INSTRUCTIONS FOR FILLING OUT AQ FORM by sgdy7777

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									                                                                       AIR QUALITY
                                                                                                                                     PERMIT APPLICATION FORM   CD-02
                                                                                                                             COMPLIANCE CERTIFICATION
                                                                       520 LAFAYETTE ROAD                                                                             5/11/98
                                                                       ST. PAUL, MN 55155-4194


1) AQ Facility ID No.:                   2) Facility Name:
3)
           3a)                3b)                          3c)                                                    3d)                                        3e)
 Requirement That        Compliance      Briefly Describe the Non-Compliance                      How Did You Determine if You Were                     Compliance
 is Basis of             Status On the   (If You Checked Non-Compliance in the Previous Column)   In or Out of Compliance?                              Status On the
 Certification           Date of                                                                  (Monitoring, Reporting, Recordkeeping, Emission       Day You
                                                                                                  Calculations, Performance Test Data, Operation and
                         Application                                                              Maintenance Methods)                                  Receive Your
                         (Check One)                                                                                                                    Permit
                                                                                                                                                        (Check One)
 # 1b from GI-09,          Compliance                                                                                                                     Compliance
 National Emission         Non-                                                                                                                           Non-
 Standards for             Compliance                                                                                                                     Compliance
 Hazardous Air             Not                                                                                                                            Not
 Pollutants                Applicable                                                                                                                     Applicable
 (40 CFR pt. 63 and
 1990 Clean Air Act,
 as amended, Section
 112)
 # 1c from GI-09,          Compliance                                                                                                                     Compliance
 Case-by-case MACT         Non-                                                                                                                           Non-
 (1990 Clean Air Act,      Compliance                                                                                                                     Compliance
 as amended, Section       Not                                                                                                                            Not
 112(g)(2)(B))             Applicable                                                                                                                     Applicable




aq-f1-cd02.doc                                                                                                                                                 Form CD-02
                                                                                                                                                                Page 1 of 14
  Requirement That     Compliance             Briefly Describe the Non-Compliance                      How Did You Determine if You                         Compliance
  is Basis of          Status On the          (If You Checked Non-Compliance in the Previous Column)   Were In or Out of Compliance?                        Status On the
  Certification        Date of                                                                         (Monitoring, Reporting, Recordkeeping, Emission      Day You
                                                                                                       Calculations, Performance Test Data, Operation and
                       Application                                                                     Maintenance Methods)(                                Receive Your
                       (Check One)                                                                                                                          Permit
                                                                                                                                                            (Check One)
  # 2b from GI-09,        Compliance                                                                                                                           Compliance
  National Emission       Non-                                                                                                                                 Non-
  Standards for           Compliance                                                                                                                           Compliance
  Hazardous Air           Not                                                                                                                                  Not
  Pollutants              Applicable                                                                                                                           Applicable
  (40 CFR pt. 61;
  Minn. R. 7011.9900
  - 7011.9990)

  #3b from GI-09,         Compliance                                                                                                                           Compliance
  New Source Review       Non-                                                                                                                                 Non-
  (40 CFR pt. 52)         Compliance                                                                                                                           Compliance
                          Unknown                                                                                                                              Not
                       You may check                                                                                                                           Applicable
                       "Unknown" if you
                                                                                                                                                            If you checked
                       checked "Unknown"
                                                                                                                                                            "Unknown" or "Non-
                       under item 2b in the
                                                                                                                                                            Compliance" in
                       GI-09 form.
                                                                                                                                                            column 2 and will be
                          Not                                                                                                                               receiving a permit with
                          Applicable                                                                                                                        synthetic minor limits
                                                                                                                                                            to avoid New Source
                                                                                                                                                            Review, check
                                                                                                                                                            "Compliance" here.




