7610-1 Certificate of Representation

United States Environmental Protection Agency
Acid Rain and CAIR Programs

OMB Nos. 2060-0258, 2060-0570, and 2060-0584
Approval Expires 7/31/2009

Certificate of Representation

Page 1

For more information, see instructions and 40 CFR 72.24; 40 CFR 96.113, 96.213, or 96.313, or a
comparable state regulation under the Clean Air Interstate Rule (CAIR) NOX Annual, SO2, and NOX
Ozone Season Trading Programs or 40 CFR 97.113, 97.213, or 97.313.
FACILITY (SOURCE)
INFORMATION
STEP 1
Provide
information for
the facility
(source).

This submission is:

~ New ~ Revised (revised submissions must be complete; see instructions)

Facility (Source) Name

State

County Name

STEP 2
Enter requested
information for
the
designated
representative.

Latitude

Longitude

Name

Title

Company Name

Address

Phone Number

Fax Number

E-mail address

STEP 3
Enter requested
information for
the
alternate
designated
representative.

Name

Title

Company Name

Address

Phone Number

E-mail address

EPA Form 7610-1 (rev. 02-2009; previous versions obsolete)

Fax Number

Plant Code

Certificate of Representation - Page 2
Page

Facility (Source) Name (from Step 1)

~ of ~

UNIT INFORMATION
STEP 4: Complete one page for each unit located at the facility identified in STEP 1 (i.e., for each boiler, simple cycle combustion turbine, or combined cycle combustion
turbine) Do not list duct burners. Indicate each program to which the unit is subject, and enter all other unit-specific information, including the name of each owner and operator of
the unit and the generator ID number and nameplate capacity of each generator served by the unit. If the unit is subject to a program, then the facility (source) is also subject. (For
units subject to the NOX Budget Trading Program, a separate "Account Certificate of Representation" form must be submitted to meet requirements under that program.)
Applicable Program(s):

~ Acid Rain ~ CAIR NO

X

Annual

~ CAIR SO

2

~ CAIR NO

X

Ozone Season
Generator ID Number
(Maximum 8 characters)

Acid Rain Nameplate
Capacity (MWe)

Source Category

Unit ID#

Unit Type

NAICS Code
Check One:

~
Projected ~
Actual

Date unit began (or will begin) serving any generator producing electricity for sale
(including test generation) (mm/dd/yyyy):

Company Name:

~ Owner
~ Operator

Company Name:

~ Owner
~ Operator

Company Name:

~ Owner
~ Operator

Company Name:

~ Owner
~ Operator

Company Name:

~ Owner
~ Operator

EPA Form 7610-1 (rev. 02-2009; previous versions obsolete)

CAIR Nameplate
Capacity (MWe)

Certificate of Representation - Page 3
Facility (Source) Name (from Step 1)

STEP 5: Read the appropriate certification statements, sign, and date.

Acid Rain Program
I certify that I was selected as the designated representative or alternate designated representative (as applicable) by an
agreement binding on the owners and operators of the affected source and each affected unit at the source (i.e., the source
and each unit subject to the Acid Rain Program, as indicated in "Applicable Program(s)" in Step 4).
I certify that I have all necessary authority to carry out my duties and responsibilities under the Acid Rain Program on behalf
of the owners and operators of the affected source and each affected unit at the source and that each such owner and
operator shall be fully bound by my representations, actions, inactions, or submissions.
I certify that the owners and operators of the affected source and each affected unit at the source shall be bound by any
order issued to me by the Administrator, the permitting authority, or a court regarding the source or unit.
Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, an affected unit, or where a utility or
industrial customer purchases power from an affected unit under a life-of-the-unit, firm power contractual arrangement,
I certify that:
I have given a written notice of my selection as the designated representative or alternate designated
representative (as applicable) and of the agreement by which I was selected to each owner and operator of
the affected source and each affected unit at the source; and
Allowances, and proceeds of transactions involving allowances, will be deemed to be held or distributed in
proportion to each holder's legal, equitable, leasehold, or contractual reservation or entitlement, except that,
if such multiple holders have expressly provided for a different distribution of allowances, allowances and
proceeds of transactions involving allowances will be deemed to be held or distributed in accordance with
the contract.

