Form RP-01 "Registration Permit Facility Information" - Minnesota

What Is Form RP-01?

This is a legal form that was released by the Minnesota Pollution Control Agency - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 18, 2020;
  • The latest edition provided by the Minnesota Pollution Control Agency;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form RP-01 by clicking the link below or browse more documents and templates provided by the Minnesota Pollution Control Agency.

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RP-01
Registration permit facility information
Air Quality Permit Program
Doc Type: Permit Application
Instructions on page 3
1a)
AQ Facility ID number:
1b) Agency Interest ID number:
2)
Facility name:
3)
Facility location:
Street address:
City:
MN
County:
ZIP code:
Note: If the facility is or will be located within the city limits of Minneapolis, include a map showing the exact location.
Mailing address:
City:
State:
ZIP code:
4)
Corporate/Company owner:
Name:
Mailing address:
City:
State:
ZIP code:
Owner classification:
Private
Local Govt
State Govt.
Federal Govt.
Utility
5)
Corporate/Company operator (if different than owner):
Name:
Mailing address:
City:
State:
ZIP code:
6)
Co-permittee (if applicable):
Name:
Mailing address:
City:
State:
ZIP code:
7)
Legally responsible official for this permit/facility:
Mr/Ms:
Phone:
Title:
Fax:
At (check one):
Owner address
Operator address
Emission facility address
Other (specify):
Email address:
8)
Contact person for this permit:
Mr/Ms:
Phone:
Title:
Fax:
At (check one):
Owner address
Operator address
Emission facility address
Other (specify):
Email address:
https://www.pca.state.mn.us
651-296-6300
800-657-3864
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aq-f3-rp01 • 2/18/20
Page 1 of 5
RP-01
Registration permit facility information
Air Quality Permit Program
Doc Type: Permit Application
Instructions on page 3
1a)
AQ Facility ID number:
1b) Agency Interest ID number:
2)
Facility name:
3)
Facility location:
Street address:
City:
MN
County:
ZIP code:
Note: If the facility is or will be located within the city limits of Minneapolis, include a map showing the exact location.
Mailing address:
City:
State:
ZIP code:
4)
Corporate/Company owner:
Name:
Mailing address:
City:
State:
ZIP code:
Owner classification:
Private
Local Govt
State Govt.
Federal Govt.
Utility
5)
Corporate/Company operator (if different than owner):
Name:
Mailing address:
City:
State:
ZIP code:
6)
Co-permittee (if applicable):
Name:
Mailing address:
City:
State:
ZIP code:
7)
Legally responsible official for this permit/facility:
Mr/Ms:
Phone:
Title:
Fax:
At (check one):
Owner address
Operator address
Emission facility address
Other (specify):
Email address:
8)
Contact person for this permit:
Mr/Ms:
Phone:
Title:
Fax:
At (check one):
Owner address
Operator address
Emission facility address
Other (specify):
Email address:
https://www.pca.state.mn.us
651-296-6300
800-657-3864
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Page 1 of 5
9)
All billings for annual fees should be addressed to:
Mr/Ms:
Phone:
Title:
Fax:
At (check one):
Owner address
Operator address
Emission facility address
Other (specify):
Email address:
10)
North American Industry Classification System (NAICS) and Standard Industrial Classification (SIC) Codes and description
for the facility:
NAICS
SIC
Description
Primary:
/
Secondary (if applicable):
/
Tertiary (if applicable):
/
11)
Primary product produced (or activity performed) at the facility is:
12)
Facility is:
Stationary
Portable
13)
Number of full time employees or equivalent FTE at this facility:
14)
Check and complete the option that best applies:
New Facility. Construction will begin on (estimated date):
Existing Facility. Applying for the first time for any MPCA air emission permit.
Attach a project description to this form that lists the reasons for applying for an air emission permit.
Existing Facility. Moving equipment to new location/building on (estimated date):
Existing Facility. Facility currently has an air emission permit (Permit No.
) Applying for a new
Registration Permit (option indicated in item 15) because the facility is now or will be qualified for this option.
15)
This application is for Registration Permit Option :
Form RP-03 attached (required)
Option A
Applicable NSPS Checklist form attached (required unless a copy of the applicable NSPS is attached instead).
gallons/year of volatile organic compound (VOC)-containing materials = _
__
Option B
(must be < 2000 gallons/year)
based on:
Purchase
Use
Form RP-04 attached (required only if estimating totals because there is less than 12 months’ data)
Potential to emit (PTE) calculations for exising facilities (including HAPs PTE calculations).
