Siskiyou — Boilers, Dryers & Process Heaters - Supplemental Application

Source: https://www.siskiyoucounty.gov/sites/default/files/fileattachments/air_pollution_control_district/page/4361/apcd-20151001_supplementalboilerapplication1.pdf

Siskiyou County Air Pollution Control District

Supplemental Application Form

Boilers, Steam Generators, Dryers, and Process Heaters Please complete one form for each different piece of equipment.

This form must be accompanied by a completed Application for Authority to Construct and Permit to Operate form.

Permit to be issued to: Location where the equipment will be operated:

Equipment Description

Equipment Details: Boiler Steam Generator Dryer Process Heater Other: Manufacturer: Model: Serial Number: Steam: lb/hr psig boiler hp Load-Following unit? Yes No Indirect-Fired Direct-Fired Flue Gas Recirculation: Forced FGR Induced FGR None O2 Controller present? No Yes, Manufacturer:

Fuel Use Meter: Gaseous Fuel Meter Liquid Fuel Meter None

Primary Burner: Manufacturer: Type: Standard Low NOx Ultra Low NOx Model: Serial Number: Maximum Heat Input Rating: MMBtu/hr Annual Heat Input: billion Btu/year

Secondary Burner: Manufacturer: Type: Standard Low NOx Ultra Low NOx Model: Serial Number: Maximum Heat Input Rating: MMBtu/hr Annual Heat Input: billion Btu/year

Emissions Data

Primary Fuel: Fuel Type: Natural Gas LPG/Propane Diesel Other: Higher Heating Value: Btu/gal or Btu/scf Sulfur Content: % by weight or g/scf

Primary Fuel Emissions Data: Pollutant ppm v lb/M M Btu Nitrogen Oxides Carbon M onoxide Volatile Organic Com pounds

Secondary Fuel: Fuel Type: Natural Gas LPG/Propane Diesel Other: Higher Heating Value: Btu/gal or Btu/scf Sulfur Content: % by weight or g/scf

Secondary Fuel Emissions Data: Pollutant ppm v lb/M M Btu Nitrogen Oxides Carbon M onoxide Volatile Organic Com pounds

Source of Data: Manufacturer’s Specifications Emissions Source Test Other Please provide copies

Additional Emissions Control Equipment: Selective Catalytic Reduction – Manufacturer: Model: Ammonia Urea Other: Non-Selective Catalytic Reduction – Manufacturer: Model: Control Efficiencies: NOx %, SOx: %, PM10 %, CO %, VOC % Other (Please specify):

Health Risk Assessment Data

Operating Hours: Maximum Operating Schedule: hours/day hours/year Receptor Data: Distance to nearest Residence feet Direction to nearest Residence Distance to nearest Business feet Direction to nearest Business Are you with in 1000 ft of a school? Yes No If yes, which school? Stack Parameters: Release Height: feet above grade Stack Diameter: inches at point of release Rain Cap: Flapper-type Fixed-type None Other: Direction of Flow: Vertically upward Horizontal Exhaust Data: Flowrate: acfm Temperature: º F Facility Location: Urban Rural

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