3. Vendor’s and/or Manufacturer’s information attached? YES NO 4. Modeling Information attached? YES NO 5. Fugitive Dust Control Plan attached? YES NO 6. All Enclosures for your Specific Proposal attached? YES NO 7. Name and Title of Person Filling out this Form Printed Name Signature Date 8. Name and of Responsible Official Printed Name Signature Date XIII. ADDITIONAL INFORMATION FOR SPECIFIC EQUIPMENT (Attach Vendor’s Information) SAND / BOILER BURNER ASPHALT BOOTH GRAVEL 1. Type and 1. Type and 1. Type (Drum, 1.Crusher Type 1.Operation Type Number Number Batch) (Prim., Sec., Tertiary) 2. Application Method (attach layout) 2. Size (BTU 2. Size (BTU per 2. Size (tons per per hour hour input hour) 2. Size (tons per 3. Filter Bank Area hour) 3. NOx Rating 3. VOC Emission 3. Size (steam (PPPM@7% Points (attach 4. Filter Exhaust Flow pounds per Oxygen) layout) 3. Number of hour) Screens 5. Coating & Solvent Types & MSDS 4. CO Rating 4. VOC Controls Sheets (attach 4. Efficiency (PPM @ 4. Number of 7% Oxygen) Conveyors details) 5. Aggregate 5. NOx Rating Piles (acres) 6. Gun Cleaning Method (PPM@ 5. Fog 7% Oxygen) Location 6. Off Road (attach layout) 7. Drying Method Vehicle 6. CO Rating Use (miles per (PPM @ year) 6. Aggregate 7% Oxygen) (acres) 7. (Line, Genset, 7. Off Road etc.) Vehicle Use (miles per year)
3. Vendor’s and/or Manufacturer’s information attached? YES NO 4. Modeling Information attached? YES NO 5. Fugitive Dust Control Plan attached? YES NO 6. All Enclosures for your Specific Proposal attached? YES NO 7. Name and Title of Person Filling out this Form Printed Name Signature Date 8. Name and of Responsible Official Printed Name Signature Date XIII. ADDITIONAL INFORMATION FOR SPECIFIC EQUIPMENT (Attach Vendor’s Information) BOILER BURNER ASPHALT SAND / GRAVEL BOOTH 1. Type and Number 2. Size (BTU per hour 3. Size (steam pounds per hour) 4. Efficiency 5. NOx Rating (PPM@ 7% Oxygen) 6. CO Rating (PPM @ 7% Oxygen) 1. Type and Number 2. Size (BTU per hour input 3. NOx Rating (PPPM@7% Oxygen) 4. CO Rating (PPM @ 7% Oxygen) 1. Type (Drum, Batch) 2. Size (tons per hour) 3. VOC Emission Points (attach layout) 4. VOC Controls 5. Aggregate Piles (acres) 6. Off Road Vehicle Use (miles per year) 7. (Line, Genset, etc.) 1.Crusher Type (Prim., Sec., Tertiary) (attach layout) 2. Size (tons per hour) 3. Number of Screens 4. Number of Conveyors 5. Fog Location (attach layout) 6. Aggregate (acres) 7. Off Road Vehicle Use (miles per year) 1.Operation Type 2. Application Method 3. Filter Bank Area 4. Filter Exhaust Flow 5. Coating & Solvent Types & MSDS Sheets (attach details) 6. Gun Cleaning Method 7. Drying Method
ecy070412other.docx