2700-PM-AQ0006
Instructions
7/2001
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF AIR QUALITY
INSTRUCTIONS FOR COMPLETING
A PLAN APPROVAL APPLICATION

See the detailed instruction package
available for plan approval applications.

Use only the pages for the air cleaning
devices that pertain to this project and
remove the remaining pages.



If there is more than one air cleaning device
of the same type, copy the page for air
cleaning devices and provide the
appropriate information for each device.
If the proposed source is connected to
more than one stack and exhauster, copy
the page for the stack and and provide the
appropriate information for each stack and
exhauster.
Use additional sheets of paper, if the space
provided is not sufficient to provide detailed
information required for review and
approval..

Information may be grouped into a single
attachment for each section or air cleaning
device.

Number all pages of the application
(Sections A through G) accordingly.

Attach appropriate calculations and
documentation.

Attach any and all information on source
and air cleaning device(s) for a thorough
evaluation of the extent and nature of
emissions.

Identify, number and list all attachments
made to this application (e.g., Attachment
#1-Section A).

Submit three (3) sets of the completed
application with all attachments to the
appropriate Regional Office.
2700-PM-AQ0006
7/2001
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF AIR QUALITY
Submit in Triplicate
BULK GASOLINE PLANTS/TERMINALS/ GASOLINE STORAGE TANKS
Application for Plan Approval to Construct, Modify or Reactivate an
Air Contamination Source and/or Install an Air Cleaning Device
This application and the General Information Form (GIF) must be included in the submittal
Before completing this form, read the instructions provided with this form.
Section A - Facility Name, Checklist And Certification
Organization Name or Registered Fictitious Name/Facility Name:
DEP Client ID# ( See General Information Form [GIF] , Section B ):
Type of Review required and Fees:
Source which is not subject to NSPS, NESHAPs, MACT, NSR and PSD: ............... $
Source requiring approval under NSPS or NESHAPS or both: ................................. $
Source requiring approval under NSR: ...................................................................... $
Source requiring the establishment of a MACT limitation:......................................... $
Source requiring approval under PSD: ...................................................................... $
Applicant’s Checklist
Check the following list to make sure that all the required documents are included.
Permit Application-General Information Form (GIF)
Sections A through G: Bulk gasoline plants/terminals/gasoline storage tanks application
Compliance Review Form or provide reference of most recently submitted compliance review form for
facilities submitting on a periodic basis:
Copy and Proof of County and Municipal Notifications
Permit Fees
Addendum A: Source Applicable Requirements (only applicable to existing Title V facility)
Certification of Truth, Accuracy and Completeness by a Responsible Official
, certify under penalty of law in 18 Pa. C. S. A. §4904, and
I,
35 P.S. §4009(b) (2) that based on information and belief formed after reasonable inquiry, the statements and information
in this application are true, accurate and complete.
(Signature):
Name (Print):
Date:
Title:
OFFICIAL USE ONLY
Application No.
DEP Client ID #:
Date Received
Date of 1st Technical Deficiency
Comments:
Unit ID
APS. ID
Date Assigned
Site ID
AUTH. ID
Reviewed By
Date of 2nd Technical Deficiency
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2700-PM-AQ0006
7/2001
Section B - Bulk Gasoline Plants, Terminals and Tanks Information
Bulk Gasoline Plants/Terminals Information (25 Pa. Code § 129.59, § 129.60 and § 129.62)
Check appropriate box:
Bulk Gasoline Plants
Bulk Gasoline Terminals
Type of vehicular receiving tank loading:
Bottom fill with the inlet flush with the receiving vehicular tank bottom
Top-submerged fill with the fill pipe extended to within six (6) inches of the bottom of the vehicular tank
Provide following information in gallons:
Maximum unrestricted daily throughput:
Maximum unrestricted annual throughput:
Requested annual throughput:
Type of hatch vapor closure on loading arms of bulk gasoline terminals:
Pneumatic
Hydraulic
Other mechanical device, explain
Is a vapor balance technique utilized for filling storage tanks from vehicular tanks?
Yes
No
Is a vapor balance technique utilized for filling vehicular tanks from storage tanks?
Yes
No
Rated capacity of gasoline tank trucks:
Specify the vapor collection and vapor disposal systems
Mark the following requirements that apply to Bulk Gasoline Plants/Terminals (25 Pa. Code § 129.62)
For the transfer of gasoline between the tank truck or trailer and a stationary storage tank, the vapor balance
system is in good working order and designed and operated in a manner that prevents:

Gauge pressure from exceeding 18 inches of water (4,500 pascals) and vacuum from exceeding six (6)
inches of water (1,500 pascals) in the gasoline tank truck.

