Initial Notification Report – 40 CFR Part 63,
Subpart MMMM
Air Quality Permit Program
Doc Type: Notifications – MACT/Compliance Status
Initial Notification Report
Surface Coating of Miscellaneous Metal Parts and Products
40 CFR Part 63, Subpart MMMM (63.3880-63.3981)
An initial notification is required by 40 CFR 63.3910(b) and 40 CFR 63.9(b)(2) for existing major Hazardous Air Pollutant (HAP) sources subject to the conditions of Subpart MMMM, Surface Coating of Miscellaneous Metal Parts and Products
Please print or type the following information for each source subject to the applicable rule mentioned above.
1a)AQ Facility ID No.:1b)Agency Interest ID No.:
Section I - Facility Information (40 CFR 63.9(b)(2)(ii))
Facility name:
Street address (Physical location of facility):
City: / MN / Zip:Facility contact name:
Title: / Phone number:Section II –Owner/Operator Information (40 CFR 63.9(b)(2)(i))
Owner/Operator name:
Owner/Operator mailing address:
City: / State: / Zip:Section III - Compliance Date (40 CFR 63.9(b)(2)(iii) and (v))
An initial notification is required by 40 CFR 63.3910(b) and 40 CFR 63.9(b)(2) for existing major HAP sources subject to the conditions of Subpart MMMM, Surface Coating of Miscellaneous Metal Parts and Products.
The above facility (choose one):
is a new or reconstructed affected source and is a major source at startup; therefore, this facility must comply upon start-up or January 2, 2004, whichever is later. Indicate Compliance Date below.
is an existing affected source; therefore, the compliance date is January 2, 2007.
was an existing area source that increased emissions or potential emissions and is now a major HAP source and a new or reconstructed affected source; therefore, the compliance date is the date of initial startup of the new or reconstructed source, or January 2, 2004, whichever is later. Indicate Compliance Date below.
was an existing area source that increased emissions or potential emissions and is now a major HAP source and an existing affected source; therefore, the compliance date is the date 1 year after becoming a major source, or January 2, 2007, whichever is later. Indicate Compliance Date below.
Compliance date (mm/dd/yyyy):If you own or operate an existing affected source, submit this notification by January 2, 2005. If you own or operate a new or reconstructed affected source, submit this notification within 120 days after initial startup, or by May 1, 2004, whichever is later.
Section IV – Source Description (40 CFR 63.9(b)(2)(iv)
A.Briefly describe the nature, size, design, and method of operation of the source. If this information is contained in a Title V permit or application, you may attach the relevant pages from that document to this notification and reference those pages below.
B.Identify the types of emission points within the affected source subject to the relevant standard.
C.Identify the principal types of HAP emitted by the affected source (i.e. toluene, xylene, xylene (mixed), methylene chloride, methanol, cadmium, glycol ethers, etc.)
Section V - Certification
I certify under penalty of law that, based on information and belief formed after reasonable inquiry, the statements and information contained or referenced in this initial notification report are true, accurate, and complete.
Permittee Responsible Official: / Co-Permittee Responsible Official (if applicable)Mr./Ms. / Mr./Ms.
Title: / Title:
Signature: / Signature:
Date: / Date:
Note: The individual signing must meet the definition of “responsible official” in Minn. R. 7007.0100, subp. 21.
•TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
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