Iowa Operating Permit Application

AIR QUALITY BUREAU Form 2.0 502 E 9th St Des Moines IA 50319

Operating Permit Application - Part 1 FORM 2.0: EMISSION POINT INFORMATION Form 2.0 Page of 1. Company/Facility Name: 2. EIQ Number: 3. Emission Point (EP) Number: 4. Emission Point Description: 5. Is this stack/vent used as an Emergency Bypass Stack? Yes No If Yes, for which stack(s)? List Emission Point Numbers:

EMISSION POINT INFORMATION 6. EP Type Vertical Stack/Vent Fugitive (specify) Wall Vent Other (specify) 7. Stack Shape and Dimensions: (interior dimensions at exit point) Circular Diameter: in. Rectangular Dimensions: in. x in. Other Dimensions in. 8. Stack Height Above Ground: ft.

9. Stack Location UTM Coordinates Easting (meters): Zone 14 Zone 15 UTM Zone and Datum: Northing (meters): NAD 27 NAD 83 10. Does the EP have a rain cap (or anything else) which obstructs the flow of gases leaving the EP? Yes No If Yes, specify:

11. Exhaust Stream Information Exhaust Stream Characteristics Units of Measure Exhaust Stream Value a) Flow Rate ACFM or SCFM b) Temperature Deg F 12. Bypass Stacks associated with this Emission Point Bypass Stack – Bypass Stack EP Number: Description Bypass Stack – Bypass Stack EP Number: Description 13. List of Emission Units (EU) Venting through this Emission Point EU Number EU Number EU Number EU Number

14. List of Control Equipment (CE) Associated with this Emission Point CE Number CE Number CE Number CE Number

15. List of Monitoring Equipment (ME) Associated with this Emission Point ME Number ME Number ME Number ME Number

12/2017 cmc Type or print all information DNR Form 542-4013 Duplicate this form for each emission point