63.11225(a)(4)(vi) Notification of Compliance Status |
63.11225(a)(4)(vi) |
ICR Draft v2.01 |
11/17/2021 |
OMB No.: 2060-0668 Form 5900-568 For further Paperwork Reduction Act information see: https://www.epa.gov/electronic-reporting-air-emissions/paperwork-reduction-act-pra-cedri-and-ert |
40 CFR Part 63, Subpart JJJJJJ Industrial, Commercial, and Institutional Boilers Area Sources: 63.11225(a)(4)(vi) Notification of Compliance Status Spreadsheet Template |
Instructions for Spreadsheet Template Purpose: |
The CEDRI spreadsheet template upload feature allows you to submit data in a single report for a single company or multiple companies, as well as multiple sites, using this EPA provided Excel workbook. Data for each company must be entered into the worksheet labeled "Company Information" in this Excel workbook. Each row in the "Company Information" worksheet includes the data for a single company. The Company Record No. will be used to match the information on each tab to the appropriate company. For each facility record found in the "Company Information" worksheet, you may reference a single file attachment that includes additional information. |
Do not submit information you claim as confidential business information (CBI) to EPA via CEDRI. EPA will make all the information submitted through CEDRI available to the public without further notice to you. Anything submitted using CEDRI cannot later be claimed to be CBI. Furthermore, under CAA section 114(c) emissions data is not entitled to confidential treatment and requires EPA to make emissions data available to the public. Thus, emissions data will not be protected as CBI and will be made publicly available. |
Although we do not expect persons to assert a claim of CBI, if persons wish to assert a CBI claim, you must submit the report via CEDRI with the CBI omitted and mail a complete report, including any information claimed to be CBI, to EPA on a compact disc, flash drive, or other commonly used electronic storage media via U.S. postal service. You must mark the outside of the digital storage media as CBI and then identify electronically within the digital storage media the specific information that is claimed as CBI. Mail the media to the address in the referencing federal regulation. If no address is specified, mail the media to: |
U.S. EPA/OAQPS/CORE CBI Office Attention: Group Leader, Measurement Policy Group MD C404-02 4930 Old Page Rd Durham, North Carolina 27703 |
IMPORTANT: The spreadsheet must be uploaded into CEDRI as a single ZIP file, which must include this Excel workbook and any related attachments that were referenced in the workbook (i.e., additional information file found in the "Company Information" worksheet). Note: If you are uploading file attachments for your report, the uploaded files may be in any format (e.g., zip, docx, PDF). If you would like to include an Excel file(s) as an attachment, you must first zip the excel file(s) into a separate ZIP file to the master ZIP file that will be uploaded into CEDRI. |
Once all data have been entered in the worksheet, combine this Excel workbook and all attachment files (including any ZIP file containing separate excel file(s), if applicable) into a single ZIP file for upload to CEDRI. Please ensure your report includes all of the required data elements found in the listed citations below for this spreadsheet upload submission. |
Within the tabs, example rows are colored light red (rows 14 through 23), and the XML tags (row 13) are colored green. These rows are locked; no data entry is made in these rows. |
40 CFR Part 63, Subpart JJJJJJ Industrial, Commercial, and Institutional Boilers Area Sources: 63.11225a_4_vi_Notification_of_Compliance_Status Spreadsheet Template | |||||||||||
63.11225a_4_vi_Notification_of_Compliance_Status Spreadsheet Template | |||||||||||
The asterisk (*) next to each field indicates that the corresponding field is required. | |||||||||||
Site Information | |||||||||||
Facility Record No. * (Field value will automatically generate when Facility Name entered in Column C.) |
