Form MO780-1875 "Emissions Banking and Trading" - Missouri

What Is Form MO780-1875?

This is a legal form that was released by the Missouri Department of Natural Resources - a government authority operating within Missouri. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2004;
  • The latest edition provided by the Missouri Department of Natural Resources;
  • 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 MO780-1875 by clicking the link below or browse more documents and templates provided by the Missouri Department of Natural Resources.

ADVERTISEMENT
ADVERTISEMENT

Download Form MO780-1875 "Emissions Banking and Trading" - Missouri

Download PDF

Fill PDF online

Rate (4.7 / 5) 20 votes
APCP USE ONLY
PROJECT NUMBER
MISSOURI DEPARTMENT OF NATURAL RESOURCES
AIR POLLUTION CONTROL PROGRAM
CONSTRUCTION PERMIT VERIFICATION
P.O. BOX 176
JEFFERSON CITY, MO 65102
OPERATING PERMIT VERIFICATION
EMISSIONS BANKING AND TRADING
INSTALLATION/COMPANY INFORMATION
1. NAME OF INSTALLATION
2. INSTALLATION ID NUMBER
3. INSTALLATION/COMPANY MAILING ADDRESS
4. CITY, STATE, ZIP CODE
5. CONSTRUCTION PERMIT NUMBER
6. OPERATING PERMIT NUMBER
7. ACCOUNT ID NUMBER
8. CONTACT PERSON
9. CONTACT PERSON’S TELEPHONE NUMBER
10. CONTACT PERSON’S FAX NUMBER
11. CONTACT PERSON’S EMAIL ADDRESS
CRITERIA AIR POLLUTANT
12. APPLICABLE POLLUTANT
SITE LOCATION
13. STREET ADDRESS OR PHYSICAL LOCATION OF SITE
14. PLANT/SITE ID NUMBER
15. COUNTY NAME
16. 1/4 OF, 1/4 OF, SECTION, TOWNSHIP, RANGE
PURPOSE OF NOTICE
17. CHECK ONE
Notice and Certification of Generation (Form 4B)
Notice of Intent to Use ERCs (Form 4C)
Notice of Withdrawal (Form 4D)
Notice of Transfer (Form 4E)
FORM 4B: NOTICE AND CERTIFICATION OF GENERATION
18. ATTACH A BRIEF NARRATIVE DESCRIPTION OF THE EMISSION REDUCTION CREDIT (ERC) GENERATION ACTIVITY
19. The ERCs generated must be real, properly quantified, permanent, and surplus. Please contact the Operating Permit Unit of the Air
Pollution Control Program to determine if the ERC generation activity requires modification of the operating permit.
20. START DATE OF PRE-GENERATION PERIOD
21. FINISH DATE OF PREGENERATION PERIOD
22. EMISSION RATE DURING PRE-GENERATION PERIOD
23. START DATE OF GENERATION PERIOD
24. FINISH DATE OF GENERATION PERIOD*
25. EMISSION RATE DURING GENERATION PERIOD
26. ERCS GENERATED
*ERC’s must be permanent in accordance with state rule requirements.
EMISSION REDUCTION CREDIT (ERC) QUANTITATION
27. CHECK ALL PROTOCOLS USED TO QUANTIFY ERCS AND PROVIDE COMPLETE CALCULATIONS (LISTED IN ORDER OF PRIORITY)
1. Continuous Emissions Monitoring System (CEMS)
5. Other EPA Documents
2. Stack Tests
6. Engineering Calculations
3. Material/Mass Balance
7. Other Departmentally Approved Protocol
4. AP-42 or FIRE
COMMUNITY RIGHT-TO-KNOW PROVISIONS (40 CFR 372)
28. FOR EACH SOURCE SUBJECT TO REPORTING TOXIC CHEMICALS UNDER 40 CFR 372, ATTACH A REPORT ESTIMATING THE AMOUNT OF HAPS EMITTED AS A RESULT OF ERC GENERATION.
• Report Chemical Identity, as per 10 CSR 10-6.410(4)(C)10.
• Report estimate of HAPs emissions, in pounds, with calculations,
during the ERC generation period.
MO 780-1875 (1-04)
APCP USE ONLY
PROJECT NUMBER
MISSOURI DEPARTMENT OF NATURAL RESOURCES
AIR POLLUTION CONTROL PROGRAM
CONSTRUCTION PERMIT VERIFICATION
P.O. BOX 176
JEFFERSON CITY, MO 65102
OPERATING PERMIT VERIFICATION
EMISSIONS BANKING AND TRADING
INSTALLATION/COMPANY INFORMATION
1. NAME OF INSTALLATION
2. INSTALLATION ID NUMBER
3. INSTALLATION/COMPANY MAILING ADDRESS
4. CITY, STATE, ZIP CODE
5. CONSTRUCTION PERMIT NUMBER
6. OPERATING PERMIT NUMBER
7. ACCOUNT ID NUMBER
8. CONTACT PERSON
9. CONTACT PERSON’S TELEPHONE NUMBER
10. CONTACT PERSON’S FAX NUMBER
11. CONTACT PERSON’S EMAIL ADDRESS
CRITERIA AIR POLLUTANT
12. APPLICABLE POLLUTANT
SITE LOCATION
13. STREET ADDRESS OR PHYSICAL LOCATION OF SITE
14. PLANT/SITE ID NUMBER
15. COUNTY NAME
16. 1/4 OF, 1/4 OF, SECTION, TOWNSHIP, RANGE
PURPOSE OF NOTICE
17. CHECK ONE
Notice and Certification of Generation (Form 4B)
Notice of Intent to Use ERCs (Form 4C)
