DAQ-2024-010149

Utah Division of Air Quality
New Source Review Section Company___________________________
Site/Source__________________________
Form 4 Date_______________________________
Flare Systems

Equipment Information

1. Manufacturer:
_________________________
Model no.:
_________________________
(if available)

2. Design and operation shall be in accordance with 40CFR63.11. In addition
to the information listed in this form, provide the following: an assembly
drawing with dimensions, interior dimensions and features, flare’s
maximum capacity in BTU/hr.
3.Characteristics of Waste Gas Stream Input
Components Min. Value Expected
(scfm @ 68 oF, 14.7 psia)
Ave. Value Expected
(scfm @ 68oF, 14.7 psia)
Design Max.
(scfm @ 68oF, 14.7 psia)
a.

b.

c.

d.

e.

f.

g.

h.

4. Percent of time this
condition occurs

5. Flow rate: Minimum Expected Design Maximum Temp oF Pressure (psig)

Waste Gas Stream _______________ _______________ _______ ____________
Fuel Added to Gas Stream _______________ _______________ _______ ____________
Heat content of the gas to be flared ______________ BTU/ft3

6. Number of pilots

7. Type of fuel

8. Fuel Flow Rate (scfm @ 68oF & 14.7 psia) per pilot

Page 1 of 3
Page 2 of 3
Flare Systems
Form 4
(Continued)

Steam Injection

9. Steam pressure (psig)

Minimum Expected __________________
Design Maximum __________________

10. Total steam flow Rate (lb/hr)

11. Temperature (oF)

12. Velocity (ft/sec)

13. Number of jet streams

14. Diameter of steam jets (inches)

15. Design basis for steam injected (lb steam/lb hydrocarbon)
Water Injection

16. Water pressure (psig)

Minimum Expected __________________
Design Maximum __________________

17. Total Water Flow Rate (gpm)

Minimum Expected __________________
Design Maximum __________________

18. Number of water jets

19. Diameter of Water jets (inches)

20. Flare height (ft)

21. Flare tip inside diameter (ft)
Emissions Calculations (PTE)

22. Calculated emissions for this device
PM10 _________Lbs/hr_________ Tons/yr PM2.5 __________Lbs/hr________ Tons/yr
NOx __________Lbs/hr_________ Tons/yr SOx ___________Lbs/hr________ Tons/yr
CO __________Lbs/hr_________ Tons/yr VOC ___________Lbs/hr________Tons/yr
CO2 _________Tons/yr CH4 ___________Tons/yr
N2O _________Tons/yr
HAPs_________Lbs/hr (speciate)__________Tons/yr (speciate)
Submit calculations as an appendix. If other pollutants are emitted, include the emissions in the appendix.

Page 3 of 3

Instructions - Form 4 Flare Systems

NOTE: 1. Submit this form in conjunction with Form 1 and Form 2.

2. Call the Division of Air Quality (DAQ) at [phone] if you have problems or questions in filling out
this form. Ask to speak with a New Source Review engineer. We will be glad to help!

1. Specify the manufacturer and model number.
2. Supply an assembly drawing, dimensioned and to scale of the interior dimensions and features of the
equipment.
3. Supply the specifications of the fuel components in the waste gas stream.
4. Indicate what percent of the time the waste gas stream is at minimum, average, and maximum value.
5. Supply the specifications of the total waste gas stream and the fuel added to the gas stream.
6. Indicate the number of pilots in the flare.
7. Specify the type of fuel to be used.
8. Specify the fuel flow rate.
9. Indicate the minimum and design maximum steam pressure for steam injection.
10. Supply the steam flow rate.
11. Supply the temperature of the steam.
12. Specify the velocity of the steam.
13. Indicate the number of jet streams.
14. Give the diameter of the steam jets.
15. Give the design basis for the steam injection.
16. Specify the water pressure at minimum and design maximum using water injection.
17. Give the total water flow rate at minimum and design maximum.
18. Supply the number of water jets.
19. Give the diameter of the water jets.
20. Supply the flare height.
21. Supply the flare tip inside diameter.
22. Supply calculations for all criteria pollutants and HAPs. Use AP-42 or Manufacturers’ data to complete your
calculations.

U:aq\ENGINEER\GENERIC\Forms 2010\ Form04 Flare Systems.doc
Revised 12/20/10