Facility Name* | Facility Address 1* | Facility Address 2 | City* | County* | State Code* | Zip Code* | Responsible Official Title | Responsible Official Name | Please enter any additional information. | Please provide the file name that contains the additional information. Please provide only one file per record. |
RecordId | FacilityName | AddressLine1 | AddressLine2 | CityName | CountyName | StateName | ZIPCode | OfficialTitle | OfficialName | AddInfo | AddFile |
e.g.: 1 | e.g.: EPA Brooklyn Facility 1 | e.g.: 123 Main Street | e.g.: Suite 100 | e.g.: Brooklyn | e.g.: Kings | e.g.: NY | e.g.: 11221 | e.g.: President | e.g.: John Smith | e.g.: Provide any additional information here. | e.g.: addlinfo.zip |
40 CFR Part 63, Subpart JJJJJJ Industrial, Commercial, and Institutional Boilers Area Sources: 63.11225a_4_vi_Notification_of_Compliance_Status Spreadsheet Template | |||||||||
63.11225a_4_vi_Notification_of_Compliance_Status Spreadsheet Template | |||||||||
The asterisk (*) next to each field indicates that the corresponding field is required. | |||||||||
Facility Record No. * (Select from dropdown) |
1. The methods that were used to determine compliance.* [§63.9(h)(2)(i)(A)] |
2. The methods that will be used for determining continuing compliance, including a description of monitoring and reporting requirements and test methods.* [§63.9(h)(2)(i)(C)] | 3. Select Yes if this affected existing, new, or reconstructed source has complied with the relevant standard or other requirements.* [§63.9(h)(2)(i)(G)] (Select from Dropdown) |
4. Select Yes if this facility complies with the requirements in 63.11214 to conduct an initial tune-up of the boiler. * [§63.11225(a)(4)(ii)] (Select from Dropdown) |
5. Select Yes if this facility has had an energy assessment performanced according to 63.11214(c). * [§63.11225(a)(4)(iii)] (Select from Dropdown) |
6. For units that install bag leak detection systems: Select yes if the statement "This facility complies with the requirements in 63.11224(f)." applies.* [§63.11225(a)(4)(iv)] (Select from Dropdown) |
7. If this facility does not qualify for the statutory exemption under section 129(g)(1) of the Clean Air Act, were secondary materials that are solid waste combusted in any affected unit. * [§63.11225(a)(4)(v)] (Select from Dropdown) |
8a. Date of the test showing conformance with the emission standards and operating limits of this subpart (if applicable). [§63.11225(a)(5)] |
8b. Summary of Results showing conformance with the emission standards and operating limits of this subpart (if applicable). [§63.11225(a)(5)] |
RecordId | ComplianceMethod | TestMethod | StandardReqFlag | TuneUpFlag | EnergyAssessFlag | BagLeakFlag | AffectedUnitFlag | TestDate | TestResults |
e.g.: 1 | e.g.: Boiler Tune Up | e.g.: Boiler Tune up | e.g.: Yes | e.g.: Yes | e.g.: Yes | e.g.: Yes | e.g.: Not Applicable | e.g.: 3/20/2020 | e.g.: Not applicable |
40 CFR Part 63, Subpart JJJJJJ Industrial, Commercial, and Institutional Boilers Area Sources: 63.11225a_4_vi_Notification_of_Compliance_Status Spreadsheet Template | ||
63.11225a_4_vi_Notification_of_Compliance_Status Spreadsheet Template | ||
Date | Version | Description |
1/22/2016 | 1.00 | Original implementation of template. |
3/14/2019 | 1.00 | Updated the State dropdown with VI, PR, AS, MP, and GU; added the CBI disclaimer to Welcome sheet |
10/13/2020 | 2.00 | Updated the CBI Disclaimer to Welcome worksheet, updated XML tagging; split out facility information into its own worksheet; add/hide column A in Data worksheet; add hidden mapping worksheet; updated zip code format under Facility_Information sheet |
11/17/2021 | ICR Draft 2.01 | Add title to Revisions tab, Add PRA Information and updated formatting of Welcome tab, On Facility_Information, updated formatting, updated dropdown list of states, on the Data tab, updated formatting, entered "e.g.:" in all hidden example cells to ease filtering out of those sells, updated phrasing of some of the statements to make the applicable response easier to discern, Updated the dynamic dropdown to direct the user to the correct sheet to completein order to generate the list when the data has not yet been entered. |
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |