Engineering Report for Generator Set GENERAL INFORMATION Name of firm/establishment: Plant address/location: Nature of business: Business Operation: Average Maximum Hrs/day Days/week Hrs/day Days/week FUEL BURNING STATIONARY SOURCE INSTALLATIONS Standby Generator Set ENGINE SPECIFICATIONS Brand Name/Model Rated HP Type of Fuel Fuel Consumption per Hour No. of Hrs. of Operation/Year Amount of Fuel Consumed No. of Cylinder Rated RPM Corresponding Air Pollution Control Device Liters/hour ALTERNATOR SPECIFICATIONS Brand Name Model No. Capacity Phase Voltage Frequency Power Factor/ Cos KVA CERTIFICATION ATTACHMENTS Emission Computation YES Vicinity Map Certificate of Registration Issued by the SEC or DTI Pictures of air pollution source and control installations Pollution Control Officer (PCO) appointment with conformance including Bio-data and Diploma/Official Transcript of Records This is to certify that all the information given above are true, accurate and complete. Should I / we learn if any information which would make this Engineering Report inaccurate, I / we should bring said information to the attention of the Environmental Management Bureau Regional Office. Attested by: __________________________ Preparer (Mechanical Engineer) ______________________ Owner SUBSCRIBED AND SWORN TO before me this _______day of _____________, at _________________________, Philippines. __________________________