aq-f1-cd02.doc                                                                                                                                                    Form CD-02
                                                                                                                                                                   Page 2 of 14
  Requirement That       Compliance                Briefly Describe the Non-Compliance                      How Did You Determine if You                         Compliance
  is Basis of            Status On the             (If You Checked Non-Compliance in the Previous Column)   Were In or Out of Compliance?                        Status On the
  Certification          Date of                                                                            (Monitoring, Reporting, Recordkeeping, Emission      Day You
                                                                                                            Calculations, Performance Test Data, Operation and
                         Application                                                                        Maintenance Methods)                                 Receive Your
                         (Check One)                                                                                                                             Permit
                                                                                                                                                                 (Check One)
  # 4a from GI-09,          Compliance                                                                                                                              Compliance
  National Ambient          Non-                                                                                                                                    Non-
  Air Quality               Compliance                                                                                                                              Compliance
  Standards;                Not                                                                                                                                     Not
  Increment and             Applicable                                                                                                                              Applicable
  Visibility             You must check "Non-                                                                                                                    You must check "Non-
                         Compliance" if you                                                                                                                      Compliance" if you
  Requirements           submitted an NSR                                                                                                                        will not have
  (1990 Clean Air Act,   application and did not                                                                                                                 completed any
                         complete any required                                                                                                                   required analysis of
  Sections 109 and       analysis of ambient                                                                                                                     ambient air, increment
  160-169(B))            air, increment, or                                                                                                                      by the time your
                         visibility.                                                                                                                             permit is issued..
  # 5d from GI-09,          Compliance                                                                                                                              Compliance
  Standards of              Non-                                                                                                                                    Non-
  Performance for           Compliance                                                                                                                              Compliance
  New Stationary            Not                                                                                                                                     Not
  Sources                   Applicable                                                                                                                              Applicable
  (40 CFR pt. 60)




aq-f1-cd02.doc                                                                                                                                                         Form CD-02
                                                                                                                                                                        Page 3 of 14
  Requirement That       Compliance                 Briefly Describe the Non-Compliance                      How Did You Determine if You                         Compliance
  is Basis of            Status On the              (If You Checked Non-Compliance in the Previous Column)   Were In or Out of Compliance?                        Status On the
  Certification          Date of                                                                             (Monitoring, Reporting, Recordkeeping, Emission      Day You
                                                                                                             Calculations, Performance Test Data, Operation and
                         Application                                                                         Maintenance Methods)                                 Receive Your
                         (Check One)                                                                                                                              Permit
                                                                                                                                                                  (Check One)
  # 6c from GI-09,          Compliance                                                                                                                               Compliance
  Acid Rain Program         Non-                                                                                                                                     Non-
  under Title IV            Compliance                                                                                                                               Compliance
  (40 CFR pt. 72; 40        Not                                                                                                                                      Not
  CFR pt. 73; and           Applicable                                                                                                                               Applicable
  1990 Clean Air Act,
  as amended,
  Sections 401-416)
  # 7b from GI-09,          Compliance                                                                                                                               Compliance
  Stratospheric Ozone       Non-                                                                                                                                     Non-
  Protection                Compliance                                                                                                                               Compliance
  (1990 Clean Air Act,      Not                                                                                                                                      Not
  as amended,               Applicable                                                                                                                               Applicable
  Sections 601-618)

  # 11b) from GI-09,        Compliance                                                                                                                               Compliance
  Air Quality               Non-                                                                                                                                     Non-
  Emission Fees             Compliance                                                                                                                               Compliance
  (Minn. R. 7002.0025    Check "Compliance"                                                                                                                       Check "Compliance"
                         here unless you have                                                                                                                     here unless you have
  - 7002.0095)           an overdue emission                                                                                                                      an overdue emission
                         fee bill (including late                                                                                                                 fee bill that you have
                         fees).                                                                                                                                   not paid and do not
                                                                                                                                                                  intend to pay the bill
                                                                                                                                                                  and/or associated late
                                                                                                                                                                  fees by the time you
                                                                                                                                                                  get a permit.




