South Coast Air Quality Management District, Form 400-E-1b (2014.07)
Mail To:
SCAQMD
P.O. Box 4944
Diamond Bar, CA 91765-0944
Tel: (909) 396-3385
www.aqmd.gov
South Coast Air Quality Management District
Form 400-E-1b
Particulate Matter Control
Cyclone Separator
This form must be accompanied by a completed Application for a Permit to Construct/Operate - Forms 400-A, Form 400-CEQA, and
Form 400-PS.
Page 1 of 2
Section A - Operator Information
Facility Name (Business Name of Operator That Appears On Permit): Valid AQMD Facility ID (Available On Permit Or Invoice Issued By AQMD):
Address where the equipment will be operated (for equipment which will be moved to various location in AQMD’s jurisdiction, please list the initial location site):
Fixed Location Various Locations
Micron Range
Particle Size Distribution
(Wt%)
Manufacturer’s Guaranteed Removal
Efficiency For Each Micron Range
(%)
0.5 - 1.0
1.0 - 5.0
5 - 10
10 - 20
Over 20
Section B - Equipment Description
Equipment
Manufacturer: Model No.:
Dimensions
Type of Cyclone
Wet Dry
Type of Cyclone Unit
Single Dual Quadruple Multiclone
Blower
Blower Horsepower:
H.P. Design Flow Rate: SCFM
Draft: Forced Induced
Design Criteria
Cyclone Configuration: Positive Pressure Negative Pressure
Pre-Treatment Device
Cyclone Precooler Preheater Knock-Out Chamber None
Post-Treatment Device
Baghouse/Cartridge HEPA Other:
Particulate Size Distribution
Data
B
TOP VIEW
FRONT
VIEW
Z
L
H
D
J
A
S
Gas Out
Gas In
Give Dimensions of Cyclone (See sample sketch):
1. B in. 5. Z in.
2. H in. 6. D in.
3. S in. 7. A in.
4. L in. 8. J in.
South Coast Air Quality Management District, Form 400-E-1b (2014.07)
South Coast Air Quality Management District
Form 400-E-1b
Particulate Matter Control
Cyclone Separator
This form must be accompanied by a completed Application for a Permit to Construct/Operate - Forms 400-A, Form 400-CEQA, and Form 400-PS.
Page 2 of 2
CONFIDENTIAL INFORMATION
Under the California Public Records Act, all information in your permit application will be considered a matter of public record and may be disclosed to a third party. If you wish to keep
certain items as confidential, please complete the following steps:
(a) Make a copy of any page containing confidential information blanked out. Label this page “public copy.”
(b) Label the original page “confidential.” Circle all confidential items on the page.
(c) Prepare a written justification for the confidentiality of each confidential item. Append this to the confidential copy.
THIS IS A PUBLIC DOCUMENT
Pursuant to the California Public Records Act, your permit application and any supplemental documentation are public records and may be disclosed to a third party. If you wish to
claim certain limited information as exempt from disclosure because it qualifies as a trade secret, as defined in the District’s Guidelines for Implementing the California Public Records
Act, you must make such claim at the time of submittal
to the District.
Check here if you claim that this form or its attachments contain confidential trade secret information.
Section C - Process Stream Characteristics
Brief Description Of
Process
Please include a process flow diagram and engineering drawing of the filter system and material processed. In the space provided, indicate what
equipment is vented to the cyclone and how material is handled and disposed.
Flow Data
Gas Stream Temperature:
˚F
Pressure Drop Range: High
in. H
2
O Low in. H
2
O
Inlet Flow Rate:
ACFM
Moisture Content:
grams of water/cubic feet (ft
3
) of dry air
Dew Point Temperature of Process Stream:
˚F
Operating Schedule
Normal:
hours/day days/week weeks/yr
Maximum:
hours/day days/week weeks/yr
Dust Collection Device
Pneumatic Drag Conveyor Closed Container
Rotary Airlock Values Double Dump
Screw Conveyors Manual Discharge Device: Slide Gate Hinged Doors or Drawers
Section D - Authorization/Signature
I hereby certify that all information contained herein and information submitted with this application is true and correct.
Preparer
Info
Signature: Date:
Title: Company Name:
Name:
Phone #: Fax #:
Email:
Contact
Info
Name:
Title: Company Name:
Phone #: Fax #:
Email:
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