Post 2010 Revisions BAMM optional form

OMB Control No. 2060-0629

ICR Approval Expires 11/30/2012

Mandatory Reporting of Greenhouse Gases (40 CFR Part 98)

Optional Facility Form For Requesting an Extension of Use of Best Available Monitoring Methods for Subparts P (Hydrogen Production), X (Petrochemical Production), and Y (Petroleum Refineries)

OMB Control No. 2060-0629

ICR Approval Expires 11/30/2012

The public reporting and recordkeeping burden for this collection of information is estimated to average 30 minutes per response (the burden was already included in ICR 200909-2060-007). This is an optional application form. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

General Information: If you are an owner or operator subject to 40 CFR 98 Subparts P (Hydrogen Production), X (Petrochemical Production), or Y (Petroleum Refineries) you may request to extend the use of best available monitoring methods through December 31, 2013 for any process equipment or unit that operates continuously and for which it is not reasonably feasible to install a required measurement device without a process equipment or unit shutdown, or through a hot tap. To obtain approval, you must have filed an initial notice of intent to EPA by January 1, 2011 and a complete extension request by February 15, 2011. The extension request must demonstrate to the EPA Administrator's satisfaction that it is not practicable to isolate the process equipment or unit and install the measurement equipment without a full shutdown or hot tap, and that there was no opportunity to do so during 2010.

To submit your extension request to the EPA Administrator for the use of best available monitoring methods under Part 98 Subpart A (40 CFR 98.3(j)), you have the option of using the form that follows this page. You must submit your request by February 15, 2011. Requests to use best available monitoring methods past December 31, 2013 will not be granted at this time.

You also may use this form if you find it necessary to file a subsequent extension to your original request as described in Part 98 Subpart A (§98.3(j)(3)(ii) or §98.3(j)(7)).

This form can be submitted electronically (preferred) to MRRpetition@epa.gov.

As an alternative, the form can be printed and mailed to:

Carole Cook

Climate Change Division

Office of Atmospheric Programs (MC – 6207J)

Environmental Protection Agency

1200 Pennsylvania Ave., N.W.

Washington, DC 20460

Upon receipt, the extension request will be recorded in the EPA tracking system, and the requester will be notified that EPA is evaluating the request. EPA will evaluate your request to confirm that it is consistent with §98.3(j). The agency will then notify you to confirm approval or denial of the application. As a general matter, EPA will base its decision on the information provided in the timely extension request and does not intend to negotiate on specific issues, or necessarily follow-up with the requester regarding missing data. As time allows, however, EPA may follow up on extension requests with additional questions. All measurement devices must be installed by July 1, 2011, unless EPA approves an extension request before that date.

General Information
1. Name of Person to Contact about the Request
2. Contact Person Address (include street address, city, state, and zip code)
3. Contact Person Phone Number
4. Contact Person Email Address
5. Signature: “I am authorized to make this submission on behalf of the owners and operators of the facility or supplier, as applicable, for which the submission is made. I certify under penalty of law that I have personally examined, and am familiar with, the statements and information submitted in this document and all its attachments. Based on my inquiry of those individuals with primary responsibility for obtaining the information, I certify that the statements and information are to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant penalties for submitting false statements and information or omitting required statements and information, including the possibility of fine or imprisonment.” Note: The designated representative or alternate designated representative must sign (i.e. agree to) this certification statement.  If you are an agent you are not agreeing to the certification statement, but are submitting the certification statement on behalf of the designated representative or alternate designated representative who is agreeing to the certification statement.   An agent is only authorized to make the submission on behalf of the designated representative, not to sign (i.e., agree to) the certification statement. [All submissions must be submitted by the DR, an alternative DR or an Agent- see §98.4(e) and §98.4(m). Please include the DR, ADR or Agent signature here.]
6. Date Signed
7. Date Submitted
Facility and Emissions Unit Information
8. Facility Name
9. Facility Physical Address (include street address, city, state, and zip code)
10. Unit ID or Group ID, Common Pipe ID or Common Stack ID (list for each applicable unit)
11. Type of Unit (e.g., boiler, process heater)
12. Total Number of Units at Facility Included in this Application
Measurement Device and Rule Requirement Information
13. Measurement Device(s) Description (list all)
14. Parameter (e.g., process emissions, process off-gas, fuel combusted)
15. Rule Subpart (P, X, Y)
16. Rule Citation for Monitoring Requirement (e.g., (e.g., §98.253(b)(1)(ii) or §98.33(a)(2)(ii))
Identification of Equipment Location
17. Location where each measurement device will be installed. Please indicate if documentation (e.g., a diagram) for the unit with monitor or sampling location is attached. (Indicate whether you are including attachments and include a list of files attached.)

Reason for the Extension Request
18. Reason for the Extension Request (e.g., why the needed equipment could not be installed by April 1, 2010 or expiration date for the previously granted extension under 98.3(d) or §98.3(j)).
19. Please provide supporting documentation showing that it is not practicable to isolate the process equipment or unit and install the measurement device without a full shutdown or hot tap and that there was no opportunity during 2010 to install the device. (Indicate whether you are including attachments and include a list of files attached.)
19a. Dates of three (3) most recent shutdowns for each relevant process equipment or unit.	1. 2. 3.
19b. If there was a shutdown during 2010 explain why the measurement device was not obtained and installed during that shutdown.
19c. What is the typical frequency of shutdowns for each relevant process equipment or unit?
20. Date of next planned shutdown for each relevant process equipment or unit during which the measurement device could be installed.
Proposed Best Available Monitoring Method Information
21. Provide a description of the proposed best available monitoring method for estimating GHG emissions during the time prior to installation of the meter (or measurement device). Include information about why the proposed method is appropriate (you may attach additional pages).
Additional Information Required for Subsequent Extension Requests (§98.3(j)(3)(ii)) and One-Time Extension Requests (§98.3(j)(7))
22. If this application is being filed under §98.3(j)(3)(ii), is it being submitted within 4 weeks of the owner or operator identifying the need to extend the request? (yes/no)
23. On what date did the owner or operator identify the need to submit under §98.3(j)(3)(ii).
24. Please indicate the planned shutdown date in the extension request most recently approved by EPA under §98.3(j).

EPA Form TBD