A reading equal to or greater than 100% of the lower explosive limit LEL, measured as propane at 1 inch
from points on the perimeter of a potential leak source when measured by the method referenced in 25 Pa.
Code § 139.14 during loading or unloading operations at small gasoline storage tanks, bulk plants and bulk
terminals.

Avoidable liquid leaks during loading or unloading operations at small gasoline storage tanks, bulk plants
and bulk terminals.
There are no visually or audibly detectable leaks in the tank truck’s or trailer’s pressure/vacuum relief valves and
hatch covers, the truck tanks or storage tanks, or associated vapor and liquid lines during loading or unloading.
The pressure and vacuum relief valves on storage vessels and tank trucks or trailers are set to release at no
less than .7 psig (4.8 kilopascals) of pressure or .3 psig (2.1 kilopascals) of vacuum.
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2700-PM-AQ0006
7/2001
Section B - Bulk Gasoline Plants, Terminals and Tanks Information (Continued)
Gasoline Storage Tank Information
Storage Tank Type:
Fixed roof tank
Other:
Internal floating roof tank
External floating roof tank
Tanks Detail (specify unit):
Height
Diameter
Design Capacity
Color
Layout:
Internal tank condition
External tank condition
Tank Construction (welded, riveted, etc)
Average Liquid Height
Maximum Liquid Height
Net throughput (gals or barrels/year)
Vertical
Horizontal
Working Volume
Attach monthly throughput volumes if there are variations in throughput from month to month.
Is tank heated:
Yes, explain
No
Is tank insulated:
Yes, explain
No
Breather Vent Settings: Vacuum Setting (psig):
Turnovers/year:
Pressure Setting (psig):
Primary Seal Type
Secondary Seal Type
Roof Details:
Type of roof
Roof height
Roof radius
Roof slope
Roof condition
Self supporting roof:
Yes
No
Roof color/shade
Roof fitting category
Deck Details:
Type of deck
Deck construction
Deck seam
Deck seam length
Deck fitting category
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2700-PM-AQ0006
7/2001
Section B - Bulk Gasoline Plants, Terminals and Tanks Information (Continued)
Miscellaneous Information
Mark the following requirements that apply to storage tanks. If answer is no, provide explanation on a separate sheet.
External Floating Roof
Is external floating roof fitted with a primary seal and a continuous secondary seal extending from the
floating roof to the tank wall (rim-mounted secondary seal)?
For tanks with vapor-mounted primary seals, is the accumulated area of gaps exceeding 1/8 inch in
width between the secondary seal and the tank wall exceed one (1) square inch per foot of tank
diameter?
Are openings in the external floating roof, except for automatic bleeder vents, rim space vents and leg
sleeves, equipped with covers, seals or lids in the closed position except when the openings are in
actual use? Also, shall opening equipped with projections into the tank that remain below the liquid
surface at all times?
Are automatic bleeder vents closed at all times except when the roof is floated off or landed on the roof
leg supports?
Are rim vents set to open when the roof is being floated off the leg supports and at the recommended
setting of the manufacturer?
Are emergency roof drains provided with slotted membrane fabric covers or equivalent covers which
cover at least 90% of the area of the opening?
Internal Floating Roof
Is internal floating roof fitted with a primary seal and a closure seal or seals, to close the space
between the roof edge and tank wall?
Are openings except stub drains equipped with covers, lids or seals such that:

The cover, lid or seal is in the closed position at all times except when in actual use;

Automatic bleeder vents are closed at all times except when the roof is floated off or landed on the
roof leg supports; and