aq-f1-cd02.doc                                                                                                                                                          Form CD-02
                                                                                                                                                                         Page 4 of 14
  Requirement That      Compliance               Briefly Describe the Non-Compliance                      How Did You Determine if You                         Compliance
  is Basis of           Status On the            (If You Checked Non-Compliance in the Previous Column)   Were In or Out of Compliance?                        Status On the
  Certification         Date of                                                                           (Monitoring, Reporting, Recordkeeping, Emission      Day You
                                                                                                          Calculations, Performance Test Data, Operation and
                        Application                                                                       Maintenance Methods)                                 Receive Your
                        (Check One)                                                                                                                            Permit
                                                                                                                                                               (Check One)
  # 11b) from GI-09,       Compliance                                                                                                                             Compliance
  Air Emission          You may check                                                                                                                          You may check
                        "Compliance" if you                                                                                                                    "Compliance" here if,
  Permits               are in compliance with                                                                                                                 by applying for and
  (Minn. R. 7007.0050   all state and federal                                                                                                                  obtaining a permit,
                        permitting                                                                                                                             you have satisfied all
  - 7007.1850)          requirements                                                                                                                           state and federal
                        (including the                                                                                                                         permitting
                        requirement to obtain                                                                                                                  requirements that
                        a state permit and/or                                                                                                                  apply to your facility.
                        permit amendment(s)                                                                                                                       Non-
                        under Minnesota's
                        prior air permitting                                                                                                                      Compliance
                        rules), and you have
                        submitted a complete
                        permit application by
                        the deadline listed in
                        Minn. Rules
                        7007.0350.
                           Non-
                           Compliance
                        Check "Non-
                        Compliance" if any of
                        the above conditions
                        are not true.
  # 11b) from GI-09,       Compliance                                                                                                                             Compliance
  Minnesota and            Non-                                                                                                                                   Non-
  National Ambient         Compliance                                                                                                                             Compliance
  Air Quality              Unknown                                                                                                                                Unknown
  Standards             You may only check                                                                                                                     You may only check
                        "Unknown" if your                                                                                                                      "Unknown" if your
  (Minn. R. 7009.0010   facility has never                                                                                                                     facility has never
  - 7009.0080)          modeled ambient air                                                                                                                    modeled ambient air
                        impacts or done                                                                                                                        impacts or done
                        ambient air testing.                                                                                                                   ambient air testing.




aq-f1-cd02.doc                                                                                                                                                       Form CD-02
                                                                                                                                                                      Page 5 of 14
  Requirement That      Compliance                 Briefly Describe the Non-Compliance                      How Did You Determine if You                         Compliance
  is Basis of           Status On the              (If You Checked Non-Compliance in the Previous Column)   Were In or Out of Compliance?                        Status On the
  Certification         Date of                                                                             (Monitoring, Reporting, Recordkeeping, Emission      Day You
                                                                                                            Calculations, Performance Test Data, Operation and
                        Application                                                                         Maintenance Methods)                                 Receive Your
                        (Check One)                                                                                                                              Permit
                                                                                                                                                                 (Check One)
  # 11b) from GI-09        Compliance                                                                                                                               Compliance
  Circumvention            Non-                                                                                                                                     Non-
  (Minn. R.                Compliance                                                                                                                               Compliance
  7011.0020)            Check "Compliance"                                                                                                                       Check "Compliance"
                        if you are not currently                                                                                                                 if you are not currently
                        concealing or diluting                                                                                                                   concealing or diluting
                        your emissions.                                                                                                                          your emissions.
  # 11b) from GI-09,       Compliance                                                                                                                               Compliance
  Emission Standards       Non-                                                                                                                                     Non-
  for Visible Air          Compliance                                                                                                                               Compliance
  Contaminants             Unknown                                                                                                                                  Unknown
  (Minn. R. 7011.0100   Check "Unknown" if                                                                                                                       Check "Unknown" if
                        you have neither                                                                                                                         you have neither
  - 7011.0120)          certified monitors , nor                                                                                                                 certified monitors , nor
                        have personnel who                                                                                                                       have personnel who
                        are certified in EPA                                                                                                                     are certified in EPA
                        Method 9 (visible                                                                                                                        Method 9 (visible
                        emission reading).                                                                                                                       emission reading).


