DEQ-CFW_00073250

CENTRAL OFFICE PERAUT TRACKING SLIP
Facility Name: Chemours Company - Fayetteville Works Facility/Application ID: 0900009.15B
County/Regional Office: Bladen/FRO Engineer: lHeather Sands
Send Regional Office Copy of Application: QYes . ONo
Acknowledgement Letter: . 0Already Sent
OPlease Send
Initial Event(s): O TV-Ack./Complete
D State Ack. Letter due
❑ TV-Ack./Incomplete add info 0 State App. not accepted — add info request
j 'a
Fee Information:
Acceptance Check List:
Amount Due: ❑PSD orNSR/NAA $14,294
Yes No
Appropriate.Number of Apps Submitted ® ❑
N/A
❑
❑PSD and NSR/NAA $27,80-2
# Received , Weeded
❑ TV Greenfield $ 9,442
❑ TV $ 918
Application Fee Submitted ❑ ❑
❑ Ownership Change $60, $50, $25
Zoning Addressed ❑ ❑
® ❑
❑
®Renewal/Name Change -NA
Authorized Signature
PE Seal ❑ ❑
®;.
Initial Amount Received: $0.00
Request for Confidentiality ❑
Additional Amount Due: 9'i0.00
Application Contains Toxics Modification(s) ❑ ❑
_.
❑ Required Application Forms Submitted and Completed
Application Type:
Permit Application Schedule:
❑Additional Permit
❑Appeal
❑ Director Administrative Amendment
❑ Supporting Materials & Calculations Received
®Administrative Amendment
❑Expedited State
❑ State
❑ PE Seal (If 15A NCAC 2Q .0112) `
❑Appeal -
❑PSD
❑ Modeling Protocol Acceptance
❑Greenfield Facility
❑ Confirmation of Pollutants Modeled
❑Last GACTiToxias
❑ ES Form (Significant Modifications)
[]Last MACT/Toxics
❑TV — State Only ❑TV — 502(b)(10)
❑Modification
❑TV -Expedited
❑TV —Minor
[]Name Change
❑TV — Greenfield
OTV - Renewal
❑New Permit
❑TV —Reopen for Cause
❑TV — Significant (2Q .0501(c)(2))
❑Ownership Change
®TV - Administrative .
OTV - Significant
❑Renewal
[]TV— Ownership Change-
❑TV —1" Time
❑Renewal w/Modincation
WEE Updated (by EngineerrJ12St TVEE Verified) ' Supervisor: AtItChie /��i� f
Regulations Applicable to This Application (indicate all new regulations): rermtt moss ]tnrormanon,_
❑ NESHAPS/MACT ❑ PSD/NSR ❑ Toxics/Conibustio'h Sources After 7/10/10 Before After
❑ NESHAPS/GACT ❑ PSD/NSR Avoidance ❑ Small ❑ Title V
❑ NSPSJ ❑ Existing Source RACT/LAER ❑ Syn. Minor
02D.1100 ❑ New Source RACT/LAER ❑ Title V
❑ 2Q .0711 ❑ RACT Avoidance „' = ❑ Proh. Small
❑ 1120J/112(d) ❑ RACT/LAER Added Fee*
: +i `.. ❑General
«
(Notify Connie Horne)
HAP Major Status (after) ❑ Major ❑ Minor ❑ Not Determined
PSD or NSR Status (after) ❑ Major ❑ Minor
Miscellaneous ❑ Multiple Permits at Facility ❑ Multi -Site Permit ❑ Recycled Oil Condition
Permit Dates Issue: Effective: Expiration:
IBEAM Closed Out By- Permit Number: Revision Number:
❑ Public Notice Published ❑ Public -Notice Affidavit (if not noticed via DAQ Website)
Document Manager Updated by Engineer: Date:
Tracking SUp V44 - cjh 9/9/15
DEQ-CFW 00073250