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FAX TO:Maine Dept of Environmental Protection, Bureau of Air QualityFROM: symbol 114 \f "Wingdings" AUGUSTA (207) 287-7826 symbol 114 \f "Wingdings" BANGOR (207) 941-4584COMPANY: symbol 114 \f "Wingdings" PORTLAND (207) 822-6303 symbol 114 \f "Wingdings" PRESQUE ISLE (207) 760-3143LICENSE NUMBER:ATTN: Air Compliance InspectorFAX:PHONE:SOURCE OF EMISSIONTYPE OF EMISSIONsymbol 114 \f "Wingdings" Cl2/ClO2 symbol 114 \f "Wingdings" Opacity symbol 114 \f "Wingdings" NOx symbol 114 \f "Wingdings" SO2 symbol 114 \f "Wingdings" TRS symbol 114 \f "Wingdings" VOC symbol 114 \f "Wingdings" CODATETIME BEGANTIME ENDEDDURATIONMAGNITUDE*LICENSE CONDITION / LIMIT / STANDARD1234567CAUSE OF EMISSIONsymbol 114 \f "Wingdings" Start-up symbol 114 \f "Wingdings" Shut-down symbol 114 \f "Wingdings" Process Problem symbol 114 \f "Wingdings" Control Equipment Problem symbol 114 \f "Wingdings" Cleaning/Sootblow symbol 114 \f "Wingdings" Other Known Cause symbol 114 \f "Wingdings" Unknown CauseEXPLANATIONACTIONS TO LIMIT EMISSIONACTION TO LIMIT RECURRENCEEXEMPTION REQUESTED symbol 114 \f "Wingdings" Yes symbol 114 \f "Wingdings" No symbol 114 \f "Wingdings" To Be Determined* Emissions shall be reported in units of the standard (This includes time period). SEE EXAMPLE NOTE: Details of this event must be documented and included in the quarterly emission report which is submitted to the Maine Dept of Environmental Protection.Signed:_____________________________________Date:_______________________________________centercenterSAMPLE00SAMPLEFAX TO:Maine Dept of Environmental Protection, Bureau of Air QualityFROM:Joe Green AUGUSTA (207) 287-7826 symbol 114 \f "Wingdings" BANGOR (207) 941-4584COMPANY:XYZ Corporation symbol 114 \f "Wingdings" PORTLAND (207) 822-6303 symbol 114 \f "Wingdings" PRESQUE ISLE (207) 760-3143LICENSE NUMBER:A-177-71-AATTN: Air Compliance InspectorFAX:777-6666PHONE:777-6667SOURCE OF EMISSIONPower Boiler #10TYPE OF EMISSIONSYMBOL 114 \f "Wingdings" Cl2/ClO2 SYMBOL 253 \f "Wingdings" Opacity SYMBOL 114 \f "Wingdings" NOx SYMBOL 114 \f "Wingdings" SO2 SYMBOL 114 \f "Wingdings" TRS SYMBOL 114 \f "Wingdings" VOC SYMBOL 114 \f "Wingdings" CODATETIME BEGANTIME ENDEDDURATIONMAGNITUDE*LICENSE CONDITION / LIMIT / STANDARD101-13-18110011066 min55%A-177-71-J-A Condition 25 <20% opacity201-23-18110611126 min56%A-177-71-J-A Condition 25 <20% opacity301-13-18111811246 min57%A-177-71-J-A Condition 25 <20% opacity4567CAUSE OF EMISSIONSYMBOL 114 \f "Wingdings" Start-up Shut-down SYMBOL 114 \f "Wingdings" Process Problem SYMBOL 114 \f "Wingdings" Control Equipment Problem SYMBOL 114 \f "Wingdings" Cleaning/Sootblow SYMBOL 114 \f "Wingdings" Other Known Cause SYMBOL 114 \f "Wingdings" Unknown CauseEXPLANATIONGoing down for annual outageACTIONS TO LIMIT EMISSIONNormal shut-down proceduresACTION TO LIMIT RECURRENCEN/AEXEMPTION REQUESTED Yes SYMBOL 114 \f "Wingdings" No SYMBOL 114 \f "Wingdings" To Be Determined* Emissions shall be reported in units of the standard (This includes time period). SEE EXAMPLE NOTE: Details of this event must be documented and included in the quarterly emission report which is submitted to the Maine Dept of Environmental Protection.Signed:___Joe Green_________________________Date:______1-14-18__________________________ ................
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