  # 11b) from GI-09,       Compliance                                                                                                                               Compliance
  Preventing               Non-                                                                                                                                     Non-
  Particulate Matter       Compliance                                                                                                                               Compliance
  from Becoming         Check "Non-                                                                                                                              Check "Non-
                        Compliance" if you                                                                                                                       Compliance" if you
  Airborne              have received an order                                                                                                                   have received an order
  (Minn. R.             or a permit condition                                                                                                                    or a permit condition
                        from the MPCA to                                                                                                                         from the MPCA to
  7011.0150)            control fugitive dust                                                                                                                    control fugitive dust
                        and you are not                                                                                                                          and you will not be
                        complying with either                                                                                                                    complying with it
                        the permit or the order.                                                                                                                 when you receive your
                                                                                                                                                                 permit.




aq-f1-cd02.doc                                                                                                                                                         Form CD-02
                                                                                                                                                                        Page 6 of 14
  Requirement That      Compliance                Briefly Describe the Non-Compliance                      How Did You Determine if You                         Compliance
  is Basis of           Status On the             (If You Checked Non-Compliance in the Previous Column)   Were In or Out of Compliance?                        Status On the
  Certification         Date of                                                                            (Monitoring, Reporting, Recordkeeping, Emission      Day You
                                                                                                           Calculations, Performance Test Data, Operation and
                        Application                                                                        Maintenance Methods)                                 Receive Your
                        (Check One)                                                                                                                             Permit
                                                                                                                                                                (Check One)
  # 11b) from GI-09,       Compliance                                                                                                                              Compliance
  Continuous               Non-                                                                                                                                    Non-
  Monitors                 Compliance                                                                                                                              Compliance
  (Minn. R.                Not                                                                                                                                     Not
  7017.1000)               Applicable                                                                                                                              Applicable
                        Check "Not                                                                                                                              Check "Not
                        Applicable" if you                                                                                                                      Applicable" if you
                        don't have and will not                                                                                                                 don't have and will not
                        be getting any                                                                                                                          be getting any
                        continuous emission                                                                                                                     continuous emission
                        monitoring systems                                                                                                                      monitoring systems at
                        at your facility to                                                                                                                     your facility to
                        measure opacity , SO2,                                                                                                                  measure opacity , SO2,
                        NOx, emissions, or the                                                                                                                  NOx, emissions, or the
                        oxygen or CO2                                                                                                                           oxygen or CO2
                        content of effluent                                                                                                                     content of effluent
                        gases.                                                                                                                                  gases.
  # 11b) from GI-09,       Compliance                                                                                                                              Compliance
  Performance Tests        Non-                                                                                                                                    Non-
  (Minn. R. 7017.2001      Compliance                                                                                                                              Compliance
  - 7017.2060)             Not                                                                                                                                     Not
                           Applicable                                                                                                                              Applicable
                        Check "Not                                                                                                                              Check "Not
                        Applicable" if you                                                                                                                      Applicable" if you will
                        have never conducted                                                                                                                    not conduct an air
                        an air emission                                                                                                                         emission performance
                        performance test.                                                                                                                       test before you get
                                                                                                                                                                your permit.


