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~, Minnesota Pollution Control Agency <br />Environmental Anaiysis and Qutcomes Division <br />Environmental Data Management Unit <br />Michael Srnith <br />520 Lafayette Road N <br />St. Paul, MN 55'{55-4194' <br />Station~t~j"Iriternal"C"omfiustior~ Engines, Genera#or~s): <br />R~:porE.either fuel usage r~r hours of operation, but do not'list tha same information both ways. <br />,Full usage ' <br /> <br /> <br /> <br /> <br /> <br /> Hours of operation " <br />_ ~~ <br /> ' <br />Fuel Type Hours of <br />Operation Morse Power <br />Deslgn Capacity <br />Units <br /> horsepower <br /> horsepower <br /> horsepower <br /> <br />1=uel jype FueE Burned Units <br />No. 1 ~ 2 disiilate cil, units less than 600 hp 'gallons <br />No. 1 ~ 2 distilate oil, units greater than 600 hp gallons <br />Natural gas, 4 cycle units cubic feet (~~ <br />Natural gas, 2 cycle units cubic feet C) <br />CJliscellaneous Fuel Usage, AC Heater: <br />Fuel Type Amount Fuel. Burned Units <br />Natural'gas. ' ~ ~ cubic feet {`) <br />Nu. 1 & 2 disti~ale off gallons <br />No. 5 & 6 residual/waste oii gallons <br />Liquefield petroleum gas gallons <br />Unpaved Roads: <br /> Round trip miles traveled on <br />unpaved roads [""} Credit Record Keeping <br />Option [circle one} <br /> c <br /> <br />(~) Natural gas may be identified in ccf (hundred cubic feet), therms, or cubic feet on gas bill. If natural gas amounts are noE in cubic feet, please identify <br />what units you are giving natural gas amounts. <br />(~*) Please do not Report the local vehicle miles Traveled. Report the distance of one round-trip only. <br />i certify under penalty of law thaE This document and all attachments were prepared under my direction or supervised by qualified personnel. The <br />information submitted is, to the best of my knowledge and belief, true, accurate and complete. I understand that the data provided in iris document <br />will be used by the MPCA to calculate a fee, which the facility will be required to pay under Minn. R. 7002.OD65, based on the tons of pollution emitted by <br />the facility. <br />Sig at an Title of Co ~ ff~ia~ I: ~~ ~ i <br />Date: <br />. ~ ' `~ <br />Name and Title o Company O icial [p ease print}: <br />z <br />~~ ~ ~~~.~ 5 ~ ~~ hit ~ r ~ ~ ~ T~ C,', ~ Ct ~ ~ <br />Forms must be received by April 1, please mail us this form with an original signature. A copied or faxed signature is unacceptable. <br />Piease contact. Michael Smith (651) 757-2733 with any questions. <br />aq-ei3-14 <br />