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EC-03 Emission Credit Registry Use Of Emission Credits 51785 - Indiana

EC-03 Emission Credit Registry Use Of Emission Credits Form. This is a Indiana form and can be used in Air Department Of Enviromental Management Statewide .
 Fillable pdf Last Modified 8/25/2010
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EC-03 EMISSION CREDIT REGISTRY ­ USE OF EMISSION CREDITS State Form 51785 (6-04) INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT IDEM - Office of Air Quality - Permits Branch 100 N. Senate Avenue P.O. Box 6015 Indianapolis, IN 46206-6015 Telephone: (317) 233-0178 or Toll Free: 1-800-451-6027 x30178 (within Indiana) Facsimile Number: (317) 232-6749 http://www.IN.gov/idem/permits/air NOTES: · · The purpose of EC-03 is to provide information regarding the use of emission credits. This is a required form. Detailed instructions for this form are available online at http://www.IN.gov/idem/permits/air/apps/instructions/ec03instructions.html. All information submitted to IDEM will be made available to the public unless it is submitted under a claim of confidentiality. Claims of confidentiality must be made at the time the information is submitted to IDEM, and must follow the requirements set out in 326 IAC 17.1-4-1. Failure to follow these requirements exactly will result in your confidential information becoming a public record, available for any one to inspect and photocopy. FOR OFFICE USE ONLY DATE RECEIVED: · Part A: EC User Information Part A is intended to provide basic information about the user of the emission credit(s). 1. EC User: 3. Address: City: 4. Name of Contact Person : 5. Title (optional): 6. Telephone Number: ( ) ­ 7. Facsimile Number (optional): ( ) ­ State: ZIP Code: 2. Source ID: 8. Electronic Mail Address (optional): 9. Permit Number Corresponding to the Use of Emission Credits: ___ ______ -- ___________ -- __________ Part B: Summary of Updates to the EC Registry Part B is intended to provide sufficient information to record the use of emission credits and update the Emission Credit Registry. 1. Date of Use 2. Pollutant 3. Reactivity 4. EC Quantity 5. EC IDs Emission Credit Registry (EC-03) Page 1 of 1 American LegalNet, Inc. www.FormsWorkflow.com
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