Clean Air Interstate Rule (CAIR) NOX Annual Trading Program
I certify that I was selected as the CAIR designated representative or alternate CAIR designated representative (as
applicable), by an agreement binding on the owners and operators of the CAIR NOX source and each CAIR NOX unit at the
source (i.e., the source and each unit subject to the CAIR NOX Annual Trading Program, as indicated in "Applicable
Program(s)" in Step 4).
I certify that I have all necessary authority to carry out my duties and responsibilities under the CAIR NOX Annual Trading
Program on behalf of the owners and operators of the CAIR NOX source and each CAIR NOX unit at the source and that each
such owner and operator shall be fully bound by my representations, actions, inactions, or submissions.
I certify that the owners and operators of the CAIR NOX source and each CAIR NOX unit at the source shall be bound by any
order issued to me by the Administrator, the permitting authority, or a court regarding the source or unit.
Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a CAIR NOX unit, or where a utility
or industrial customer purchases power from a CAIR NOX unit under a life-of-the-unit, firm power contractual arrangement,
I certify that:
I have given a written notice of my selection as the CAIR designated representative or alternate CAIR
designated representative (as applicable) and of the agreement by which I was selected to each owner and
operator of the CAIR NOX source and each CAIR NOX unit at the source; and
CAIR NOX allowances and proceeds of transactions involving CAIR NOX allowances will be deemed to be
held or distributed in proportion to each holder's legal, equitable, leasehold, or contractual reservation or
entitlement, except that, if such multiple holders have expressly provided for a different distribution of CAIR
NOX allowances by contract, CAIR NOX allowances and proceeds of transactions involving CAIR NOX
allowances will be deemed to be held or distributed in accordance with the contract.

EPA Form 7610-1 (rev. 02-2009; previous versions obsolete)

Certificate of Representation - Page 4
Facility (Source) Name (from Step 1)

Page

~ of ~

Clean Air Interstate Rule (CAIR) SO2 Trading Program
I certify that I was selected as the CAIR designated representative or alternate CAIR designated representative (as applicable),
by an agreement binding on the owners and operators of the CAIR SO2 source and each CAIR SO2 unit at the source (i.e., the
source and each unit subject to the SO2 Trading Program, as indicated in "Applicable Program(s)" in Step 4).
I certify that I have all necessary authority to carry out my duties and responsibilities under the CAIR SO2 Trading Program, on
behalf of the owners and operators of the CAIR SO2 source and each CAIR SO2 unit at the source and that each such owner
and operator shall be fully bound by my representations, actions, inactions, or submissions.
I certify that the owners and operators of the CAIR SO2 source and each CAIR SO2 unit at the source shall be bound by any
order issued to me by the Administrator, the permitting authority, or a court regarding the source or unit.
Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a CAIR SO2 unit, or where a utility or
industrial customer purchases power from a CAIR SO2 unit under a life-of-the-unit, firm power contractual arrangement,
I certify that:
I have given a written notice of my selection as the CAIR designated representative or alternate CAIR
designated representative (as applicable) and of the agreement by which I was selected to each owner and
operator of the CAIR SO2 source and each CAIR SO2 unit at the source; and
CAIR SO2 allowances and proceeds of transactions involving CAIR SO2 allowances will be deemed to be held
or distributed in proportion to each holder's legal, equitable, leasehold, or contractual reservation or entitlement,
except that, if such multiple holders have expressly provided for a different distribution of CAIR SO2 allowances
by contract, CAIR SO2 allowances and proceeds of transactions involving CAIR SO2 allowances will be
deemed to be held or distributed in accordance with the contract.