Rim vents, if provided, are set to open when the roof is being floated off the roof leg supports or at
the recommended setting of the manufacturer?
Page ___ of ___
Yes
No
2700-PM-AQ0006
7/2001
Section B - Bulk Gasoline Plants, Terminals and Tanks Information (Continued)
Miscellaneous Information
Attach layout of tank location in plant. Attach schematic drawing of the roof seals used on floating roof tanks.
Describe, in detail, the equipment provided to monitor and to record the source(s) operating conditions, which may affect
emissions of air contaminants. Show that they are reasonable and adequate.
Describe each proposed modification to an existing source.
Anticipated milestones:
i. Expected commencement date of construction/reconstruction/installation:
ii. Expected completion date of construction/reconstruction/installation:
iii. Anticipated date(s) of start-up:
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2700-PM-AQ0006
7/2001
Section C - Air Cleaning Device
ADSORPTION EQUIPMENT
a. Equipment Specifications
Manufacturer
Type
Design Inlet Volume (SCFM)
Model No.
Adsorbent Charge per Adsorber Vessel and Number of
Adsorber Vessels
Length of Mass Transfer Zone (MTZ) supplied by the manufacturer based upon laboratory data
Adsorber Diameter (ft.) and Area (ft.2)
Adsorption Bed Depth (ft.)
Adsorbent Information
Adsorbent Type and Physical Properties
Working Capacity of Adsorbent (%)
Heel percent or Unrecoverable Solvent Weight percent in
the Adsorbent after Regeneration
b. Operating Parameters
Inlet Volume (ACFM)
@
F
Adsorption Time per Adsorption Bed
Breakthrough Capacity:
lbs of Solvent/100 lbs of Adsorbent =
Vapor Pressure of Solvents at the Inlet Temperature
Available Steam in Pounds to Regenerate Carbon
Adsorber (if applicable)
Percent Relative Saturation of each Solvent at the Inlet Temperature
Attach any additional data including auxiliary equipment and operation details to thoroughly evaluate the control equipment.
Attach the warning/alarm system that protects against operation when unit is not meeting design requirements.
Emissions Data
Pollutant
Inlet
Outlet
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Removal Efficiency (%)
2700-PM-AQ0006
7/2001
Section C - Air Cleaning Device, Continued
ABSORPTION EQUIPMENT
a. Equipment Specifications
Manufacturer
Type
Model No.
Design Inlet Volume (SCFM)
Tower Height (ft) and Inside Diameter (ft)
Design Inlet Volume (SCFM)
Tower Height (ft) and inside diameter (ft)
Number of Trays (If Applicable)
Number of Bubble Caps (If Applicable)
Configuration
Counter-Current
Cross Flow
Cocurrent Flow
Describe pH and/or other monitoring and controls.
Absorbent information
Absorbent type and concentration
Retention time (sec.)
Attach equilibrium data for absorption (if applicable).
Attach any additional information regarding auxiliary equipment, absorption solution supply system (once through or
recirculating, system capacity, etc) to thoroughly evaluate the control equipment. Indicate the flow rates for makeup, bleed
and recirculation.
b. Operating Parameters
Volume of gas handled (ACFM)
Inlet temperature (F)
Pressure drop (in. of water) and liquid flow rate
Describe the monitoring equipment.
State operating range for pH and/or absorbent concentration in scrubber liquid.
Describe the warning/alarm system that protects against operation when unit is not meeting design requirements.
c. Emissions Data
Pollutant
Inlet
Outlet
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Removal Efficiency (%)
2700-PM-AQ0006
7/2001
Section C - Air Cleaning Device, Continued
OTHER CONTROL EQUIPMENT
a. Equipment Specifications
Manufacturer
Type
Model No.
Design Inlet Volume (SCFM)
Capacity
Describe pH monitoring and pH adjustment, if any.
Indicate the liquid flow rate and describe equipment provided to measure pressure drop and flow rate , if any.
Attach efficiency curve and/ or other efficiency information.
Attach any additional data including auxiliary equipment and operation details to thoroughly evaluate the control equipment.
b. Operating Parameters
Volume of Gas Handled:
ACFM @
°F
% Moisture
Describe, in detail, important parameters and method of operation.
Describe the warning/alarm system that protects against operation when unit is not meeting design requirements.
c. Emissions Data
Pollutant
Inlet
Outlet
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Removal Efficiency (%)
2700-PM-AQ0006
7/2001
Section C - Air Cleaning Device, Continued
COSTS
Indicate cost associated with air cleaning device and its operating cost (attach documentation, if necessary)
Device
Direct Cost
Indirect Cost
Total Cost
Annual Operating
Cost
MISCELLANEOUS
Attach manufacturer's performance guarantees and/or warranties for each of the major components of the control system
(or complete system).
Attach the maintenance schedule for the control equipment and any part of the process equipment that, if in disrepair,
would increase air contaminant emissions.
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2700-PM-AQ0006
7/2001
Section D - Additional Information
1. Will the construction, modification, etc. of the sources covered by this application increase emissions from other
sources at the facility? If so, describe and quantify.
2. If this project is subject to any one of the following, attach a demonstration to show compliance with applicable
