           All Other Miscellaneous Electrical Equipment and                     Electrical and Electronic Equipment Finishing
                        Component Manufacturing                                              Ops (3699)



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