Example Notification of Compliance Status Report a

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Example Notification of Compliance Status Report a National Emission Standards for Hazardous Air Pollutants: Stationary Reciprocating Internal Combustion Engines 40 CFR part 63, subpart ZZZZ Note: The information to be provided in the Notification of Compliance Status Report will vary depending on the engine type. Affected sources should refer to 40 CFR part 63, subpart ZZZZ for engine-specific compliance requirements. The sample responses provided in this report are for existing stationary spark ignition (SI) 4-stroke rich burn (4SRB) engines above 500 horsepower (HP) located at an area source. SECTION I : GENERAL INFORMATION A. If you have been issued a Title V permit, do not complete this form. Submit your NOCS in accordance with your Title V permit. [ 63.9(h)(3)] B. If you have not been issued a Title V permit, complete the remaining portions of this section and also complete Sections II-IX. [ 63.9(h)(2)(i)] C. Print or type the following information for each facility for which you are making notification of compliance status: Permit Number (OPTIONAL) Facility I.D. Number (OPTIONAL) Responsible Official s Name/Title Street Address City State ZIP Code Facility Name (if different from Responsible Official s Name) Facility Street Address (If different than Responsible Official s Street Address) Facility Local Contact Name Title Phone (OPTIONAL) City State ZIP Code D. Indicate the relevant standard or other requirement that is the basis for this notification and the source s compliance date: ( 63.9(b)(2)(iii)) a This is an example of the type of information that must be submitted to fulfill the Notification of Compliance Status requirement of 40 CFR part 63, subpart ZZZZ. This Notification of Compliance Status is being made in accordance with 40 CFR 63.9(h). 1

Basis for this notification (relevant standard or other requirement) Compliance Date (mm/dd/yyyy) 40 CFR 63.6645 10/19/2013 SECTION II : CERTIFICATION (Note: you may edit this text as appropriate) Based upon information and belief formed after a reasonable inquiry, I, as a responsible official of the above-mentioned facility, certify the information contained in this report is accurate and true to the best of my knowledge. The above-mentioned facility (has/has not) complied with the relevant standard or and other applicable requirements referenced in the relevant standard. [ 63.9(h)(2)(i)(G)] Name of Responsible Official (Print or Type) Title Date (mm/dd/yyyy) Signature of Responsible Official Note: Responsible official is defined under 63.2 as one of the following: a president, vice-president, secretary, or treasurer of the company that owns the plant; the owner of the plant; the plant engineer or supervisor; a government official if the plant is owned by the Federal, State, city, or county government; or a ranking military officer if the plant is located on a military installation. SECTION III: METHODS Describe the methods you used to determine compliance. [ 63.9(h)(2)(i)(A)] Sample Response for existing stationary spark ignition (SI) 4-stroke rich burn (4SRB) engines above 500 horsepower (HP) located at an area source. This facility installed non-selective catalytic reduction (NSCR) to reduce formaldehyde emissions from their two (2) stationary existing 4SRB engines in order to comply with the emission standards in Table 2d of 40 CFR part 63, subpart ZZZZ. A performance test was conducted on 10/19/2013 using FTIR in accordance with the requirements in Table 4 of 40 CFR part 63, subpart ZZZZ. The catalyst inlet temperature and catalyst pressure drop were recorded during the initial performance test. This facility installed and operated a continuous parametric monitoring system (CPMS) to continuously measure the catalyst temperature according to the requirements in 40 CFR 63.6625(b) and (k). The catalyst inlet temperature and catalyst pressure drop that were recorded were within the allowed ranges as specified in Table 1b of 40 CFR part 63, subpart ZZZZ. This facility followed the startup requirements in 63.6625(h). The startup time was limited to 30 minutes and this facility minimized the engine s time spent at idle during startup. 2

