Powder Coating Supplemental Information form - Valley Air
San Joaquin Valley Air Pollution Control District
Supplemental Application Form
POWDER COATING OPERATIONS
This form must be accompanied by a completed Authority to Construct/Permit to Operate Application form
|PERMIT TO BE ISSUED TO: |
| |
|LOCATION WHERE THE EQUIPMENT WILL BE OPERATED: |
| |
PROCESS DESCRIPTION
| Items Coated |[ ] Metal |[ ] Other: | |
| Curing Method |[ ] Heat Cured |[ ] UV Cured |[ ] Other |
EQUIPMENT DESCRIPTION
| Application Method |[ ] Electrostatic |[ ] Other: | | |
| Applicator Data |Manufacturer: |Model: |
| |Manufacturer: |Model: |
| Compressor Data |[ ] Electric [ ] Gasoline [ ] Diesel |HP Rating: |
|Application Location |[ ] Booth [ ] Indoors with no booth [ ] Outdoors |
| Powder Coating Booth |Type of Booth |[ ] Closed |[ ] Open-Faced |[ ] Conveyorized |
|(if Applicable) |Manufacturer: |Model: |
| |Booth Dimensions |Length: ________ ft |Width: ________ ft |Height: ________ ft |
| |Powder Recovery used |[ ] Yes |[ ] No | |
| |Filtration Method |[ ] Baghouse |[ ] Cyclone |[ ] Dry Filters |
| |Bags//Filters |Quantity ________ filters |Size (each, W x H x Th) _______" x _______" x _______" |
| |Fan Diameter: _______" Motor Rating _______ hp |Exhaust Flow Rate: _____________ cfm |
| |Stack Diameter: ___________ ft |Stack Height: ___________ ft |
|Curing Oven (if fuel-fired |Burner Specifications |Heat Input Rating ________ Btu/hr |[ ] Natural Gas [ ] Propane [ ] Diesel |
|burner) |Btu/hour | | |
|If Powder Coating Booth does not |Building Specifications* |L ________ ft x W ________ ft x H ________ ft |
|exhaust outside of the building | | |
| |*Include a sketch of the building which shows the size and location of the windows, doors and vents. |
| Gun Cleaner Data |Manufacturer: |Model: |
|(if used) | | |
| |Solvent (Brand/Trade Name) |VOC: lb/gal, g/l |
Please Continue on Reverse Side SA-5 6/02
POWDER COATING INFORMATION (Please supply MSDS documentation)
| POWDER COATING |MANUFACTURER |TRADE NAME / ID # |VOC CONTENT |MAX USAGE |MAX USAGE PER YEAR |
| | | |(lb/lb) |IN ANY ONE DAY |(lb) |
|Also indicate any Solvents used. | | | |(lb) | |
|1. | | | | | |
| | | | | | |
|2. | | | | | |
| | | | | | |
|3. | | | | | |
| | | | | | |
|4. | | | | | |
| | | | | | |
|5. | | | | | |
| | | | | | |
|Cleanup Solvent | | | | | |
|Surface Preparation Solvent | | | | | |
ADDITIONAL INFORMATION
1. Operating Schedule: __________Hours per day __________Days per week __________Weeks per year.
2. Nearest Receptor:
Distance to nearest Residence1 feet 1 Examples of Residences includes apartments, houses, dormitories, etc.
Distance to nearest Business2 feet 2 Examples of Businesses includes office buidlings, guard posts, factories, etc.
3. Is there a cap (other than a flapper) on the stack which impedes the vertical exhaust flow? [ ]Yes [ ]No
4. Direction of exhaust exit from device or structure: [ ] Vertical [ ] Horizontal
5. Facility Location: [ ] Urban (area of dense population) [ ] Rural (area of sparse population)
6. If more than 5 types of powder coatings are used, make additional copies of the POWDER COATING INFORMATION table above.
7. Submit Material Safety Data Sheets (MSDS) for all materials along with this form.
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