standards.
a. Prevention of Significant Deterioration permit (PSD), 40 CFR 52?
YES
NO
b. New Source Review (NSR), 25 Pa. Code Chapter 127, Subchapter E?
YES
NO
c.
YES
NO
d. National Emissions Standards for Hazardous Air Pollutants (NESHAPS),
40 CFR Part 61? (If Yes, which subpart)
YES
NO
e. Maximum Achievable Control Technology (MACT) 40 CFR Part 63?
(If Yes, which subpart)
YES
NO
New Source Performance Standards, 40 CFR Part 60?
(If Yes, which subpart)
3. Attach a demonstration showing that the emissions from any new source will be the minimum attainable through the
use of best available technology (BAT).
4. Provide emission increases and decreases in allowable (or potential) and actual emissions within the last 5 years for
applicable PSD pollutant(s) if the facility is an existing major facility (for PSD purposes).
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2700-PM-AQ0006
7/2001
Section D - Additional Information (Continued)
5. Indicate emission increases and decreases in tons per year (tpy), for volatile organic compounds (VOCs) and nitrogen
oxides (NOx) for NSR applicability since January 1, 1991 or other applicable dates (see other applicable dates in
instructions). The emissions increases include all emissions including stack, fugitive, material transfer, other emission
generating activities, quantifiable emissions from exempted source(s), etc.
Permit
number
(if applicable)
Date
issued
Indicate Yes
or No if
emission
increases and
decreases
were used
previously for
netting
Source I. D. or Name
VOCs
Emission
increases Creditable
in
emission
potential
decreases
to emit
in actual
emissions
(tpy)
(tpy)
NOx
Emission
increase
s in
potential
to emit
(tpy)
Creditable
emission
decreases
in actual
emissions
(tpy)
6. If the source is subject to 25 Pa. Code Chapter 127, Subchapter E, New Source Review requirements,
a. Identify Emission Reduction Credits (ERCs) for emission offsets or demonstrate ability to obtain suitable ERCs for
emission offsets.
b. Provide a demonstration that the lowest achievable emission rate (LAER) control techniques will be implemented
(if applicable).
c.
Provide an analysis of alternate sites, sizes, production processes and environmental control techniques
demonstrating that the benefits of the proposed source outweigh the environmental and social costs (if applicable).
7. Attach calculations and any additional information necessary to thoroughly evaluate compliance with all the applicable
requirements of 25 Pa. Code Article III and applicable requirements of the Clean Air Act and regulations adopted there
under. The Department may request additional information to evaluate the application such as a standby plan, a plan
for air pollution emergencies, air quality modeling, etc.
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2700-PM-AQ0006
7/2001
Section E - Compliance Demonstration
Note: Complete this section if the facility is not a Title V facility. Title V facilities must complete Addendum A.
1. Method of Compliance Type: Check all that apply and complete all appropriate sections below
Monitoring
Testing
Reporting
Recordkeeping
Work Practice Standard
Other:
2. Monitoring:
a. Monitoring device type (stack test, CEM etc.):
b. Monitoring device location:
c.
Describe all parameters being monitored along with the frequency and duration of monitoring each parameter:
3. Testing:
a. Reference Test Method Citation:
b. Reference Test Method Description:
4. Recordkeeping:
Describe the parameters that will be recorded and the recording frequency:
5. Reporting:
a. Describe the types of information to be reported and the reporting frequency:
b.
Reporting start date:
6. Work Practice Standard (Describe each):
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2700-PM-AQ0006
7/2001
Section F - Flue and Air Contaminant Emission
1. ESTIMATED ATMOSPHERIC EMISSIONS*
Maximum emission rate
Pollutant
specify units
lbs/hr
Calculation/
Estimation Method
tons/yr.
PM
PM10
SOx
CO
NOx
VOC
Others: ( e.g., HAPs)
* These emissions must be calculated based on the requested operating schedule and/or process rate e.g., operating
schedule for maximum limits or restricted hours of operation and /or restricted throughput. Describe how the emission
values were determined. Attach calculations.
2. STACK(S) AND EXHAUSTER(S)
Stack Designation/Number
List Source(s) or Source IDs Exhausted to this stack
% of flow exhausted to stack
Stack height above grade (ft.)
Grade elevation (ft.)
Stack diameter (ft) or Outlet duct area (sq.
ft.)
Weather Cap
YES
NO
Distance of discharge to nearest property line (ft.). Locate on topographic map.
Does stack height meet Good Engineering Practice (GEP), if applicable.
If modeling (estimating) of ambient air quality impacts is needed, attach a site plan with buildings and their dimensions and other
obstructions.
UTM Location of Stack:
Stack exhaust
Easting :
Volume
ACFM
Northing:
Temperature
F
Moisture
%
Indicate on an attached sheet the location of sampling ports with respect to exhaust fan, breeching, etc. Give all necessary dimensions.
Exhauster (attach fan curves)
in. of water
Page ___ of ___
HP @
RPM.
2700-PM-AQ0006
7/2001
Section G - Attachments
Number and list all attachments submitted with this application below:
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