Form SFN8539 "Oil Seed Processing Equipment Annual Emission Inventory Report" - North Dakota

What Is Form SFN8539?

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

Form Details:

  • Released on June 1, 2014;
  • The latest edition provided by the North Dakota Department of Health;
  • 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 fillable version of Form SFN8539 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Health.

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Download Form SFN8539 "Oil Seed Processing Equipment Annual Emission Inventory Report" - North Dakota

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OIL SEED PROCESSING EQUIPMENT
ANNUAL EMISSION INVENTORY REPORT
NORTH DAKOTA DEPARTMENT OF HEALTH
DIVISION OF AIR QUALITY
SFN 8539 (06-14)
GENERAL
Name of Firm or Organization
Permit to Operate Number
Year of Emissions
Mailing Address
City
State
ZIP Code
Facility Name
Facility Location
Emission Unit Number
PROCESSING DATA
OPERATION
ANNUAL QUANTITY
ACTUAL HOURS OF
(Specify Units)
OPERATION
Seeds Received
Seeds Dried
Seeds Processed
Meal Produced
Meal Shipped
Solvent Loss
N/A
STACK EMISSIONS
Air Contaminant *
Emission Factor
Emission Factor Source
Tons
(Include Units)
(Include Test Date if Applicable)
Particulate - Total PM (Filterable)
Particulate - PM
(Filterable)
10
Particulate - PM
(Filterable)
2.5
Particulate - CPM (Condensable)
Total Organic Compounds: Nonmethane
Other (Specify):
Other (Specify):
* Submit SFN 19839 for Hazardous Air Pollutants if applicable.
I declare under the penalties of perjury that this report has been examined by me and to the best of my knowledge is a true, correct and complete report.
Print Name of Person Submitting Report
Title
Telephone Number
Signature
Email Address
Date
Return completed form to:
North Dakota Department of Health
Division of Air Quality
918 E Divide, 2nd Floor
Bismarck, ND 58501-1947
Telephone:(701)328-5188
OIL SEED PROCESSING EQUIPMENT
ANNUAL EMISSION INVENTORY REPORT
NORTH DAKOTA DEPARTMENT OF HEALTH
DIVISION OF AIR QUALITY
SFN 8539 (06-14)
GENERAL
Name of Firm or Organization
Permit to Operate Number
Year of Emissions
Mailing Address
City
State
ZIP Code
Facility Name
Facility Location
Emission Unit Number
PROCESSING DATA
OPERATION
ANNUAL QUANTITY
ACTUAL HOURS OF
(Specify Units)
OPERATION
Seeds Received
Seeds Dried
Seeds Processed
Meal Produced
Meal Shipped
Solvent Loss
N/A
STACK EMISSIONS
Air Contaminant *
Emission Factor
Emission Factor Source
Tons
(Include Units)
(Include Test Date if Applicable)
Particulate - Total PM (Filterable)
Particulate - PM
(Filterable)
10
Particulate - PM
(Filterable)
2.5
Particulate - CPM (Condensable)
Total Organic Compounds: Nonmethane
Other (Specify):
Other (Specify):
* Submit SFN 19839 for Hazardous Air Pollutants if applicable.
I declare under the penalties of perjury that this report has been examined by me and to the best of my knowledge is a true, correct and complete report.
Print Name of Person Submitting Report
Title
Telephone Number
Signature
Email Address
Date
Return completed form to:
North Dakota Department of Health
Division of Air Quality
918 E Divide, 2nd Floor
Bismarck, ND 58501-1947
Telephone:(701)328-5188