A Branch of the Georgia Environmental Protection Division

Example 502(b)(10) Request Letter

[Note:  copy/paste into your document and edit]

Company Letterhead
[date]

[EPD Permit Engineer]
Environmental Engineer
Stationary Source Permitting Program
Georgia EPD - Air Protection Branch
4244 International Parkway, Suite 120
Atlanta, Georgia 30354

Re: Permit No. XXXX-XXX-XXXX-V-XX-X
Section 502(b)(10) Change

Dear [Mr./Ms. EPD Permit Engineer]:

[Company Name] plans to make the following change pursuant to Georgia Air Quality Control Rule 391-3-1-.03(10)(b)5.

1) Description of the change: [insert description of change]

2) Planned date of the change: [insert planned date of change]

3) Change in emissions: [insert increase or decrease in emissions due to change]

4) Permit terms or conditions that are no longer applicable as a result of the change: [list any permit conditions that will no longer apply after the change is made]

This change does not constitute a Title I modification and does not exceed the allowable emission rate for [insert regulated pollutants affected by the change]. This change does not violate applicable requirements or contravene federally enforceable permit terms and conditions that are monitoring, record keeping, reporting or compliance certification requirements. 

Based on information and belief formed after reasonable inquiry, the statements and information in the document are true, accurate, and complete.

Sincerely,


[Name of "Responsible Official" for Title V ]
[Title of Responsible Official]

cc: U.S. EPA Region 4
Operating Source Section
Air and Radiation Technology Branch
61 Forsyth Street
Atlanta, Georgia 30303