DHEC Form 2951 "Title V Operating Permit Application - Designated Responsible Official Notification" - South Carolina

What Is DHEC Form 2951?

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

Form Details:

  • Released on April 1, 2020;
  • The latest edition provided by the South Carolina Department of Health and Environmental Control;
  • 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 DHEC Form 2951 by clicking the link below or browse more documents and templates provided by the South Carolina Department of Health and Environmental Control.

ADVERTISEMENT
ADVERTISEMENT

Download DHEC Form 2951 "Title V Operating Permit Application - Designated Responsible Official Notification" - South Carolina

491 times
Rate (4.8 / 5) 29 votes
Bureau of Air Quality
Title V Operating Permit Application
Designated Responsible Official Notification Instructions
Page 1 of 1
PLEASE DO NOT SEND A COPY OF THE INSTRUCTIONS IN WITH YOUR APPLICATION
If you have any questions while filling out the Designated Responsible Official form, please contact the Bureau of Air Quality,
Air Permitting Division by calling (803) 898-4123. Submit the Designated Responsible Official form to:
Air Permitting Division Director
Bureau of Air Quality
2600 Bull Street
Columbia, South Carolina, 29201
RESPONSIBLE OFFICIAL QUALIFICATIONS
(https://www.scdhec.gov/sites/default/files/media/document/R.61-62.70_20190125_0.pdf#page=8
)
For a corporation:
A president, secretary, treasurer, or vice-president of the corporation in charge of a principal business function, or
any other person who performs similar policy or decision-making functions for the corporation; or a duly authorized
representative of such person if the representative is responsible for the overall operation of one or more
manufacturing, production, or operating facilities applying for or subject to a permit and either:
(i) The facilities employ more than 250 persons or have gross annual sales or expenditures exceeding $25 million
(in second quarter l980 dollars); or
(ii) The delegation of authority to such representative is approved in advance by the Department.
For a partnership or sole proprietorship:
A general partner; or the proprietor, respectively.
For a municipality, state, federal, or other public agency:
Either a principal executive officer; or ranking elected official. For the purposes of this Part, a principal executive
officer of a federal agency includes the chief executive officer having responsibility for the overall operations of a
principal geographic unit of the agency (for example, a Regional Administrator of EPA).
For affected sources:
The designated representative in so far as actions, standards, requirements, or prohibitions under the Title IV acid
rain requirements of the Act or the regulations promulgated thereunder are concerned; and the designated
representative for any other purposes under Part 70.
This form is subject to Retention Schedule 16303.
DHEC 2951 (04/20)
Bureau of Air Quality
Title V Operating Permit Application
Designated Responsible Official Notification Instructions
Page 1 of 1
PLEASE DO NOT SEND A COPY OF THE INSTRUCTIONS IN WITH YOUR APPLICATION
If you have any questions while filling out the Designated Responsible Official form, please contact the Bureau of Air Quality,
Air Permitting Division by calling (803) 898-4123. Submit the Designated Responsible Official form to:
Air Permitting Division Director
Bureau of Air Quality
2600 Bull Street
Columbia, South Carolina, 29201
RESPONSIBLE OFFICIAL QUALIFICATIONS
(https://www.scdhec.gov/sites/default/files/media/document/R.61-62.70_20190125_0.pdf#page=8
)
For a corporation:
A president, secretary, treasurer, or vice-president of the corporation in charge of a principal business function, or
any other person who performs similar policy or decision-making functions for the corporation; or a duly authorized
representative of such person if the representative is responsible for the overall operation of one or more
manufacturing, production, or operating facilities applying for or subject to a permit and either:
(i) The facilities employ more than 250 persons or have gross annual sales or expenditures exceeding $25 million
(in second quarter l980 dollars); or
(ii) The delegation of authority to such representative is approved in advance by the Department.
For a partnership or sole proprietorship:
A general partner; or the proprietor, respectively.
For a municipality, state, federal, or other public agency:
Either a principal executive officer; or ranking elected official. For the purposes of this Part, a principal executive
officer of a federal agency includes the chief executive officer having responsibility for the overall operations of a
principal geographic unit of the agency (for example, a Regional Administrator of EPA).
For affected sources:
The designated representative in so far as actions, standards, requirements, or prohibitions under the Title IV acid
rain requirements of the Act or the regulations promulgated thereunder are concerned; and the designated
representative for any other purposes under Part 70.
This form is subject to Retention Schedule 16303.
DHEC 2951 (04/20)
Bureau of Air Quality
Title V Operating Permit Application
Designated Responsible Official Notification
Page 1 of 1
FACILITY IDENTIFICATION
Facility Name
SC Air Permit Number
Notification Date
(This should be the name listed on your Title V Permit)
(8-digits only)
DESIGNATED RESPONSIBLE OFFICIAL
Action:
Add RO
Update Current RO Information
Remove a Current RO
Title/Position:
Salutation:
First Name:
Last Name:
Mailing Address:
City:
State:
Zip Code:
E-mail Address:
Phone No.:
Cell No.:
Reason
(Only provide if removing a RO)
Action:
Add RO
Update Current RO Information
Remove a Current RO
Title/Position:
Salutation:
First Name:
Last Name:
Mailing Address:
City:
State:
Zip Code:
E-mail Address:
Phone No.:
Cell No.:
Reason
(Only provide if removing a RO)
Action:
Add RO
Update Current RO Information
Remove a Current RO
Title/Position:
Salutation:
First Name:
Last Name:
Mailing Address:
City:
State:
Zip Code:
E-mail Address:
Phone No.:
Cell No.:
Reason
(Only provide if removing a RO)
Action:
Add RO
Update Current RO Information
Remove a Current RO
Title/Position:
Salutation:
First Name:
Last Name:
Mailing Address:
City:
State:
Zip Code:
E-mail Address:
Phone No.:
Cell No.:
Reason
(Only provide if removing a RO)
RESPONSIBLE OFFICIAL SIGNATURE
(Any Designated Responsible Official for the facility can sign form)
Title/Position:
Salutation:
First Name:
Last Name:
As a duly authorized representative of this facility, with the responsibility to ensure that this facility is in compliance with
the requirements of the operating permit issued by the Department, I certify that the information in this form is true,
accurate, and complete.
Signature of Responsible Official
Date
DHEC 2951 (04/20)
Page of 2