Title Page
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Company Name
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Prepared by
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Conducted on
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Location
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Has upper-management been informed of all contact between on-site personnel and regulatory agencies?
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Has every source of air contaminants been identified?
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Is there an emissions inventory of actual and potential emissions from each source of air contaminants?
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Is the facility located in a non-attainment area?
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Is the facility a “major source”?
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Is the facility a “synthetic minor source”?
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Is the facility a “natural minor source”?
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Does the facility/all sources of air contaminants that require permits under federal, state, or local regulations have the appropriate construction and/or operating permits?
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Has the facility implemented any production changes that would alter its air emissions and thus the conditions under which any air quality permit was issued?
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If the facility has had any changes affecting air emissions, has the facility submitted the necessary permit applications to account for the change?
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Is every source of air contaminants at the facility in compliance with the terms and conditions of the permit issued for that source?
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Is the air emissions inventory being compiled according to the frequency outlined in any applicable permit condition?
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Is every source of air contaminants at the facility in compliance with the applicable federal, state, and local air quality regulations?
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Is emissions control equipment being maintained properly?
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Do the appropriate workers have adequate knowledge of the permit conditions and applicable federal, state, and local air quality regulations?
Sign off
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Inspector's name and signature