Clean Air Interstate Rule (CAIR) NOX Ozone Season Trading Program
I certify that I was selected as the CAIR designated representative or alternate CAIR designated representative (as applicable),
by an agreement binding on the owners and operators of the CAIR NOX Ozone Season source and each CAIR NOX Ozone
Season unit at the source (i.e., the source and each unit subject to the CAIR NOX Ozone Season Trading Program, as indicated
in "Applicable Program(s)" in Step 4).
I certify that I have all necessary authority to carry out my duties and responsibilities under the CAIR NOX Ozone Season
Trading Program on behalf of the owners and operators of the CAIR NOX Ozone Season source and each CAIR NOX Ozone
Season unit at the source and that each such owner and operator shall be fully bound by my representations, actions, inactions,
or submissions.
I certify that the owners and operators of the CAIR NOX Ozone Season source and each CAIR NOX Ozone Season unit shall be
bound by any order issued to me by the Administrator, the permitting authority, or a court regarding the source or unit.
Where there are multiple holders of a legal or equitable title to, or a leasehold interest in, a CAIR NOX Ozone Season unit, or
where a utility or industrial customer purchases power from a CAIR NOX Ozone Season unit under a life-of-the-unit, firm power
contractual arrangement, I certify that:
I have given a written notice of my selection as the CAIR designated representative or alternate CAIR
designated representative (as applicable) and of the agreement by which I was selected to each owner and
operator of the CAIR NOX Ozone Season source and each CAIR NOX Ozone Season unit; and
CAIR NOX Ozone Season allowances and proceeds of transactions involving CAIR NOX Ozone Season
allowances will be deemed to be held or distributed in proportion to each holder's legal, equitable, leasehold, or
contractual reservation or entitlement, except that, if such multiple holders have expressly provided for a
different distribution of CAIR NOX Ozone Season allowances by contract, CAIR NOX Ozone Season allowances
and proceeds of transactions involving CAIR NOX Ozone Season allowances will be deemed to be held or
distributed in accordance with the contract.

EPA Form 7610-1 (rev. 02-2009; previous versions obsolete)

Certificate of Representation - Page 5
Facility (Source) Name (from Step 1)

Page

~ f~

General
I am authorized to make this submission on behalf of the owners and operators of the source or units 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.

Signature (Designated Representative)

Date

Signature (Alternate Designated Representative)

Date

EPA Form 7610-1 (rev. 02-2009; previous versions obsolete)

Instructions for the Certificate of Representation

Note: The Certificate of Representation information can be submitted online through the
CAMD Business System (CBS) at https://camd.epa.gov/cbs/index.cfm. You must have a user
ID and password. If you need a user ID and password, or if you have questions about CBS, contact
Laurel DeSantis at desantis.laurel@epa.gov or (202) 343-9191, or Alex Salpeter at
salpeter.alex@epa.gov or (202) 343-9157.
Any reference in these instructions to the Designated Representative means the Acid Rain
Designated Representative and/or CAIR Designated Representative, as applicable. Any reference
to the Alternate Designated Representative means the Alternate Acid Rain Designated
Representative and/or the Alternate CAIR Designated Representative, as applicable. As reflected
in this form, the Acid Rain Designated Representative, the CAIR Designated Representative for a
facility (source) must be the same individual, and the Alternate Acid Rain Designated
Representative and the Alternate CAIR Designated Representative for a facility (source) must be
the same individual.
Please type or print. Submit one copy of page 2 for each unit subject to the Acid Rain Program or a
CAIR Trading Program at the facility (source), and indicate the page order and total number of
pages (e.g., 1 of 4, 2 of 4, etc.) in the boxes in the upper right hand corner of page 2. A Certificate
of Representation amending an earlier submission supersedes the earlier submission in its
entirety and must therefore always be complete. Submit one Certificate of Representation form
with original signature(s). NO FIELDS SHOULD BE LEFT BLANK. For assistance, contact Laurel
DeSantis at desantis.laurel@epa.gov or (202) 343-9191.
STEP 1
(i) A Plant Code is a 4 or 5 digit number assigned by the Department of Energy=s (DOE) Energy
Information Administration (EIA) to facilities that generate electricity. For older facilities, "Plant
Code" is synonymous with "ORISPL" and "Facility" codes. If the facility generates electricity but no
Plant Code has been assigned, or if there is uncertainty regarding what the Plant Code is, contact
EIA at (202) 586-4325 or (202) 586-2402. For facilities that do not produce electricity, use the
facility identifier assigned by EPA (beginning with "88"). If the facility does not produce electricity
and has not been assigned a facility identifier, contact Laurel DeSantis at desantis.laurel@epa.gov
or (202) 343-9191.
(ii) Enter the latitude and longitude representing the location of the facility in degree decimal format.
Note that coordinates MUST be submitted in decimal degree format; in this format minutes and seconds are
represented as a decimal fraction of one degree. Therefore, coordinates containing degrees, minutes, and
seconds must first be converted using the formula:
decimal degrees = degrees + (minutes / 60) + (seconds / 3600)
Example:
39 degrees, 15 minutes, 25 seconds = 39 + (15 / 60) + (25 / 3600) = 39.2569 degrees