  Requirement That      Compliance                Briefly Describe the Non-Compliance                      How Did You Determine if You                         Compliance
  is Basis of           Status On the             (If You Checked Non-Compliance in the Previous Column)   Were In or Out of Compliance?                        Status On the
  Certification         Date of                                                                            (Monitoring, Reporting, Recordkeeping, Emission      Day You
                                                                                                           Calculations, Performance Test Data, Operation and
                        Application                                                                        Maintenance Methods)                                 Receive Your
                        (Check One)                                                                                                                             Permit
                                                                                                                                                                (Check One)
aq-f1-cd02.doc                                                                                                                                                        Form CD-02
                                                                                                                                                                       Page 7 of 14
  # 11b) from GI-09,       Compliance                                                                                                                              Compliance
  Notifications            Non-                                                                                                                                    Non-
  (Minn. R.                Compliance                                                                                                                              Compliance
  7019.1000)            Check "Non-                                                                                                                             If you intend to notify
                        Compliance" if you                                                                                                                      the MPCA about
                        had any shutdown or                                                                                                                     shutdowns and
                        breakdown in the past                                                                                                                   breakdowns you may
                        that you should have                                                                                                                    have between the date
                        notified the MPCA                                                                                                                       of application and the
                        about.                                                                                                                                  date of permit
                                                                                                                                                                issuance, you may
                                                                                                                                                                check "Compliance".
  # 11b) from GI-09,       Compliance                                                                                                                              Compliance
  Reports                  Non-                                                                                                                                    Non-
  (Minn. R.                Compliance                                                                                                                              Compliance
  7019.2000)               Not                                                                                                                                     Not
                           Applicable                                                                                                                              Applicable
                        Check "Not                                                                                                                              Check "Not
                        Applicable" if you                                                                                                                      Applicable" if you
                        don't have and will not                                                                                                                 don't have and will not
                        be getting any                                                                                                                          be getting any
                        continuous monitoring                                                                                                                   continuous monitoring
                        systems at your                                                                                                                         systems at your
                        facility.                                                                                                                               facility.
  # 11b) from GI-09,       Compliance                                                                                                                              Compliance
  Emission Inventory       Non-                                                                                                                                    Non-
  (Minn. R. 7019.3000      Compliance                                                                                                                              Compliance
  - 7019.3100)          Check "Non-
                        Compliance" if the
                        MPCA has sent an
                        emission inventory
                        form to you to fill out
                        and you didn't fill it
                        out and return it.


  Requirement That      Compliance                Briefly Describe the Non-Compliance                      How Did You Determine if You                         Compliance
  is Basis of           Status On the             (If You Checked Non-Compliance in the Previous Column)   Were In or Out of Compliance?                        Status On the
  Certification         Date of                                                                            (Monitoring, Reporting, Recordkeeping, Emission      Day You
                                                                                                           Calculations, Performance Test Data, Operation and
                        Application                                                                        Maintenance Methods)                                 Receive Your
                        (Check One)                                                                                                                             Permit
                                                                                                                                                                (Check One)



aq-f1-cd02.doc                                                                                                                                                        Form CD-02
                                                                                                                                                                       Page 8 of 14
  # 11b) from GI-09,       Compliance              Compliance
  Motor Vehicles           Non-                    Non-
  (Minn. R. 7023.0100      Compliance              Compliance
  - 7023.0120)             Not                     Not
                           Applicable              Applicable
                        If your facility does   If your facility will not
                        not operate a motor     operate a motor
                        vehicle fleet, check    vehicle fleet during the
                        "Not-Applicable."       term of your permit,
                                                check "Not-
                                                Applicable."
  # 11b) from GI-09,       Compliance              Compliance
  Noise Pollution          Non-                    Non-
  Control                  Compliance              Compliance
  (Minn. R. 7030.0010      Unknown                 Unknown
  - 7030.0080)          You may only check      You may only check
                        "Unknown" if noise      "Unknown" if noise
                        pollution has never     pollution has never
                        been tested for your    been tested for your
                        facility.               facility.
  #1a from GI-09(I)        Compliance              Compliance
  Air Pollution            Non-                    Non-
  Episodes                 Compliance              Compliance
  (Minn. R. 7009.1000      Not                     Not
  -7009.1110)              Applicable              Applicable




