Free 52541.pdf - Indiana

OAQ PROCESS INFORMATION APPLICATION PI-02G: Combustion ­ Emission Factors
State Form 52541 (R / 1-07)

INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT

IDEM ­ Office of Air Quality ­ Permits Branch 100 N. Senate Ave., MC 61-53 Indianapolis, IN 46204-2251 Telephone: (317) 233-0178, or Toll Free: 1-800-451-6027 x30178 (within Indiana) Facsimile Number: (317) 232-6749 www.idem.IN.gov/permits/air/index.html

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The purpose of this form is to specify the emission factors used to calculate potential to emit from the combustion unit. Complete one PI-02G form for each emissions unit. If there are multiple emission units that are identical in nature, capacity, and use, you may use one PI-02G form to summarize the units. Detailed instructions for this form are available online at

www.idem.IN.gov/permits/air/apps/instructions/pi02Ginstructions.doc .
All information submitted to IDEM will be made available to the public unless it is submitted under a claim of confidentiality. Claims of confidentiality must be made at the time the information is submitted to IDEM, and must follow the requirements set out in 326 IAC 17.1-4-1. Failure to follow these requirements exactly will result in your information becoming a public record, available for anyone to inspect and photocopy.

Emission Factors This table identifies all emission factors used to calculate air emissions from the combustion unit. 1. Unit ID: 2. Air Pollutant: Carbon Monoxide (CO) Lead (Pb) Hazardous Air Pollutant (HAP) (specify): Nitrogen Oxides (NOX) Mercury (Hg) Particulate Matter (PM) Particulate Matter less than 10m (PM10) Particulate Matter less than 2.5m (PM2.5) Sulfur Dioxide (SO2) Volatile Organic Compounds (VOC) Other (specify): Other (specify): Other (specify): 3. Emission Factor
value units

4. Source of Emission Factor
(if not using AP-42, include calculations)

AP-42 AP-42 AP-42 AP-42 AP-42 AP-42 AP-42 AP-42 AP-42 AP-42 AP-42 AP-42 AP-42

Other Other Other Other Other Other Other Other Other Other Other Other Other

N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

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