CLEAN AIR ACT COMPLIANCE CHECKLIST

PART I: FACILITY IDENTIFICATION

A. Facility Information

Facility Name: [________________________________]

Facility Address:
Street: [________________________________]
City: [________________________________]
State: [____] ZIP Code: [__________]
County: [________________________________]

Air Quality Permit Number(s): [________________________________]

EPA Facility ID (if applicable): [________________________________]

B. Facility Contacts

Responsible Official:
Name: [________________________________]
Title: [________________________________]
Phone: [________________________________]
Email: [________________________________]

Environmental Compliance Manager:
Name: [________________________________]
Title: [________________________________]
Phone: [________________________________]
Email: [________________________________]

C. Facility Description

SIC Code(s): [________________________________]
NAICS Code(s): [________________________________]

Primary Business Activity:
[________________________________]
[________________________________]

PART II: SOURCE CLASSIFICATION AND PERMIT STATUS

A. Major Source Determination

Potential to Emit (PTE) Calculations:

Attainment Status of Area:
☐ Attainment for all NAAQS
☐ Nonattainment for: [________________________________]
☐ Maintenance Area for: [________________________________]

B. Source Classification

Based on PTE calculations, facility is classified as:

☐ Title V Major Source
- PTE ≥ 100 tpy of any criteria pollutant (attainment), or
- PTE ≥ applicable major source threshold in nonattainment area, or
- PTE ≥ 10 tpy of any single HAP, or
- PTE ≥ 25 tpy of combined HAPs

☐ Synthetic Minor Source (with federally enforceable limitations)

☐ True Minor Source (PTE below all thresholds)

☐ Area Source (non-major HAP source)

C. Permit Status

Title V Operating Permit:
☐ Required and Obtained
Permit Number: [________________________________]
Issue Date: [__/__/____]
Expiration Date: [__/__/____]
☐ Required - Application Pending
☐ Not Required

Construction/PSD/NSR Permit:
☐ Prevention of Significant Deterioration (PSD) Permit
☐ Nonattainment New Source Review (NSR) Permit
☐ Minor Source Permit
☐ Not Required

Permit Numbers and Dates:
| Permit Type | Number | Issue Date | Expiration Date |
|-------------|--------|------------|-----------------|
| [________________] | [________________] | [__/__/____] | [__/__/____] |
| [________________] | [________________] | [__/__/____] | [__/__/____] |
| [________________] | [________________] | [__/__/____] | [__/__/____] |

PART III: EMISSION UNIT INVENTORY

A. Emission Units

B. Control Equipment

PART IV: REGULATORY APPLICABILITY DETERMINATION

A. New Source Performance Standards (NSPS) (40 CFR Part 60)

Applicable NSPS Subparts:
☐ Subpart A - General Provisions
☐ Subpart [____]: [________________________________]
☐ Subpart [____]: [________________________________]
☐ Subpart [____]: [________________________________]
☐ No NSPS Applicable

NSPS Compliance Requirements:

B. National Emission Standards for Hazardous Air Pollutants (NESHAPs)

Applicable NESHAP Subparts (40 CFR Part 61):
☐ Subpart [____]: [________________________________]
☐ No Part 61 NESHAPs Applicable

Applicable MACT Standards (40 CFR Part 63):
☐ Subpart A - General Provisions
☐ Subpart [____]: [________________________________]
☐ Subpart [____]: [________________________________]
☐ No Part 63 MACTs Applicable

HAP Emissions:

C. State Implementation Plan (SIP) Requirements

Applicable SIP Rules:
☐ Reasonably Available Control Technology (RACT)
☐ New Source Review (NSR)
☐ Emission Inventory Reporting
☐ Opacity Limits
☐ Fuel Restrictions
☐ Other: [________________________________]

PART V: TITLE V OPERATING PERMIT COMPLIANCE

A. General Permit Conditions

Compliance Status Checklist:

B. Annual Compliance Certification

Certification Due Date: [__/__/____]

Certification Checklist:
☐ All applicable requirements identified
☐ Compliance status determined for each requirement
☐ Deviations documented and reported
☐ Certification signed by responsible official
☐ Certification submitted by deadline

Last Certification Submitted: [__/__/____]
Next Certification Due: [__/__/____]

C. Deviation Reporting

Deviations in Current Reporting Period:

PART VI: MONITORING REQUIREMENTS

A. Continuous Emission Monitoring Systems (CEMS)

CEMS Equipment:

CEMS Quality Assurance:
☐ Daily Calibration Drift Checks
☐ Quarterly Cylinder Gas Audits (CGA)
☐ Quarterly Relative Accuracy Test Audits (RATA)
☐ Annual RATA (if applicable)

B. Continuous Opacity Monitoring Systems (COMS)

COMS Status:
☐ Required and Operational
☐ Required - Not Operational (explain): [________________________________]
☐ Not Required

C. Parametric Monitoring

D. Periodic Stack Testing

Testing Schedule:

PART VII: RECORDKEEPING REQUIREMENTS

A. Required Records

Record Retention Period: [________] years (minimum 5 years for Title V)

Records Maintained:
☐ Emission calculations and supporting data
☐ Fuel usage records
☐ Production records
☐ Raw material usage records
☐ Control device operating parameters
☐ Monitoring data (CEMS, parametric, etc.)
☐ Maintenance logs
☐ Training records
☐ Inspection records
☐ Stack test reports
☐ Deviation reports
☐ Compliance certifications

B. Records Organization

Record Storage Location: [________________________________]
Electronic Records System: ☐ Yes ☐ No
If Yes, describe: [________________________________]

PART VIII: REPORTING REQUIREMENTS

A. Regular Reports

B. Notification Requirements

Startup/Shutdown Notifications:
☐ Required: [________] hours advance notice
☐ Not Required

Malfunction Notifications:
☐ Required: Within [________] hours of occurrence
☐ Not Required

Construction/Modification Notifications:
☐ Required: [________] days advance notice
☐ Not Required

PART IX: INSPECTION AND AUDIT PREPAREDNESS

A. Inspection Readiness Checklist

☐ Current permits available on-site
☐ Compliance records organized and accessible
☐ Personnel trained on inspection protocols
☐ Emergency contact list updated
☐ Facility maps/diagrams current
☐ Equipment operating properly
☐ Control devices maintained
☐ Monitoring systems calibrated

B. Recent Inspections

C. Self-Audit Schedule

Last Internal Audit: [__/__/____]
Next Internal Audit: [__/__/____]
Audit Scope: [________________________________]

PART X: COMPLIANCE CERTIFICATION

Annual Review Certification

Review Period: [__/__/____] to [__/__/____]
Review Conducted By: [________________________________]
Review Date: [__/__/____]

Overall Compliance Status:
☐ Facility is in full compliance with all applicable air quality requirements
☐ Facility has deviations that have been or are being addressed
☐ Facility has ongoing compliance issues requiring attention

Summary of Findings:
[________________________________]
[________________________________]
[________________________________]

Certification

I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations.

Signature: [________________________________]
Printed Name: [________________________________]
Title: [________________________________]
Date: [__/__/____]

STATE-SPECIFIC NOTES

California

• CARB and local Air Quality Management Districts (AQMDs) have authority
• California has stricter ambient air quality standards for some pollutants
• AB 32 (Global Warming Solutions Act) adds GHG requirements
• SCAQMD, BAAQMD, and other districts have additional requirements
• Permit fees and reporting requirements vary by district

Texas

• TCEQ administers air quality program
• Texas State Implementation Plan in 30 TAC Chapters 101, 111-117
• Permits by Rule available for certain sources
• Flexible permit program available
• Austin, Houston, Dallas-Fort Worth have ozone nonattainment requirements

Florida

• FDEP administers air quality program
• Chapter 62-210 through 62-297, F.A.C. contains state regulations
• Title V permits required for major sources
• Preconstruction review required for new/modified sources
• Operating permits valid for 5 years

New York

• NYSDEC administers air quality program
• 6 NYCRR Parts 200-261 contains state regulations
• State Facility Permits required for major sources
• Ozone Transport Region requirements apply
• Best Available Control Technology (BACT) required in nonattainment areas

SOURCES AND REFERENCES

• EPA Clean Air Act: https://www.epa.gov/clean-air-act-overview
• EPA Title V Operating Permits: https://www.epa.gov/title-v-operating-permits
• 40 CFR Parts 50-99 (Air Programs)
• EPA Compliance and Enforcement: https://www.epa.gov/enforcement/air-enforcement

This template is provided for general informational purposes. Clean Air Act compliance requirements are complex and vary by location, source type, and pollutants emitted. Always consult with qualified environmental counsel and the appropriate regulatory authority for specific compliance guidance.