DEQ-CFW_00087792

Facility Name: • �� l�bw� - -�wi on: r" Application Number: l uuu :. v re v
- Greenfield Facility: Yes 0 No (If YES thin call region and fax them, the Al Form to allow them to enter the facility into IMPAQ)
x8sip Application: ' Wc r% A�
PART I - ACCEPTANCE CKLBT c7
pdoivledgemhnt better: Already Sent O Please Send
Type Letter•. Standard O Renewal O Administrative Amendment ,K Ownership Change O Name Change 0
Application Fee Received____: 0-
Construction Notice - Construction Notice Complete
0
TV $834 TV Significant $8576
Construction Notice - Facility Name and Location
C]
Syafttic Minor $400 Small $50
Construction Notice - Permittee Name and Address
O
Ownership Change $60 Name Change $0
Construction Notice - Permit Number of All DAQ Permits ��
O
Renewal $0 Construction Notice $200
Construction Notice -Proposed Equipment List and Descriptions
Q
Construction Notice - Proposed Control Device List and Descriptions
Appropriate Number of Copies Received (minimum of 2)
O
Construction Notice - Estimated Emissions Associated w/Modificadon
O
Send Region Copy of Application
O
Construction Notice - Sdmdnie for Alterations and Expansion
O
O
Consistency Determination Applied For
O
O
Construction Notice - Will Not Operate Statement
O
Source Recycling/Redaction Form Received
Construction Notice - Fiaancfal Risk Statement
O
PE Seal
O
Construction Notice - Proof of Public Notice
O
Authorized Signature
(3
Construction Notice - Certification of Completeness
O
Emissions Inventory Received (Renewals Only)
O
Construction Notice - Fee Received
Permit Application
PART II - IIOAQ UPDATSS
Processlnx
Schedule
Addittonat Permit
13
Appeal
TV - Greenfield
Administrative Amendmeat
Construction Notice
O
TV - Initial
O
Appeal
O
Dkoctor Administrative Amendment
O
TV - Ownership Change
O
Construction Notice
(3
Greenfield Facility
O
Permit Applicability Request
O
TV - Reopen ibr Cause
O
Modification
O
PSD
O
TV -Significant
C7 '
Name Change
O
Rescission
O
TV - Significant (2Q .0501(c)(2))
O
NOW Permit
O
Rswestion
O
TV - State Qnly
O
Owunhdp Change
O
State
O
TV -14 Time
(3
Reaawal.
O
Tax Gedfication
O
TV - sm)('10)
O
Radasim Request
O
Title 1V
O
112Q) Part I
O
Revocation
O
Transportation
O
ULCedification.
112Q) Part I
O
O
TV -Administrative
TV - Expedited
If
i t r ►o'r f
PART M • COMPLETENESS CBECffi.YST
Required Application Forms Submitted and Completed O
Modeling
Protocol Aeapw=A O
Suppmft Materials tit Cdc uladons Received
O
Confirmation ofPollutants Modeled O
PE Seal (If 15A NCAC 2Q .0I12)
O
- P y� PART 1v -GENERAL CON�avUWJS
/_ 1 ' 4A" /'01�VI Ye A•r �,h br w Vi'l. fit... V.— 2-
L
PART VI- CLOSEM DWORMATION
Regulations Applicable to Tbis NWHAP/MACT O PSD Avoidance O 2D .1100 O Prohibitory Small Cy
Applicathm NSPS O PSD O 2Q .0711 ' ; O N/
Ar
Data Issue J 7-1 `Z40'+ Effecdve 5 `Z 8 -Zoo ± Expirationf - 3 / - LOGq
BeAQ Closed Out _ L , Permit Number: d S Qj2 Revision Number: �Z-�
Permit amass Before After
information. (check all Small O Synthetic Minor O General O Small O Synowde Minor O ftetal O
that apply) Prohibitory Small O Title VIrTransportation O Prohibitory Small O Title V CkTraasportation O
SAP Major (100 tpy) Major 12l '
PSD Status Major O Minor
bilom aneous Multiple Perms at�Cf1
ag "P V24.4c
Minor C- Not
y O d-Sit ermit O A / Quarry Special Permit O cycled Oil Condition O
i V —�
1 1�J
DEQ-CFW 00087792