BAY AREA AIR QUALITY MANAGEMENT DISTRICT
375 Beale Street, Suite 600, San Francisco, CA 94105 . (415) 749-4990 . fax (415) 749-5030
Website: www.baaqmd.gov
(for District use only)
New Modified Retro
Form C is for all operations which burn fuel except for internal combustion engines (use Form ICE unless it is a gas turbine; for
gas turbines use this form). If the operation also involves evaporation of any organic solvent, complete Form S and attach to this
form. If the operation involves a process which generates any other air pollutants, complete Form G and attach to this form.
Check box if this source has a secondary function as an abatement device for some other source(s); complete lines 1,
2, and 7-13 on Form A (using the source number below for the Abatement Device No.) and attach to this form.
(If unknown, leave blank)
1. Company Name:
Source No.
2. Equipment Name & Number, or Description:
3. Make, Model :
Maximum firing rate: Btu/hr
4. Date of modification or initial operation:
(if unknown, leave blank)
5. Primary use (check one):
resource recovery other
electrical generation
process heat; material heated _
space heat waste disposal testing
abatement device cogeneration
6. SIC Number __ __ __
If unknown leave blank
7. Equipment type (check one)
Internal Use Form ICE (Internal Combustion Engine) unless it is a gas turbine
combustion
gas turbine
other
hp
hp
Incinerator salvage operation pathological waste Temperature F
liquid waste other Residence time Sec
Others boiler dryer
afterburner oven
flare furnace Material dried, baked, or heated:
open burning kiln
other _
8. Overfire air? yes no If yes, what percent %
9. Flue gas recirculation? yes no If yes, what percent %
10. Air preheat? yes no Temperature
F
11. Low NO
x
burners? yes no
Make, Model _
12. Maximum flame temperature F
13. Combustion products: Wet gas flowrate acfm at F
Typical Oxygen Content dry volume % or wet volume % or % excess air
14. Typical Use
hours/day
days/week
weeks/year
15. Typical % of annual total:
Dec-Feb
%
Mar-May
%
Jun-Aug
%
Sep-Nov
%
16. With regard to air pollutant flow, what source(s) or abatement device(s) are immediately UPSTREAM?
S
S
S
S
S
S
A
A
A
With regard to air pollutant flow, what source(s) or abatement device(s), and/or emission points are immediately
DOWNSTREAM?
S
S
A
A
P
P
Person completing this form:
Date:
(revised 4/12/16)
Data Form C
FUEL COMBUSTION SOURCE
FUELS
INSTRUCTIONS: Complete one line in Section A for each fuel. Section B is OPTIONAL. Please use the units at
the bottom of each table. N/A means "Not Applicable."
SECTION A: FUEL DATA
Fuel Name
Fuel Code**
Total Annual
Usage***
Maximum
Possible
Fuel Use
Rate
Typical Heat
Content
Sulfur
Content
Nitrogen
Content
(optional)
Ash Content
(optional)
1.
2.
3.
4.
5.
Use the appropriate
Natural Gas
therm*
Btu/hr
N/A
N/A
N/A
N/A
units for each fuel
Other Gas
MSCF*
MSCF/hr
Btu/MSCF
ppm
N/A
N/A
Liquid
m gal*
m gal/hr
Btu/m gal
wt%
wt%
wt%
Solid
ton
ton/hr
Btu/ton
wt%
wt%
wt%
SECTION B: EMISSION FACTORS (optional)
Particulates
NOx
CO
Fuel Name
Fuel Code**
Emission
Factor
**Basis
Code
Emission
Factor
**Basis
Code
Emission
Factor
**Basis
Code
1.
2.
3.
4.
Use the appropriate units for each fuel: Natural Gas = lb/therm*
Other Gas = lb/MSCF*
Liquid = lb/m gal*
Solid = lb/ton
-------------------------------------------
Note: * MSCF = thousand standard cubic feet
* m gal = thousand gallons
* therm = 100,000 BTU
** See tables below for Fuel and Basis Codes
*** Total annual usage is: Projected usage over next 12 months if equipment is new or modified.
Actual usage for last 12 months if equipment is existing and unchanged.
**Fuel Codes
**Basis Codes
Code
Fuel
Code
Fuel
Code
Method
25
Anthracite coal
189
Natural Gas
0
Not applicable for this pollutant
33
Bagasse
234
Process gas - blast furnace
1
Source testing or other measurement by plant (attach copy)
35
Bark
235
Process gas - CO
2
Source testing or other measurement by BAAQMD (give date)
43
Bituminous coal
236
Process gas - coke oven gas
3
Specifications from vendor (attach copy)
47
Brown coal
238
Process gas - RMG
4
Material balance by plant using engineering expertise and
242
Bunker C fuel oil
237
Process gas - other
knowledge of process
80
Coke
242
Residual oil
5
Material balance by BAAQMD
89
Crude oil
495
Refuse derived fuel
6
Taken from AP-42 (compilation of Air Pollutant Emission
98
Diesel oil
511
Landfill gas
Factors, EPA)
493
Digester gas
256
Solid propellant
7
Taken from literature, other than AP-42 (attach copy)
315
Distillate oil
466
Solid waste
8
Guess
392
Fuel oil #2
304
Wood - hogged
551
Gasoline
305
Wood - other
158
Jet fuel
198
Other - gaseous fuels
160
LPG
200
Other - liquid fuels
165
Lignite
203
Other - solid fuels
167
Liquid waste
494
Municipal solid waste
(revised: 4/12/16)