Notice of Withdrawal (Form 4D)
Notice of Transfer (Form 4E)
FORM 4B: NOTICE AND CERTIFICATION OF GENERATION
18. ATTACH A BRIEF NARRATIVE DESCRIPTION OF THE EMISSION REDUCTION CREDIT (ERC) GENERATION ACTIVITY
19. The ERCs generated must be real, properly quantified, permanent, and surplus. Please contact the Operating Permit Unit of the Air
Pollution Control Program to determine if the ERC generation activity requires modification of the operating permit.
20. START DATE OF PRE-GENERATION PERIOD
21. FINISH DATE OF PREGENERATION PERIOD
22. EMISSION RATE DURING PRE-GENERATION PERIOD
23. START DATE OF GENERATION PERIOD
24. FINISH DATE OF GENERATION PERIOD*
25. EMISSION RATE DURING GENERATION PERIOD
26. ERCS GENERATED
*ERC’s must be permanent in accordance with state rule requirements.
EMISSION REDUCTION CREDIT (ERC) QUANTITATION
27. CHECK ALL PROTOCOLS USED TO QUANTIFY ERCS AND PROVIDE COMPLETE CALCULATIONS (LISTED IN ORDER OF PRIORITY)
1. Continuous Emissions Monitoring System (CEMS)
5. Other EPA Documents
2. Stack Tests
6. Engineering Calculations
3. Material/Mass Balance
7. Other Departmentally Approved Protocol
4. AP-42 or FIRE
COMMUNITY RIGHT-TO-KNOW PROVISIONS (40 CFR 372)
28. FOR EACH SOURCE SUBJECT TO REPORTING TOXIC CHEMICALS UNDER 40 CFR 372, ATTACH A REPORT ESTIMATING THE AMOUNT OF HAPS EMITTED AS A RESULT OF ERC GENERATION.
• Report Chemical Identity, as per 10 CSR 10-6.410(4)(C)10.
• Report estimate of HAPs emissions, in pounds, with calculations,
during the ERC generation period.
MO 780-1875 (1-04)
FORM 4C: NOTICE OF INTENT TO USE ERCS
29. DATE(S) ERCS WERE ACQUIRED
30. AMOUNT OF ERCS USED, WITH SERIAL NUMBERS
31. Attach a copy of applicable Notice of Certification of Generation form(s). Identify applicable emissions unit(s) IAW 6.410(4)(C)2.
32. Attach a brief narrative listing the applicable state and federal requirements that the ERCs were used to comply with.
EMISSION REDUCTION CREDIT (ERC) QUANTITATION
33. CHECK ALL PROTOCOLS USED TO QUANTIFY ERCS AND PROVIDE COMPLETE CALCULATIONS (LIST IN ORDER OF PRIORITY)
1. Continuous Emission Monitoring System (CEMS)
5. Other EPA Documents
2. Stack Tests
6. Engineering Calculations
3. Material/Mass Balance
7. Other Departmentally Approved Protocol
4. AP-42 or FIRE
COMMUNITY RIGHT-TO-KNOW PROVISIONS (40 CFR 372)
34. FOR EACH SOURCE SUBJECT TO REPORTING TOXIC CHEMICALS UNDER 40 CFR 372, ATTACH A REPORT ESTIMATING THE AMOUNT OF HAPS EMITTED AS A RESULT OF ERC GENERATION.
• Report Chemical Identity, as per 10 CSR 10-6.410(4)(C)10.
• Report estimate of HAPs emissions, in pounds, with calculations,
during the ERC generation period.
FORM 4D: NOTICE OF WITHDRAWAL
35. DATE(S) ERCS WERE ACQUIRED
36. AMOUNT OF ERCS TO BE WITHDRAWN, WITH SERIAL NUMBERS
37. Attach a copy of applicable Notice and Certification of Generation form(s). Identify applicable emissions unit(s) IAW 6.410(4)(C)2 and
(4)(D)2.
38. Attach a brief narrative of the reason(s) for withdrawal.
FORM 4E: NOTICE OF TRANSFER
39. NAME OF ACCOUNT HOLDER TRADING ERCS
40. ACCOUNT ID NUMBER
41. TRADING ACCOUNT HOLDER’S MAILING ADDRESS
42. CITY, STATE, ZIP CODE
43. NAME OF ACCOUNT HOLDER RECEIVING ERCS
44. ACCOUNT ID NUMBER
45. RECEIVING ACCOUNT HOLDER’S MAILING ADDRESS
46. CITY, STATE, ZIP CODE
47. AMOUNT OF ERCS TO BE TRANSFERRED, WITH SERIAL NUMBERS
48. Attach a copy of applicable Notice and Certification of Generation form(s).
49. Attach a statement, signed by the Authorized Representative of the Account Holder Trading ERCs, agreeing to the requested transfer.
SIGNATURE OF AUTHORIZED REPRESENTATIVE
I attest that due to diligence has been made to verify that the ERCs referenced in this notice were not previously used, and they have not
been generated in whole or in part from actions prohibited in 10 CSR 10-6.410, or other provisions of law.
50. SIGNATURE
51. DATE
52. TYPE OR PRINT NAME OF PERSON SIGNING
53. TITLE OF PERSON SIGNING
54. TYPE OR PRINT NAME OF ALTERNATE REPRESENTATIVE
55. TITLE OF ALTERNATE REPRESENTATIVE
56. TELEPHONE NUMBER
57. FAX NUMBER
MO 780-1875 (1-04)
Page of 2