ILLINOIS ENVIRONMENTAL PROTECTION AGENCY
FOR APPLICANT'S USE
DIVISION OF AIR POLLUTION CONTROL -- PERMIT SECTION
Revision #: ________________
P.O. BOX 19506
Date: _____ / _____ / _____
SPRINGFIELD, ILLINOIS 62794-9506
Page _________ of ________
FOR AGENCY USE ONLY
Request For Authorization
ID NUMBER:
PERMIT #:
For NO
Averaging For
X
DATE:
Electrical Generating Units (EGU)
This application form is to be used to request a permit for an electrical generating unit that authorizes use of averaging in accordance with 35 IAC
217.708 to comply with the NOx emissions reduction requirements of 35 IAC Part 217, Subpart V.
SECTION 1: SOURCE AND EGU INFORMATION
1) COMPANY NAME:
2) PLANT OR FACILITY NAME:
3) DATE FORM
4) SOURCE ID NO.:
5) ORIS / FACILITY CODE:
PREPARED: ____ / ____ / _______
6) ELECTRICAL GENERATING UNITS:
GENERATING UNIT / EGU
EXPECTED RANGE OF
DESIGNATION & DESCRIPTION
SEASONAL NO
RATE
APPROACH TO NO
MONITORING
X
X
NOx Emissions Monitoring System (35 IAC 217.710(a))
______ to ______
Alternative Protocol for Peaking Units (35 IAC 217.710(b))
lb NO
/ mmBtu
Alternative Protocol for Certain Turbines (35 IAC 217.710(c))
X
NOx Emissions Monitoring System (35 IAC 217.710(a))
______ to ______
Alternative Protocol for Peaking Units (35 IAC 217.710(b))
lb NO
/ mmBtu
Alternative Protocol for Certain Turbines (35 IAC 217.710(c))
X
NOx Emissions Monitoring System (35 IAC 217.710(a))
______ to ______
Alternative Protocol for Peaking Units (35 IAC 217.710(b))
lb NO
/ mmBtu
Alternative Protocol for Certain Turbines (35 IAC 217.710(c))
X
NOx Emissions Monitoring System (35 IAC 217.710(a))
______ to ______
Alternative Protocol for Peaking Units (35 IAC 217.710(b))
lb NO
/ mmBtu
Alternative Protocol for Certain Turbines (35 IAC 217.710(c))
X
NOx Emissions Monitoring System (35 IAC 217.710(a))
______ to ______
Alternative Protocol for Peaking Units (35 IAC 217.710(b))
lb NO
/ mmBtu
Alternative Protocol for Certain Turbines (35 IAC 217.710(c))
X
NOx Emissions Monitoring System (35 IAC 217.710(a))
______ to ______
Alternative Protocol for Peaking Units (35 IAC 217.710(b))
lb NO
/ mmBtu
Alternative Protocol for Certain Turbines (35 IAC 217.710(c))
X
NOx Emissions Monitoring System (35 IAC 217.710(a))
______ to ______
Alternative Protocol for Peaking Units (35 IAC 217.710(b))
lb NO
/ mmBtu
Alternative Protocol for Certain Turbines (35 IAC 217.710(c))
X
NOx Emissions Monitoring System (35 IAC 217.710(a))
______ to ______
Alternative Protocol for Peaking Units (35 IAC 217.710(b))
lb NO
/ mmBtu
Alternative Protocol for Certain Turbines (35 IAC 217.710(c))
X
NOx Emissions Monitoring System (35 IAC 217.710(a))
______ to ______
Alternative Protocol for Peaking Units (35 IAC 217.710(b))
lb NO
/ mmBtu
Alternative Protocol for Certain Turbines (35 IAC 217.710(c))
X
The Illinois EPA is authorized to require, and you must disclose, the requested information on this form pursuant to Section 39.5 of the
Environmental Protection Act (“Act”) 415 ILCS 5/39.5. This information shall be provided using either this form or in an alternative manner at your
discretion. Failure to disclose the information may result in your application being denied and/or penalties as provided for in the Act, 415 ILCS
5/42-45. This form has been approved by the Forms Management Center.
FOR APPLICANT'S USE
______________
APPLICATION PAGE _______
Printed on Recycled Paper
640-CAAPP
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