aq-f1-cd02.doc                                        Form CD-02
                                                       Page 9 of 14
  Requirement That      Compliance                  Briefly Describe the Non-Compliance                      How Did You Determine if You                         Compliance
  is Basis of           Status On the               (If You Checked Non-Compliance in the Previous Column)   Were In or Out of Compliance?                        Status On the
  Certification         Date of                                                                              (Monitoring, Reporting, Recordkeeping, Emission      Day You
                                                                                                             Calculations, Performance Test Data, Operation and
                        Application                                                                          Maintenance Methods)                                 Receive Your
                        (Check One)                                                                                                                               Permit
                                                                                                                                                                  (Check One)
  #2a, b, and c from       Compliance                                                                                                                                Compliance
  GI-09(I) Standards       Non-                                                                                                                                      Non-
  of Performance for       Compliance                                                                                                                                Compliance
  Stationary Sources       Not                                                                                                                                       Not
  (Minn. R. 7011.0500      Applicable                                                                                                                                Applicable
  - 7011.0620 and
  7011.0800 -
  7011.3450)
  #3c from GI-09(I)        Compliance                                                                                                                                Compliance
  Minnesota Acid           Non-                                                                                                                                      Non-
  Deposition Control       Compliance                                                                                                                                Compliance
  Requirements             Not                                                                                                                                       Not
  (Minn. R.                Applicable                                                                                                                                Applicable
  7021.0050)
  # 4a, c, and d from      Compliance                                                                                                                                Compliance
  GI-09(I) Standards       Non-                                                                                                                                      Non-
  of Performance for       Compliance                                                                                                                                Compliance
  Industrial Process       Unknown                                                                                                                                   Unknown
  Equipment             You may only check                                                                                                                        You may only check
                        "Unknown" if you                                                                                                                          "Unknown" if you
  (Minn. R. 7011.0700   have never done                                                                                                                           have never done
  - 7011.0735)          opacity or emissions                                                                                                                      opacity or emissions
                        testing at your facility.                                                                                                                 testing at your facility.
                           Not                                                                                                                                         Not
                           Applicable                                                                                                                                 Applicable




aq-f1-cd02.doc                                                                                                                                                          Form CD-02
                                                                                                                                                                        Page 10 of 14
  Requirement That        Compliance      Briefly Describe the Non-Compliance                      How Did You Determine if You                         Compliance
  is Basis of             Status On the   (If You Checked Non-Compliance in the Previous Column)   Were In or Out of Compliance?                        Status On the
  Certification           Date of                                                                  (Monitoring, Reporting, Recordkeeping, Emission      Day You
                                                                                                   Calculations, Performance Test Data, Operation and
                          Application                                                              Maintenance Methods)                                 Receive Your
                          (Check One)                                                                                                                   Permit
                                                                                                                                                        (Check One)
  #5b from GI-09(I)         Compliance                                                                                                                    Compliance
  Waste Combustors          Non-                                                                                                                          Non-
  (Minn. R. 7011.1201       Compliance                                                                                                                    Compliance
  - 7011.1290)              Not                                                                                                                           Not
                            Applicable                                                                                                                    Applicable
  Any condition listed      Compliance                                                                                                                    Not
  in your facility's        Non-                                                                                                                          Applicable
  most recent MN Air        Compliance
  Emission Permit           Not
                            Applicable
  *Any other air            Compliance                                                                                                                    Compliance
  quality requirement       Non-                                                                                                                          Non-
  that applies to your      Compliance                                                                                                                    Compliance
  facility that has not     Not                                                                                                                           Not
  been identified           Applicable                                                                                                                    Applicable
  above
  List below:




aq-f1-cd02.doc                                                                                                                                               Form CD-02
                                                                                                                                                             Page 11 of 14
  Requirement That        Compliance      Briefly Describe the Non-Compliance                      How Did You Determine if You                         Compliance
  is Basis of             Status On the   (If You Checked Non-Compliance in the Previous Column)   Were In or Out of Compliance?                        Status On the
  Certification           Date of                                                                  (Monitoring, Reporting, Recordkeeping, Emission      Day You
                                                                                                   Calculations, Performance Test Data, Operation and
                          Application                                                              Maintenance Methods)                                 Receive Your
                          (Check One)                                                                                                                   Permit
                                                                                                                                                        (Check One)
  *Any other air            Compliance                                                                                                                    Compliance
  quality requirement       Non-                                                                                                                          Non-
  that applies to your      Compliance                                                                                                                    Compliance
  facility that has not     Not                                                                                                                           Not
  been identified           Applicable                                                                                                                    Applicable
  above
  List below:




* These boxes are intended for rules which have been promulgated but not yet added to the form, requirements from enforcement actions or SIP
order requirements.




aq-f1-cd02.doc                                                                                                                                               Form CD-02
                                                                                                                                                             Page 12 of 14
INSTRUCTIONS FOR FILLING OUT AQ FORM
CD-02 Compliance Certification

In the Compliance Certification Form (CD-02), you will identify whether your facility is in
compliance with state and federal requirements that apply. The requirements listed on this form
are reproduced from the Requirements Form (GI-09) and correspond to general program
categories (for example, New Source Performance Standards, New Source Review). It is
recommended that you complete the Compliance Plan Form (CD-01) and the Compliance
Schedule (CD-03) before you begin CD-02, since your analysis of specific requirements will help
you determine your compliance status for the regulation as a whole.

