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Home My WebLink AboutDAQ-2024-010165 Utah Division of Air Quality New Source Review Section Company: ___________________ Site/Source: _________________ Form 17 Date: _______________________ Diesel Powered Standby Generator Company Information 1. Company Name and Address: ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ Phone Number: _______________________________ Fax Number: _______________________________ 2. Company Contact: ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ Phone Number: _______________________________ Fax Number: _______________________________ 3. Installation Address: ____________________________________________ County where facility is located: __________________ ____________________________________________ ____________________________________________ Latitude, Longitude and UTM Coordinates of Facility ____________________________________________ __________________________________________ Phone Number: _______________________________ __________________________________________ Fax Number: _______________________________ Standby Generator Information 4. Engines: Maximum Maximum Emission Rate Date the engine Manufacturer Model Rated Hours of Rate of NOx was constructed Horsepower or Kilowatts Operation grams/BHP-HR or reconstructed _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ Attach Manufacturer-supplied information 5. Calculated emissions for this equipment: 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. Instructions Form 17 - Diesel Powered Standby Generator Call the Division of Air Quality (DAQ) at (801) 536-4000 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! Lines 1 Fill in the name, address, phone number, and fax number of the business applying for the and 2: permit exemption. Line 3 Fill in the address where the equipment will be located. Directions to business if needed for remote locations, i.e., five miles south of Deseret on highway 101, turn left at farmhouse, go 1.5 miles. Identify the county the equipment will be located. Also enter the latitude, longitude and UTM coordinates of the facility. Line 4 Fill in the manufacturer, model, maximum rated horsepower or kilowatts, maximum hours of operation, emission rate for NOx in grams/BHP-hr, and the date the engine was constructed or reconstructed. Attach manufacturer emission information. Note: Maximum rated horsepower not to exceed 1000hp or 750 kilowatts. Also maximum hours not to exceed 300 hours. Line 5 Supply calculations for all criteria pollutants, greenhouse gases and hazardous air pollutants. Use EPA AP-42 or manufacturers’ data to complete your calculations. Fill in the name, address, phone number, and fax number of the business applying for the U:\aq\ENGINEER\GENERIC\Forms 2010\Form17 Diesel-fired Standby Generators.doc Revised 12/20/10