Bureau of Air Quality Title V Operating Permit Application Permit Shield Instructions Page 1 of 2

PURPOSE FOR THE PERMIT SHIELD FORM:

Requesting a permit shield is optional. A permit shield means that if a facility demonstrates compliance with all terms/conditions of their Part 70 permit, it is considered to be in compliance with "all applicable requirements" as of the date of permit issuance. The permit shield will not be automatically granted to each applicant. The applicant must request this shield. In order for the BAQ to grant a permit shield, detailed information is needed from the applicant to verify all applicable as well as non-applicable requirements.

1. List the regulation citation (for example: 40 CFR 60 Subpart Dc). 2. List the regulation (for example: Standards of Performance for Small Industria1-CommercialInstitutional Steam Generating Units). 3. State whether the regulation is applicable or not. 4. If not applicable, provide a detailed explanation of why the regulation is not applicable. 5. If applicable, list all applicable requirements in the regulation that the facility requests to be shielded.

ITEM BY ITEM INSTRUCTIONS:

Additional tables or rows may be added to this form as needed. You may add additional tables in the document and/or rows in a table by selecting the “unprotect document” or “stop protection” function. The location and use of this function varies depending on your version of Word. (NOTE: password = baq.) You may copy and paste additional tables as necessary to list all of the equipment, processes, control devices, emission points, pollutants, emission rates, etc. Additional rows may be added to each table by using the tab key when the cursor is in the last cell of the bottom line, by right clicking on the mouse and inserting a row, or by copying and pasting a row. The forms “protect document” tool should then be reselected so that you may resume navigating through the forms with the “tab” key.

A. Application Identification

Please provide the information requested in this table.

1. SC Air Permit Number: The existing South Carolina Air Permit Number assigned by the Bureau of Air Quality. This number can be found on an existing permit.

2. Application Date: Please ensure that the Application Date is the same on all of the forms and required information submitted in this Title V Operating Permit application package.

3. Facility Name: The business name used to identify the commercial or industrial facility at the physical location.

B. Permit Shield Request

Please provide the information requested in this table.

1. Regulation Citation: List the regulation citation (such as S. C. Regulation 61-62.5, Standard No. 7, 40 CFR 60 Subpart Dc, etc.)

2. Regulation Title: A requirement established by the State or by the Administrator of the Environmental Protection Agency which limits the quantity, rate, or concentration of emissions of air pollutants on a continuous basis, including any requirements which limit the level of opacity, prescribe equipment, set fuel specifications, or prescribe operation or maintenance procedures for a source to assure continuous emission reduction.

3. Applicable: Select the appropriate response by checking either the "Yes" or "No" check box.

DHEC Form # 2948 (09/2013) Bureau of Air Quality Title V Operating Permit Application Permit Shield Instructions Page 2 of 2

4. Applicable / Non Applicable Requirement: If applicable, list all applicable requirements in the regulation that the facility requests to be shielded. Include emission units and equipment subject. Include emission limits, testing, monitoring, record keeping, reporting, etc. If not applicable, provide a detailed explanation of why the regulation is not applicable.

DHEC Form # 2948 (09/2013)