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STEPS 2 & 3
The Designated Representative and the Alternate Designated Representative must be individuals
(i.e., natural persons) and cannot be a company. Enter the company name and address of the
representative as it should appear on all correspondence. If an email address is provided, most
correspondence will be emailed. Although not required, EPA strongly encourages owners and
operators to designate an Alternate Designated Representative to act on behalf of the
Designated Representative.
STEP 4
(i) Complete one page for each unit subject to the Acid Rain Program or a CAIR Trading Program,
and indicate the program(s) to which the unit is subject. (For units subject to the NOX Budget
Trading Program, a separate "Account Certificate of Representation" form must be submitted to
meet requirements under that program.) Identify each unit at the facility by providing the
appropriate unit identification number, consistent with the identifiers used in previously submitted
Certificates of Representation (if applicable) and with submissions made to DOE and/or EIA. Do
not list duct burners. For new units without identification numbers, owners and operators must
assign identifiers consistent with EIA and DOE requirements. Each submission to EPA that
includes the unit identification number(s) (e.g., monitoring plans and quarterly reports) should
reference those unit identification numbers in exactly the same way that they are referenced on the
Certificate of Representation. Do not identify units that are not subject to the above-listed programs
but are part of a common monitoring configuration with a unit that is subject to any of these
programs. To identify units in a common monitoring configuration that are not subject to any of
these programs, call the CAMD Hotline at (202) 343-9620, and leave a message under the "CEMS"
submenu.
(ii) Identify the type of unit using one of the following abbreviations:

Boilers

Boilers

Turbines

AF

Arch-fired boiler

OB

Other boiler

CC

Combined cycle

BFB

Bubbling fluidized bed
boiler

PFB

Pressurized
fluidized bed boiler

CT

Combustion turbine

C

Cyclone boiler

S

Stoker

OT

Other turbine

CB

Cell burner boiler

T

Tangentially-fired
boiler

Others

CFB

Circulating fluidized
bed boiler

WBF

Wet bottom wallfired boiler

ICE

Internal
combustion engine

DB

Dry bottom wall-fired
boiler

WBT

Wet bottom turbofired boiler

KLN

Cement kiln

DTF

Dry bottom turbo-fired
boiler

WVF

Wet bottom
vertically-fired boiler

PRH

Refinery process
heater

DVF

Dry bottom verticallyfired boiler

If there is uncertainty about how a unit should be characterized, contact Robert Miller at
miller.robertl@epa.gov or (202) 343-9077.

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(iii) Indicate the source category description that most accurately describes the purpose for which
the unit is operated by entering one of the following terms. If none of these descriptions applies to
your unit, contact Robert Miller at miller.robertl@epa.gov or (202) 343-9077.
Automotive Stampings
Bulk Industrial Chemical
Cement Manufacturing
Cogeneration
Electric Utility

Industrial Boiler
Industrial Turbine
Institutional
Iron and Steel
Municipal Waste Combustor

Petroleum Refinery
Portland Cement Plant
Pulp and Paper Mill
Small Power Producer
Theme Park