SECTION IV: RESULTS Describe the results of any performance tests, opacity or visible emission observations, continuous monitoring system (CMS) performance evaluations, and/or other monitoring procedures or methods that were conducted. [ 63.9(h)(2)(i)(B)] Facility can attach test reports and output results from a CEMS and/or CPMS to this notification. Source ID Sample Response for existing stationary SI 4SRB engines above 500 HP located at an area source. Source Location Test Date Formaldeh yde Reduction Results Concentration Catalyst Inlet Temperature Catalyst Pressure Drop Startup Engine A Building 1 10/19/2013 82% 2.1 ppmvd at 15% O 2 900 F 0.2 inches 8 min Engine B Building 1 10/19/2013 85% 2.5 ppmvd at 15% O 2 1,100 F 0.15 inches 4 min Time SECTION V: CONTINUOUS COMPLIANCE Describe the methods you will use to determine continuous compliance, including a description of monitoring and reporting requirements and test methods. [ 63.9(h)(2)(i)(C)] Sample Response for existing stationary SI 4SRB engines above 500 HP located at an area source. This facility will determine continuous compliance with applicable requirements by continuing to use monitoring methods as identified in Section III and Section IV of this notification. In addition, the facility plans to do the following: (1) continuously monitoring the catalyst inlet temperature to ensure it remains greater than or equal to 750 F and less than or equal to 1,250 F; (2) monitor the catalyst pressure drop monthly to ensure that the pressure drop across the catalyst does not change by more than 2 inches of water from the pressure drop across the catalyst measured during the initial performance test; (3) conduct performance test on each engine every 8,760 hours of operation or 3 years, whichever comes first, to measure formaldehyde emissions to determine that formaldehyde is reduced by 76 percent or more; (4) record the necessary information as specified in 63.6655, and (5) submit the necessary notifications and reports, according to the requirements in 63.6645 and 63.6650. SECTION VI : EMISSIONS Describe the type and quantity of hazardous air pollutants (HAP) emitted by the source (or surrogate pollutants if specified in the relevant standard), reported in units and averaging times and in accordance with the test methods specified in the relevant standard. [ 63.9(h)(2)(i)(D)] The following hazardous air pollutants (HAP) were emitted by affected sources at this facility during the period 10/19/2013 10/31/2013. Source ID Source Location Source Description HAP Emitted HAP Emitted (tons) Engine A Building 1 Waukesha 4SRB 1,000 HP 0.008 non-emergency engine Engine B Building 1 Waukesha 4SRB 1,000 HP non-emergency engine 0.008 3

SECTION VII: FACILITY DESIGNATION If the relevant standard applies to both major and area sources, present an analysis demonstrating whether the affected source is a major source, using the emissions data generated for this notification. [ 63.9(h)(2)(i)(E)] This facility consists of two 1,000 HP rich burn engines. Each 1,000 HP engine emits 2.43 x10-4 lb/hp-hr of uncontrolled HAP emissions and operate continuously (8,760 hours per year). Consequently, yearly HAP emissions are 2.43 x10-4 lb/hp-hr x 8,760 hrs/yr x 1,000 HP x ton/2,000 lb x 2 engines = 2.1 tons/yr and below the threshold to be classified as a major source, therefore this facility is an area source. We do not expect these sources to emit HAP in quantities greater than the major source threshold. SECTION VIII: CONTROLS Describe the air pollution control equipment or method for each emission point, including each control device (or method) for each hazardous air pollutant and the control efficiency (percent) for each control device or method. [ 63.9(h)(2)(i)(F)] The following pollution control equipment is used for each engine listed at this facility. Additionally, this facility uses other compliance methods that do not involve pollution control equipment, including a CPMS. Source ID Source Location Equipment Type Control Device Control Efficiency HAP Controlled Engine A Building 1 Johnson Matthey 3-way (NSCR) Catalyst NSCR/AFR Reduces formaldehyde by 76% or more Engine B Building 1 Johnson Matthey 3-way (NSCR) Catalyst NSCR/AFR Reduces formaldehyde by 76% or more SECTION IX: CONSTRUCTION/RECONSTRUCTION A. Did you submit an application for construction or reconstruction under 63.5(d) that contained preliminary or estimated data? [ 63.9(h)(5)] Yes No Not applicable (did not submit an application for construction or reconstruction). B. If you answered yes, provide actual emission data or other corrected information below. 4

Notification of Compliance Status reports must be postmarked before the close of business on the 60 th calendar day following the completion of the relevant compliance demonstration specified in the standard, unless a different reporting period is specified. In the second case, the letter shall be postmarked before the close of business on the day the report of the testing or monitoring results is required to be delivered or postmarked. Notifications may be combined as long as the due date requirements are met for each notification. [40 CFR 63.9(h)(2)(ii)]. END OF FORM. A Responsible Official must sign this form See Section II. 5