DEQ-CFW_00072071

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ADMINISTRATIVE APPLICATION (General Information)
NCDENR
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REVISED 5/8/13 NCDENR/Division of Air Quality -Application for Air Permit to Construct/Operate Pernfs act
Operate AA
GENERAL INFORMATION
Legal Corporate/Owner Name: I The Chemours Company FC, LLC
Site Name: LChemours Company - Fayetteville Works
Site Address (911 Address) Line 1:122828 NC Highway 87 W
Site Address Line 2:
City:
Per
Ph.
State: IN. C. I Zip Code: 128306 1 County:IBladen
CONTACT INFORMATION
/ Technical Contact I
e/Title: [Michael E. Johnson / Environmental Manager 22 ng Address Line 1: 828 NC Highway 87 W
ng Address Line 2:
Fayetteville State:INC Zip Code: 28306-7332
No. (area code) [phone] Fax No. (area code) [phone]
:mail Address: I michael.e.)ohnson(cocriemours.com
Responsible Official/Authorized Contact: F_
Name/Title: Ellis H. McGaughy / Plant Manager
Mailing Address Line 1: 22828 NC Highway 87 W
Mailing Address Line 2:
City: Fayetteville State: NC Zip Code: 28306-7332
Ph. No. (area code) [phone] Fax No. (area code) [phone]
Email Address: [e-mail]
Facility/Inspection Contact:
Name/Title: Michael E. Johnson / Environmental Manager
Mailing Address Line 1: 122828 NC Highway 87 W
Mailing Address Line 2: -�
City: (Fayetteville j State: NC Zip Code: 28306-7332-�
Ph. No. (area code) [phone] Fax No. (area code) [phone]]
Email Address: [e-mail]
Invoice Contact:
Name/Title: Michael E. Johnson / Environmental Manager
Mailing Address Line 1: 22828 NC Highway 87 W
Mailing Address Line 2: C
City: I Fayetteville State: `NC �D Zip Code: 28306-7332
Ph. No. (area code) [phone] 1 Fax No. (area code) [phone]
Email Address:
APPLICATION IS BEING MADE FOR
❑ Renewal (non -Title V) ❑ Renewal Title V ❑ Name Change ® Ownership Change ❑ Administrative Amendment
FACILITY CURRENT CLASSIFICATION (Check Only One)
❑ Small ❑ Synthetic Minor ® Title V
FACILITY (Plant Site) INFORMATION I
Describe nature of (plant site) operation(s):
The site manufactures fluorocarbon gases and liquids and manufactures perfluorinated resins and membranes. To support these manufacturing processes,
the site operates natural gas -fired / No. 2 fuel oil -fired boilers and operates an NPDES permitted wastewater treatment plant.
Primary SIC/NAICS Code: 1325120 7 Current/Previous Air Permit No. 03735T39 Expiration Date: I01-31-2020
Facility Coordinates: Latitude: 134 deg 50' 38" Longitude: -78 deg 50' 13" Facility ID No. 10900009
Does this application contain confidential data? YES _ NO _ ***If yes, please contact the DAQ Regional Office prior to submitting tis application.*** (See Instructions)
PERSON OR FIRM THAT PREPARED APPLICATION I
Person Name: I Michael E. Johnson / Environmental Manager I
Mailing Address Line 1: 22828 NC Highway 87 W
City: Fayetteville State: NC
Ph. No. ( area code) [phone]-1 Fax No. (area code) [phone]
Firm Name: I I
Mailing Address Line 2:
Zip Code: 28306-7332 County: I Bladen
Email Address:
SIGNATURE OF RESPONSIBLE OFFICIAL/AUTHORIZED CONTACT
Name (typed): I Ellis H. McGaughy A Title: Plant Manager
XrSig/nature (Blue Ink): <A= Date: 06-19-2015
T4(j"
tach Additional Sheets As Necessary Page 1 of 2
DEQ-CFW 00072071

c1*0d
REVISED 5/8/13
FORM AA (continued, page 2 of 2)
ADMINISTRATIVE APPLICATION
Application for Air Permit to Construct/Operate
JUN " Z015
Air Permits ectio AA
SECTION AA1 -APPLICATION FOR NON -TITLE V PERMIT RENEWAL
(Company Name) hereby formally requests renewal of Air Permit No, C I
There have been no modifications to the originally permitted facility or the operations therein that would require an air permit since the last permit was issued.
