Permit Application FormCotton Ginning

[SIC Code 0724]

North Carolina Division Of Air Quality

Facility Name / Mailing Address
Site Address
County / Technical Contact
Facility Latitude & Longitude / Phone Number
Facility SIC Code / Current Permit No.

General Instructions

1.Please provide appropriate response for all questions in Table 1. This information will determine whether your facility qualifies for this permit.

2.This permit covers cotton ginning facilities only, with a Standard Industrial Classification Code (SIC Code)[1] 0724.

3.For the purposes of this application form only, the following definitions apply:

Facility - all the pollutant emitting activities that are located on one or more contiguous or adjacent properties under common control.

4.This application must include the appropriate permit processing fee as determined pursuant to 2Q .0203 "Permit and Application Fees."

5.If the facility qualifies for an air quality permit according to this application, the facility will be issued a permit and will be subject to the annual fee for small facilities as specified in 2Q .0203 (a).

6.Pursuant to the terms of this permit, the Permittee is required to renew this permit every five years. Failure to submit the required information could result in enforcement action and revocation of a permit.

7.If the Permittee determines for any reason that they no longer qualify for this permit, the Regional Office must be notified immediately. The appropriate air permit application forms must be submitted prior to making the change that will disqualify the facility from this permit. Failure to do so will result in a Notice of Violation and possible enforcement action.

Table 1: Qualification Checklist for General Permit

Check the appropriate answer: / Yes / No
1.Does this facility process less than 167,000 bales of cotton per year (or ginning season)?
2.Are all indirect heat transfer combustion equipment exempt from permitting pursuant to 15A NCAC 2Q .0102(b)(2)(B)?
3.Is this facility currently exempt from 15A NCAC 2D .1100 "Control of Toxic Air Pollutants?"
4.Is this facility exempt from 15A NCAC 2D .1110 "NESHAP" or 2D .1111 "MACT" standards?
5.Is this facility exempt from 15A NCAC 2D .0530 "Prevention of Significant Deterioration?"
6.Is this facility exempt from 15A NCAC 2D .0524 "New Source Performance Standards"?
7.Is this facility exempt from Title V as defined in 15A NCAC 2Q .0502, "Applicability"?
8.Are all of the emission sources at the facility subject solely to the following regulations 15A NCAC 2D .0515, .0521 and .0535, and 2Q .0310?

If the answer toany of questions 1 through 8 in Table 1 is “NO,” a separate permit application must be submitted to address the specific sources not covered under this permit.

I certify that I am familiar with the information contained in this application and that to the best of my knowledge and belief such information is true, complete, and accurate.

Printed Name of Responsible Official[2]______

Title______

Date Application Signed______

Signature of Responsible Official ______

[1]Standard Industrial Classification Manual 1987.

[2] Pursuant to 15A NCAC 2Q .0305(j), Permit applications shall be signed as follows:

(1)for corporations, by a principal executive officer of at least the level of vicepresident, or his duly authorized representative, if such representative is responsible for the overall operation of the facility from which the emissions described in the permit application form originates;

(2)for partnership or limited partnership, by a general partner;

(3)for a sole proprietorship, by the proprietor;

(4)for municipal, state, federal, or other public entity, by a principal executive officer, ranking elected official, or other duly authorized employee.