Temporary Internal Combustion Engine Replacement

Temporary Internal Combustion Engine Replacement Notification ENF - 94 Santa Barbara County Air Pollution Control District

260 N. San Antonio Road, Suite A Santa Barbara, CA 93110-1315

Company Name

FID Number

Contact Name

Permit Number

Pursuant to the operating permit under which this engine is permitted, notice is hereby given regarding the temporary replacement of the IC engine noted below.

Is this engine being replaced due to "Routine" repair and maintenance? Yes No

Phone Number

Email

Model Name

Engine Location

Date Out of Service

Manufacturer

Emission Controls No Yes

Serial No.

PM10PMSOxCO

EPA Tier

Device ID

Replacement Reason

ROC

Emission Factor Units

NOxEmission Factors:

Engine BHP

I hereby certify pursuant to H&SC Section 42303.5, that the temporary replacement engine has the same or lower manufacturer, or orifice plate, rated horsepower, and the same or lower potential to emit of each pollutant as the permitted engine that is being temporarily replaced and that the above information and any infomation submitted with this form is true and correct.

Completed By

ENF - 94 (9/2011)

Signature

Date/Time Field

Company

Permitted Engine Data

Temporary Replacement Engine Data

Model Name

Engine Location

Date Put in Service

Manufacturer

Emission Controls No Yes

Emission Factors:

Serial No.

SOx PM PM10

EPA Tier

COROCNOx

Emission Factor Units

Engine BHP

Diesel

Natural GasEmergency/StandbyPrime Firewater Pump

Stationary

Portable

MAIL or FAX THIS FORM TO THE APCD (fax: 961-8801)