Form RP-C1 attached (required)
Option C
Form EC-03 attached (required only if installing a non-emergency engine or if there are existing non-emergency
engines not modeled and installed after January 1, 2000)
Form RP-04 attached (required only if estimating totals because there is less than 12 months’ data)
Form RP-D1 attached (required)
Option D
Emission calculations attached (required)
Material Safety Data Sheets (MSDS) attached (required if using MSDS information in calculations)
Form RP-04 attached (required if estimating totals because there is less than 12 months’ data)
Form RP-D2 attached (required if using listed control equipment in calculations)
Form RP-D3 attached (required if using control equipment employing hoods for capture)
Form EC-03 attached (required if installing a non-emergency engine or if there are existing non-emergency
engines not modeled and installed after January 1, 2000)
Form RP-D4 attached (required)
Submittal cover page (Form SCP-01) attached (required)
All Options
Form RP-03 attached (required only if an NSPS applies)
Applicable NSPS checklist (Form NSPS-xx, whichever is applicable) attached (required only if an NSPS
applies) unless a highlighted copy of the applicable NSPS is attached instead
Form RP-07 attached (required only if an area-source NESHAP applies)
Highlighted copy of applicable area-source NESHAP attached (required only if Form RP-07 is required)
Potential to Emit calculations if this is an existing facility applying for the first time for any MPCA air emission permit.
16) Person preparing this permit application:
Mr/Ms:
Title:
Phone:
Fax:
Date:
Email address:
https://www.pca.state.mn.us
651-296-6300
800-657-3864
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Page 2 of 5
Instructions for Form RP-01
1a)
AQ Facility ID number -- Fill in your Air Quality (AQ) Facility identification (ID) number. This is the first eight digits of the
permit number for all new permits issued under the operating permit program. If your facility has never been issued a permit
under this program, leave this line blank.
1b)
Agency Interest ID number -- Fill in your Agency Interest ID number. This is an ID number assigned to your facility through
the Tempo database. If you don’t know this number, leave this line blank.
2)
Facility name -- Enter your facility name.
3)
Facility location -- Fill in the facility's street address and the city and county where the facility is located. Also indicate the
facility's mailing address., if this is different from the facility’s location (for example, if the mailing address is a P.O. Box). If the
facility is or will be located within the city limits of Minneapolis, provide a map showing the exact location.
4)
Corporate/Company owner -- Fill in the owner name and mailing address. (By “owner” we mean a corporate or company
name, not necessarily an individual.) The owner is issued the air emission permit from the Minnesota Pollution Control
Agency (MCPA). The owner is the "Permittee". Check the one "owner classification box" that most closely describes your
facility.
5)
Corporate/Company operator (if different from owner) -- The operator runs the facility on a day-to-day basis. If a separate
management company operates the facility, its name goes here. The operator is also a "Permittee". Fill in if applicable. If not
applicable, fill in "N/A".
6)
Co-permittee (if applicable) -- If the emission facility has more than one owner, for example a partnership, then the second
owner's name and address go here. Another example is two facilities, owned separately, where one facility exists to support
the other; both facilities are subject to one permit and the two owners are considered co-permittees.
7)
Legally responsible official for this permit/facility -- Fill in the name, title, phone number, fax number (if applicable) and
email address of the Legally Responsible Official. For the purpose of Form RP-01, the Legally Responsible Official must be a
person meeting the criteria for signing the application (defined in Minn. R. 7007.0100, subp. 21), which is the person who
performs policy or decision making functions for the company. (A delegate may be allowed in some cases. Please refer to
the rule section listed above.)
Indicate which address applies to this person by checking the appropriate box.
8)
Contact-person for this permit -- Fill in the name, title, phone number, fax number (if applicable), and email address of the
individual to whom the permit and other permitting correspondence should be sent. Indicate which address applies to this
person by checking the appropriate box. Include the email address at which the contact person can be reached.
9)
All billings and annual fees should be addressed to -- Fill in the name, title, phone number, fax number (if applicable),
and email address of the individual to whom the annual emissions inventory and emissions fee billing should be sent.
Indicate which address applies to this person by checking the appropriate box.
10)
North American Industry Classification System (NAICS) and Standard Industrial Classification (SIC) Codes and
description for the facility -- Fill in the primary (and secondary and tertiary if applicable) NAICS and SIC code(s) for the
facility. A single stationary source may have more than one NAICS or SIC code. For example a facility makes and prints on
cardboard boxes. The facility would have a primary SIC code of 2653. If the facility does some of its own printing on-site, it
would have a secondary SIC code of 2751.
11)
Primary product produced (or activity performed) at the facility is -- Indicate the primary product or activity of your
business.
12)
Facility is stationary or portable -- Indicate whether the facility is a stationary or a portable source. A portable facility is one
that operates and moves from site to site. An example of a portable facility might be an asphalt plant.
13)
Number of full time employees(FTE) at this facility: Enter the number of people employed full-time (or FTE equivalent) at
this facility.
14)
Check and complete the option that best applies to this facility -- Indicate whether this application is for a new facility, or
if the facility exists and does or does not currently hold an air emissions permit. For existing facilities, include a project
description. The project description must include reasons for applying for an air emission permit.
15)
This Application is for Registration Permit Option -- Place a check-mark in the box corresponding to the Registration
Permit Option for which you are applying (A, B, C, or D). Next to each option is a list of the additional forms or other
information that may be required when applying for that type of permit. Please make sure all of the necessary forms and
information are included with your application. For existing facilities, include PTE calculations. The last row of the table lists
forms that are or may be required for all Registration Permit Options.
