2700-PM-AQ0202 Rev. 2/2002
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF AIR QUALITY
GENERAL PLAN APPROVAL & GENERAL OPERATING PERMIT
APPLICATION
General Permit BAQ-GPA/GP-2: Storage Tanks for Volatile Organic Liquids
SECTION A. OWNER INFORMATION
Owner
Address Line1
Address Line2
City State Zip+4
Phone
SECTION B. CONTACT INFORMATION
Contact Name
Contact Title
Address Line1
Address Line2
City State Zip+4
Phone
SECTION C. STORAGE TANK INFORMATION
Address Line1
Address Line2
Municipality
County
Tank ID#
Manufacturer
Date Installed
Capacity
Max Allowable Working Pressure (psig)
(gallons/M3)
PSV
Type of Relief Device
Relief Valve/Vent Set Pressure (psig)
Fixed
Type of Roof
Conservation Vent
Emergency Vent
Open Vent
Floating
Type of Liquid Stored
Vap Press of Liquid at Storage Temp (psia/kPa)
Closed Vent w/ Vapor Recovery & Control Device
Estimated Efficiency of Control Device
Yes
No
SECTION D. AFFIDAVIT
I certify that, subject to 18 Pa. C.S.A. Section 4904 and 35 P.S. Section 4009(b) that I am the official having
primary responsibility for the design and operation of the facilities to which this application applies and the
information provided in this application is true to the best of my knowledge, information and belief formed after
reasonable inquiry. I further certify that the facility will be operated in conformity with all limitations and conditions
of the Storage Tanks General Permit
Signature
Typed/Printed Name
Date