Is your facility subject to 40 CFR Part 68 "Prevention of Accidental Releases"- Section 112 ( r) of the Clean Air Act? [:]Yes ❑ No
If yes, have you already submitted a Risk Manaqement Plan (RMP) to EPA? ❑ Yes ❑ No Date Submitted
Did you attach a current emissions inventory? ❑ Yes ❑ No If no, was it submitted via AERO or by mail (date mailed).
SECTION AA2 - APPLICATION FOR TITLE V PERMIT RENEWAL
In accordance with the provisions of Title 15A 2Q .0513 the responsible official of I I (Company Name)
hereby formally requests renewal of Air Permit No. I (Air Permit No.) and further certifies that:
(1) the current air quality permit identifies and describes all emissions units at the above subject facility, except where such units are exempted under the
North Carolina Title V regulations at 15A NCAC 2Q .0500,
(2) the current air quality permit cites all applicable requirements and provides the method or methods for determining compliance with the applicable
requirements,
(3) the facility is currently in compliance, and shall continue to comply, with all applicable requirements. (Note: As provided under 15A NCAC 2Q. 0512
compliance with the conditions of the permit shall be deemed compliance with the applicable requirements specifically identified in the permit.),
(4) for applicable requirements that become effective during the term of the renewed permit that the facility shall comply on a timely basis,
(5) the facility shall fulfill applicable enhanced monitoring requirements and submit a compliance certification as required by 40 CFR Part 64.
The responsible official (signature on page 1) certifies under the penalty of law that all information and statements provided above, based on
information and belief formed after reasonable inquiry, are true, accurate, and complete.
SECTION AA3 - APPLICATION FOR NAME CHANGE
New Facility Name:
Former Facility Name:
An official facility name change is requested as described above for the air quality permit mentioned on page 1 of this form. Complete the other
sections if there has been modifications to the originally permitted facility that would require an air quality permit since the last permit was issued
and if there has been an ownership change associated with this name change.
SECTION AA4 - APPLICATION FOR AN OWNERSHIP CHANGE
By this application we hereby request transfer of Air Quality Permit No. 103735T39 from the former owner to the new owner as describe
below. The transfer of permit responsibility, coveraqe and liability shall be effective 07-01-2015 (immediately or insert date). The leqal
ownership of the facility described on paqe 1 of this form has been or will be transferred on 07-01-2015 (date). There have been no
modifications to the originally permitted facility that would require an air uaRV permit since the last permit was issued.
Signature of New (Buyer) Responsible Official/Authorized Contact (as ty d on page 1):
X Signature (Blue Ink):
Date: 06-19-2015
New Facility Name: I The Chemours Company FC, LLC DBA, Chemours Com an - Fayetteville Works
Former Facility Name: IThe Chemours Company FC, LLC DBA, Chemours Company - Fayetteville Works
Signature of Former (Seller) Responsible Official/Authorized Contact:
Name (typed or print): Ellis H. McGau h
Title: Plant Manager
X Signature (Blue Ink):
Date:06-19-2015
Former Legal Corporate/Owner Name: E. I. du Pont de Nemour nd Company
In lieu of the seller's signature on this form, a letter may be submitted with the seller's signature indicating the ownership change.
SECTION AA5 - APPLICATION FOR AN ADMINISTRATIVE AMENDMENT
Describe the requested administrative amendment here (attach additional documents as necessary):
Attach Additional Sheets As Necessary
Page 2 of 2
DEQ-CFW 00072072