Initial Notification / Notification of Compliance Status Report for

Paint Stripping and Miscellaneous Surface Coating Facilities

Applicable Rules: 40 CFR Part 63, Subpart HHHHHH — National Emission Standards for Hazardous Air Pollutants: Paint Stripping and Miscellaneous Surface Coating at Area Sources, and 40 CFR Part 63, Subpart A — National Emission Standards for Hazardous Air Pollutants for Source Categories, Subpart A — General Provisions. Initial notification is being made in accordance with §63.9(b).

Note: This initial notification is due on July 7, 2008 (or 180 days after start up if starting after January 9, 2008) for new sources and January 11, 2010 for existing sources. If you are a new or reconstructed major source, you must also include information required under 63.5(d) and 63.9(b)(5, the Application for Approval of Construction or Reconstruction. You may use the Application for Approval of Construction and Reconstruction as your initial notification. (§63.5(d)(1)(ii)).

Mail one copy to each of the following addresses:

MACT Notifications USEPA Region 5

WI DNR - Air Program AM/7 Compliance Tracker AE-17J

PO Box 7921 77 W Jackson Blvd

Madison, WI 53707-7921 Chicago, IL 60604

SECTION I GENERAL INFORMATION

Print or type the following information for each facility for which you are making initial notification: (§63.9(b)(2)(i)-(ii))

Responsible Official’s Name/Title
Street Address
City / State / ZIP Code / E-MAIL (if available)
Facility Local Contact Name / Title / Phone
Facility Name
Facility Street Address (If different than Responsible Official’s Street Address)
City / State / ZIP Code / E-MAIL (if available)
Is the source a motor vehicle or mobile equipment surface coating operation that repairs vehicles at the customer’s location, rather than a fixed location? o Yes o No

SECTION II APPLICABILITY AND SOURCE DESCRIPTION

Answer the following questions by checking each box that applies.

o Yes / A1. I understand that I am subject to 40 CFR Part 63 Subpart HHHHHH, National Emission Standards for Hazardous Air Pollutants: Paint Stripping and Miscellaneous Surface Coating Operations at Area Sources.
Source Description
B. Surface Coating Operations (enter number of each operation) / # spray booths / # prep stations / # painters
o / B1. Motor Vehicle or Mobile Equipment Surface Coating Operation
o / B2. Miscellaneous Surface Coating Operation painting plastic and/or metal parts with paints containing cadmium, chromium, lead, manganese and nickel.
C. Paint Stripping Operations
o Yes
o No / C1. Methylene Chloride is used in paint stripping. Skip to D if you answer No.
C2. Method of paint stripping:
o Chemical / o Mechanical / o Other (describe):
C3. Substrates stripped of paint:
o Wood / o Metal / oPlastic / o Other (describe):
o Yes
o No / C4. If yes to C1, do you/will you use more than 1 ton of MeCl annually?
D. Start Date
Enter
Date / / / / My operation started on the date indicated here.

SECTION III COMPLIANCE STATUS AND CERTIFICATION

All sources must check one of the boxes below. For paint stripping operations, the relevant requirements that you must evaluate in making this determination are specified in 40 CFR 63.11173(a) through (d) of subpart HHHHHH. For surface coating operations, the relevant requirements are specified in 40 CFR 63.11173(e) through (g) of subpart HHHHHH.
NEW SOURCES: If your source is a new source (after September 17, 2007) the responsible official must certify by signing below that the source is in compliance with each of the relevant requirements of this subpart.
o I am already in compliance with each of the relevant requirements.
o I will be in compliance with each of the relevant requirements by the compliance date.

NOTE: New Source (initial start-up after Jan 9, 2008): Compliance date is date of startup

New Source (initial start-up after September 17, 2007 but before January 9, 2008): Compliance date is January 9, 2008

Existing source (initial start-up before September 17, 2007): Compliance date is January 10, 2011
EXISTING SOURCES ONLY: If your source is an existing source the responsible official, whose information is provided above, may certify below that the source is already in compliance with each of the relevant requirements of this subpart or certification may be done by March 11, 2011 in the Notification of Compliance Status as specified in 40 CFR Section 63.11175(b). Indicate which option you have chosen by checking one of the two boxes below.
o I am certifying below.
o I will certify by March 11, 2011. (There is no need to sign below; you must sign a statement by March 11, 2011.)

Based upon information and belief formed after a reasonable inquiry, I, as a responsible official of the above-mentioned facility, certify that the information contained in this report is accurate and true to the best of my knowledge.

Name of Responsible Official (Print or Type) / Title / Date (mm/dd/yy)
Signature of Responsible Official

Note: Notifications should be sent to the addresses above. Title V permit applications can be used in lieu of an initial notification provided the same information is contained in the permit application as required by this rule and has been submitted to the WDNR (§63.9(a))