(iv) Provide the primary North American Industrial Classification System (NAICS) code that most
accurately describes the business type for which the unit is operated. If unknown, go to
http://www.census.gov for guidance on how to determine the proper NAICS code for the unit.
(v) Enter the date the unit began (or will begin) serving any generator producing electricity for sale,
including test generation. Enter this date and check the "actual" box for any unit that has begun to
serve a generator producing electricity for sale as of the date of submission of this form. (This
information should be provided even if the unit does not currently serve a generator producing
electricity for sale.) For any unit that will begin, but has not begun as of the date of submission of
this form, to serve a generator producing electricity for sale, estimate the future date on which the
unit will begin to produce electricity for sale and check the "projected" box. When the actual date is
established, revise the form accordingly by entering the actual date and checking the "actual" box.
Enter "NA" if the unit has not ever served, is not currently serving, and is not projected to serve, a
generator that producing electricity for sale. You are strongly encouraged to use the CAMD
Business System to update information regarding when a unit begins serving a generator
producing electricity for sale.
If you have questions regarding this portion of the form, contact Robert Miller at
miller.robertl@epa.gov or (202) 343-9077.
(vi) For a unit subject to the Acid Rain Program or a CAIR Trading Program, that, as of the date of
submission of this form, serves one or more generators (whether or not the generator produces
electricity for sale), indicate the generator ID number and the nameplate capacity (in MWe) of each
generator served by the unit. A unit serves a generator if it produces, or is able to produce, steam,
gas, or other heated medium for generating electricity at that generator. For combined cycle units,
report separately the nameplate capacities of the generators associated with the combustion
turbine and the steam turbine. Please ensure that the generator ID numbers entered are consistent
with those reported to the EIA.
The definitions of "nameplate capacity" under the Acid Rain Program and under the CAIR Program
differ slightly. Therefore, for a unit subject to the Acid Rain Program and any CAIR Program, the
nameplate capacity for the same generator under the Acid Rain Program and under the CAIR
Program may differ in certain limited circumstances. Specifically, for a unit subject to the Acid Rain
Program, the nameplate capacity of a generator, if listed in the National Allowance Database
("NADB"), is not affected by physical changes to the generator after initial installation that result in
an increase in the maximum electrical generating output that the generator is capable of producing.
Otherwise, for a unit subject to the Acid Rain Program or a CAIR Program, the nameplate capacity
of a generator is affected by physical changes to the generator after initial installation that result in
an increase in the maximum electrical generating output that the generator is capable of producing.
In such a case, the higher maximum electrical generating output number in MWe should be
reported in the nameplate capacity column. Enter "NA" if, as of the date of submission of this form,
the unit does not serve a generator.
See the definition of "nameplate capacity" at 40 CFR 72.2, 96.102, 97.102, 96.202, 97.202, 96.302,
and 97.302, as applicable.
The NADB is located at the CAMD website at
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http://www.epa.gov/airmarkets/trading/allocations.html. If you have questions regarding nameplate
capacity, contact Robert Miller at miller.robertl@epa.gov or (202) 343-9077; if you have questions
regarding the NADB, contact Craig Hillock at hillock.craig@epa.gov or (202) 343-9105.
(vii) Enter the company name of each owner and operator in the "Company Name" field. Indicate
whether the company is the owner, operator, or both. For new units, if the operator of a unit has not
yet been chosen, indicate that the owner is both the owner and operator and submit a revised form
when the operator has been selected within 30 days of the effective date of the selection. EPA
must be notified of changes to owners and operators within 30 days of the effective date of the
change. You are strongly encouraged to use the CAMD Business System to provide updated
information on owners and operators.
STEP 5
Read the appropriate certification statements, sign, and date.
Mail this form to:
For regular/certified mail:

For overnight mail:

U.S. Environmental Protection Agency
Clean Air Markets Division (6204J)
Attention: Designated Representative
1200 Pennsylvania Avenue, NW
Washington, DC 20460

U.S. Environmental Protection Agency
Clean Air Markets Division (6204J)
Attention: Designated Representative
1310 L Street, NW
Second Floor
Washington, DC 20005
(202) 343-9191

Submit this form prior to making any other submissions under the Acid Rain Program, CAIR
NOX Trading Program, CAIR SO2 Trading Program, or CAIR NOX Ozone Season Trading
Program. Submit a revised Certificate of Representation when any information in the existing
Certificate of Representation changes. You are strongly encouraged to use the CAMD
Business System to provide updated information.
Paperwork Burden Estimate
The public reporting and record keeping burden for this collection of information is estimated to
average 15 hours per response annually. Burden means the total time, effort, or financial resources
expended by persons to generate, maintain, retain, or disclose or provide information to or for a
Federal agency. This includes the time needed to review instructions; develop, acquire, install, and
utilize technology and systems for the purposes of collecting, validating, and verifying information,
processing and maintaining information, and disclosing and providing information; adjust the
existing ways to comply with any previously applicable instructions and requirements; train
personnel to be able to respond to a collection of information; search data sources; complete and
review the collection of information; and transmit or otherwise disclose the information. An agency
may not conduct or sponsor, and a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number.

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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.

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