INTERNAL COMBUSTION ENGINES
PORTABLE EQUIPMENT REGISTRATION SUPPLEMENTAL APPLICATION
This form must be submitted in conjunction with the PORTABLE EQUIPMENT REGISTRATION APPLICATION form.
1.
REGISTRATION TO
BE ISSUED TO:
2.
WILL THE EQUIPMENT BE REGISTERED AS NON-OPERATIONAL? [ ] YES [ ] NO
If YES, a non-operational registration will be issued. Emission units registered as non-operational at the time of initial registration
shall not be operated until the District has evaluated the equipment and has issued a revised registration authorizing equipment
operation. The registered owner or operator shall submit a written request, including the standard registration fees, to activate
non-operational equipment. The District shall have up to 30 days to act on such requests.
3. COMPLETE THE TABLE BELOW:
IC ENGINE EMISSION FACTORS
In grams per Brake Horsepower-Hour, g/BHP-HR
SERIAL #
MANUFACTURER
MODEL #
NOx
SOx
CO
VOC
PM10
4. INDICATE THE SOURCE OF THE EMISSION FACTORS.
[ ] Emission Tests [ ] Manufacturer’s Guarantee/Estimate
Please provide the appropriate supporting documentation.
[ ] Other
5. INDICATE THE MAXIMUM RATED POWER OUTPUT OF THE ENGINE (BHP):_____________________________
6. THE INITIAL DATE OF OPERATION OF THE ENGINE: ______________ Attach documentation of historical operation.
7. PROCESS THE ENGINE SERVES:________________________________________________________
8. EMISSIONS INFORMATION:
EPA/ARB Teir certification level (0, 1, 2, 3 or 4): ______ If certified, provide documentation of resided (operated) in CA.
If non-certified, you must provide documentation of being operated in SJV between 03/04/04 and 10/01/06. Non-certified engines may not
operate beyond December 31, 2009.
9.
CONTROL EQUIPMENT INFORMATION:
Please indicate which of the following is applicable.
[ ] Turbocharged
[ ] Intercooled
[ ] Aftercooled
[ ] Timing Retarded 4°
[ ] PCV
[ ] NSCR
[ ] Pre-Certified, Certification #:____________________________________________________________________
10. INDICATE THE MAXIMUM ANTICIPATED OPERATING TIME, IN HOURS PER DAY:
Central Region Office * 1990 East Gettysburg Avenue, Fresno, California 93726-0244 * (559) 230-5900 FAX (559) 230-6061
01/2009
SUPPLMENTAL APPLICATION FOR
PORTABLE IC ENGINE REGISTRATION
- INSTRUCTIONS A.
A non-refundable fee of $177.00 is required for each emissions unit that will be registered ($12 is required if the equipment will
be registered as non-operational). $106 will be credited for the first year’s operation. An emissions unit is any distinct internal
combustion engine with a maximum rating greater than 50 hp. If you do not know the total number of emissions units, the
District will determine that for you and send a bill for the appropriate fee. Make checks or money orders payable to the
SJVAPCD.
B.
Line 1. Indicate the name of the business exactly as it should appear on the Portable Equipment Registration.
C.
Line 2. Indicate if the engine will be registered as non-operational. If non-operational, the engine may not be operated until a
valid portable registration application has been processed by the District.
D.
Line 3. Indicate complete the engine information as complete as possible. If information is unknown, the District will attempt
to gather the information independently.
E.
Line 4. Identify the source of the emission factors.
F.
Line 5 Indicate the maximum rated brake horsepower (bhp) of the engine.
G.
Line 6 List the date that the unit was initially operated in California.
H.
Line 7. Identify the process the engine is coupled to (for instance, electrical generator, grinder, etc.)
I.
Line 8. Indicate EPA/ARB Tier certification level. If the engine is not certified, please indicate by a “0”. If the engine is not
certified, please provide documentation (purchase, maintenance, or fuel records, etc.) that show the engine operated in the
District sometime between March 4, 2004 and October 1, 2006. If the engine is certified, please provide documentation
(purchase, maintenance, or fuel records, etc.) that show the date the engine first operated in California. If the engine is not
certified, it may not operate beyond December 31, 2009.
J.
Line 9. Check all known emissions control equipment installed on the engine. Write the EPA/ARB certification number on the
line given.
K.
Line 10. Indicate the maximum anticipated operating time, in hours per day.
Applications may be submitted by mail or in person at any District office. The District is pleased to provide small businesses with
assistance in all aspects of the registration process. Businesses are welcome to call the Small Business Assistance (SBA) Hotline or visit
the Small Business Assistance Office located in each of our regional offices. No appointment is necessary. For more information call the
SBA Hotline serving the region in which your business is located.
Northern Regional Office
(San Joaquin, Stanislaus and Merced Counties)
Central Regional Office
Southern Regional Office
(Madera, Fresno and Kings Counties) (Tulare and Kern Counties)
4800 Enterprise Way
Modesto, CA 95356-8718
(209) 557-6400
FAX: (209) 557-6475
SBA HOTLINE: (209) 557-6446
1990 E. Gettysburg Avenue
Fresno, CA 93726-0244
(559) 230-5900
FAX: (559) 230-6061
SBA HOTLINE: (559) 230-5888
34946 Flyover Court
Bakersfield, CA 93308
(661) 392-5500
FAX: (661) 392-5585
SBA HOTLINE: (661) 392-5665
01/2009