1) AQ Facility ID No. -- Fill in your Air Quality Facility ID Number as indicated on the
   Facility Information Form (GI-01), item 1a.

2) Facility Name -- Enter your facility name as indicated on the Facility Information Form
   (GI-01), item 2.

3a) Requirement That is Basis of Certification -- Identify Applicable Requirements. All state
    and federal air quality rules and regulations listed in GI-09 are reproduced in the first column
    (3a) of this form. Identify those requirements that apply to your facility.

    NOTE: The last cell in this column is intended to allow you to fill in any air quality rule or
    regulation that may not have been identified in the CD-02 form. (The application forms will
    be updated periodically to reflect new regulations. If the CD-02 form has not yet been
    changed to reflect a new regulation, or if you have an old form, you may need to write
    something in this box.) If there is another requirement that applies to your facility, list the
    requirement name and citation in the box.

3b) Compliance Status for the Date of Application -- You must determine whether your
    facility is in or out of compliance with each of the applicable requirements on the date of
    application. To do this, you must be familiar with the specifics of each applicable
    requirement. If the rule or regulation does not apply to you, check "Not Applicable" in this
    column. Do not leave any box blank. If your facility is in compliance with every aspect of a
    requirement, check "Compliance." If your facility is out of compliance with any aspect of a
    requirement, check "Non-Compliance." If your facility violated any requirement in the past
    and the violation has not been corrected by the time you apply for a permit, the facility is still
    not in compliance.

    NOTE: In some cases you are given the option of certifying that your compliance status is
    unknown for a particular requirement. You may only check the "Unknown" box if your
    facility meets the criteria listed in the box.



aq-f1-cd02.doc

                                             Form CD-02
                                                                                          Page 13 of 14
3c) Briefly Describe the Non-Compliance -- If you determined that your facility is not in
    compliance with any requirement on the date of application, briefly describe the non-
    compliance in the third column. For example, if volatile organic compound emissions from
    your spray paint booth are greater than what is allowed by a regulation, include a description
    of how the spray booth is out of compliance. If you checked "Not Applicable", "Unknown",
    or "Compliance" in the second column, you may write in "Not Applicable" in the
    corresponding box in this column.

3d) How Did You Determine if You Were In or Out of Compliance -- Describe How You
    Determined Your Compliance Status. Briefly describe the methods (such as recordkeeping,
    performance test data, emission calculations, and operation and maintenance procedures) you
    used to determine your compliance status. If you need more room than has been provided
    for, attach well labeled sheets to this form with the additional information.

      If you checked "Not-Applicable" or "Unknown" in the Compliance Status on the Date of
      Application column (3b), you may write in "Not Applicable" in the corresponding cell in this
      column.

3d)      Compliance Status On the Day You Receive Your Permit -- Determine Your
         Compliance Status for the Date of Permit Issuance. Determine whether your facility will
         be in or out of compliance with each of the applicable requirements on the day you
         receive your permit. Your compliance status may change between the date of application
         and the date your permit is issued. For example, you may check "Compliance" in this
         column if you will have completed the corrective action you outlined in the Compliance
         Schedule Form (CD-03) by the time you get your permit. The form provides some
         guidance regarding how to determine the appropriate compliance status. For some
         requirements, you again are given the option of certifying that your compliance status is
         unknown. You may only check the "Unknown" box if your facility meets the criteria
         listed in the box.




aq-f1-cd02.doc

                                            Form CD-02
                                                                                       Page 14 of 14

								
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