The following New Source Performance Standards (NSPS) and area-source National Emission Standards for Hazardous Air
Pollutants (NESHAP) may be applicable to a facility receiving a registration permit. If the facility is subject to any NSPS not
on this list, or any NESHAP other than the area source standards listed, then the facility is not eligible for any registration
permit. If an NSPS does apply, attach Form RP-03 and either a copy of the standard with the applicable portions highlighted,
or include the appropriate NSPS Check-off Form (listed on the following table). If an area source NESHAP applies, attach
Form RP-07 and a copy of the standard with the applicable portions highlighted.
https://www.pca.state.mn.us
651-296-6300
800-657-3864
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NSPS check-off
Allowed NSPS (40 CFR Part 60) subpart and title
form number
Dc -- Standards of Performance for Small Industrial-Commercial-Institutional Steam Generating Units
NSPS-Dc
I -- Standards of Performance for Hot Mix Asphalt Facilities
NSPS-I
K -- Standards of Performance for Storage Vessels for Petroleum Liquids for Which Construction,
NSPS-K
Reconstruction, or Modification Commenced after June 11, 1973 and Prior to May 19, 1978
Ka -- Standards of Performance for Storage Vessels for Petroleum Liquids for Which Construction,
NSPS-Ka
Reconstruction, or Modification Commenced after May 18, 1978 and Prior to July 23, 1984
Kb -- Standards of Performance for Volatile Organic Liquid Storage Vessels (Including Petroleum Storage
NSPS-Kb
Vessels) for Which Construction, Reconstruction, or Modification Commenced After July 23, 1984
DD -- Standards of Performance for Grain Elevators (constructed, reconstructed, or modified after August
NSPS-DD
3, 1978)
EE -- Standards of Performance for Surface Coating of Metal Furniture (constructed, reconstructed, or
NSPS-EE
modified after November 28, 1980)
SS -- Standards of Performance for Industrial Surface Coating: Large Appliances (constructed,
NSPS-SS
reconstructed, or modified after December 24, 1980)
JJJ -- Standards of Performance for Petroleum Dry Cleaners
NSPS-JJJ
OOO -- Standards of Performance for Nonmetallic Mineral Processors (constructed, reconstructed, or
NSPS-OOO
modified after August 31, 1983)
TT -- Standards of Performance for Industrial Surface Cleaning of Plastic Parts for Business Machines
NSPS-TT
(constructed, reconstructed, or modified after January 8, 1986)
GG – Standards of Performance for Stationary Gas Turbines
NSPS-GG
IIII – Standards of Performance for Stationary Compression Ignition Internal Combustion Engines
No form available
JJJJ – Standards of Performance for Stationary Spark Ignition Internal Combustion Engines
No form available
Allowed NESHAP (40 CFR Part 63)
Industry or Operation
Part 63 Subpart
Acrylic and Modacrylic Fibers Production
LLLLLL
Aluminum, Copper, and Other Nonferrous Foundries
ZZZZZZ
Asphalt Processing and Asphalt Roofing Manufacturing
AAAAAAA
1
Chemical Manufacturing Area Sources
VVVVVV
Chemical Preparations Industry
BBBBBBB
Chromic acid anodizing; Decorative and Hard chromium electroplating (Chromium Electroplating)
N
Clay Ceramics Manufacturing
RRRRRR
Commercial dry cleaning (Perc) transfer machines
M
Commercial sterilization facilities
O
Ferroalloys Production Facilities
YYYYYY
Flexible Polyurethane Foam Production and Fabrication
OOOOOO
Gasoline Dispensing Facilities
CCCCCC
Gasoline Distribution Bulk Terminals, Bulk Plants, and Pipeline Facilities
BBBBBB
Halogenated solvent cleaners (Degreasing Organic Cleaners)
T
Hospital Sterilizers Using Ethylene Oxide
WWWWW
Industrial, Commercial and Institutional Boilers and Process Heaters
JJJJJJ
Iron and Steel Foundries Area Sources
ZZZZZ
Lead Acid Battery Manufacturing
PPPPPP
Metal Fabrication and Finishing Sources
XXXXXX
https://www.pca.state.mn.us
651-296-6300
800-657-3864
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Industry or Operation
Part 63 Subpart
Oil and natural gas production
HH
Paint Stripping and Miscellaneous Surface Coating Operations at Area Sources
HHHHHH
Paints and Allied Products Manufacturing
CCCCCCC
Plating and Polishing Operations
WWWWWW
Polyvinyl Chloride and Copolymers Production
DDDDDD
Prepared Feeds Manufacturing
DDDDDDD
Reciprocating Internal Combustion Engines
ZZZZ
Secondary aluminum processing
RRR
Secondary Nonferrous Metals Processing
TTTTTT
Wood Preserving
QQQQQQ
1
If a source subject to this subpart was a major source of HAP and installed control equipment after November 15, 1990, to
become an area source of HAP, the source must obtain a Part 70 operating permit, regardless of the facility emissions.
16)
Person preparing this permit application -- Fill in the name, title, phone number, fax number (if applicable), and email
address of the individual filling out this permit application. Include the date of application.
https://www.pca.state.mn.us
651-296-6300
800-657-3864
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