Certification Pollution Form – Fill Out and Use This PDF

1.Applicants are advised that separate regulations pertaining to accelerated depreciation under Section 169 of the Internal Revenue Code have been published by EPA as Part 20, Chapter 1, Title 40, Code of Federal Regulations and by the Treasury Department as Section 1.169 of the Income Tax Regulations, Part 1, Subchapter A, Chapter 1, Title 26, Code of Federal Regulations. These instructions do not include all the information contained in the statute and regulations, nor do they in any way modify the statute and regula- tions, to which applicants are encouraged to refer.

2.Applicants seeking certifications of facilities used for pol- lution control and eligible for rapid amortization as authorized by section 169 of the Internal Revenue Code shall complete one ap- plication original and 3 copies) for each facility for which certifica- tion is sought. When necessary, attach additional sheets of paper to furnish required information, referring to the relevant section and item number on each such additional sheet. If any of the informa- tion requested on the application form is inapplicable to the facility for which certification is being sought, so indicate by writing the word "inapplicable" in the space provided after each item. In ac- cordance with section 20.3 of the EPA regulations, an application for certification may pertain to several identical control facilities installed at the same plant, and information submitted to support certification of a control facility may be incorporated by reference in a subsequent application pertaining to an identical facility.

3.Applicants shall submit the original of the completed applica- tion (with attachments such as drawings, flow sheets, charts or other explanatory material) to the Regional Administrator for the region in which the control facility is located. Copies 1 and 2 of the com- pleted application shall be submitted (with attachments) to the ap- propriate State Water or Air Pollution Control Agency of the State in which the control facility is located. Copy 3 is for the applicant's meso

4.The responsible State Water or Air Pollution Control Agency may complete the attached State Certification Form, or may use such other form containing substantially the same information, as it may deem appropriate. The completed State Certification, together with Copy 1 of the application and associated documents, should be forwarded by the State Agency to the appropriate EPA Regional Administrator, and a copy of the State Certification furnished the applicant. Copy 2 of the application may be retained by the State Agency for its records.

5.In accordance with section 20.4 of the EPA regulations, the Regional Administrator will notify the applicant and the State Water or Air Pollution Control Agency that Federal certification will be issued if the control facility is completed and operated in accordance with the application. Such a notice of intent to certify shall be issued only after receipt from the State certifying authority of a statement that the facility, if constructed, reconstructed, ac- quired, erected, instaUed and operated in accordance with the ap- plication, will be in conformity with the State program or re- quirements for abatement or control of water or air pollution. The Notice of Federal Certification, however, will be issued only if it is determined that the facility has been completed and is operating in accordance with the application, and only after receipt of a com- pleted State Certification. When the application indicates that the facility to which it relates is not yet in operation, such application may be amended by a letter addressed to the Regional Adminis- trator specifying the date on which the facility was placed in opera- tion.

6.Certification of a control facility by an official of the En- vironmental Protection Agency does not of itself entitle an appli- cant to rapid amortization pursuant to Section 169 of the Internal Revenue Code. Such entitlement shall be determined by the Com-

missioner of Internal Revenue in accordance with applicable pro- visions of the Internal Revenue Code and rules and regulations issued thereunder.

SPECIFIC

SECTION A - IDENTITY AND LOCATION OF POLLUTION CONTROL FACILITY

Items 1 thru 6 - ｓ･ｬｦｾｸｰｬ｡ｮ｡ｴｯｲｲＮ

SECTION B - DESCRIPTION OF POLLUTION CONTROL FACILITY

Item 1 - Include in the description of the control facility a reference to the types of effluents or emissions controlled by the facility, and attach a process flow diagram, if available.

Item 2 - In most cases, the date the facility was placed in operation will be easily ascertainable. As is more fully set forth in section 1.169-2 (b) (2) (iv) of the Income Tax Regulations, how- ever, a taxpayer's depreciation practices may affect the determina- tion of when a facility is deemed to be placed in operation.

Item 3 - Section 169 does not permit rapid amortization of a building unless it is exclusively devoted to the abatement of pollu- tion. A building which performs no function other than housing or sheltering a pollution control facility is itself considered to be ex- clusively devoted to the abatement of pollution. The term "build- ing" is explained in section 1.169-2 (b) (2) (i) of the Income Tax Regulatiol!.s, which provides, in part, that the term "building" does not include "an enclosure which is so closely combined with the machinery or equipment which it supports, houses, or serves that it must be replaced, retired, or abandoned contemporaneously with such machinery or equipment, and which is depreciated over the life of such machinery or equipment."

Item 4 - Section 169 provides that pollution control facilities are eligible for certification only if they do not significantly increase the output or capacity, extend the useful life, or reduce the total operating costs of the plant or other property in connection with which the facility is used. For purposes of this provision, the term "plant or other property" includes only the operating unit most directly associated with the pollution control facility; that is, the identifiable and separable part of the "plant or other property" which creates (or would otherwise create) the pollutants controlled by the facility. In accordance with the legislative history of sec- tion 1312 of the Tax Reform Act of 1976, both EPA and .IRS regulations define the term "significant" as being more than 5%.

SECTION C - DESCRIPTION OF COMMERCIAL PROCESS OR ACTIVITY.

Item 1 - Describe briefly in a narrative manner the general nature of the operation conducted at the location of the control facility.

Item 2 - If known, provide the Standard Industrial Classifica- tion (SIC) Code number for the activity in connection with which the control facility is used.

Item 3 - Self-explanatory.

Item 4 - Section 169 permits rapid amortization only of facili- ties used in connection with a plant or other property in operation prior to January 1,1976. When a facility serves more than one plant or other property, therefore, it may be necessary to determine the portion of the cost of the facility which is attributable to its use in connection with plants or properties in use prior to January 1, 1976. In many cases, a proper allocation will be based on the ef- fluent output capacities of the plants or properties served, in com-

parison to the treatment capacity ot the facility to which the appli- cation relates. Exceptions to the foregoing may be justified if ade- quately explained in Part (b) of this Item; for example, the effluent capacities of the plants or properties served may differ substantially from the amounts of effluents actually produced and treated over a period of time.

Item 5 - Section 169 does not permit certification of a facility to the extent it performs a function other than the control of pol- lution. When the facility to which the application relates performs such an additional function, it will be necessary to identify that portion of its cost which is allocable only to pollution control. The need to make such an allocation should seldom arise if the facility to which the application relates is defined with as much particu- larity as circumstancces permit. If such need is unavoidable, the proper manner of making the allocation may vary, depending on the type of equipment involved. If, for example, the facility serves a production function when it is not being used for abatement pur- poses, then a proper allocation would be based on the percentage of on-stream time devoted to each of its several functions. If those features of the facility which result in the abatement of pollution are inseparable from its production-related features, then it may be appropriate to make the necessary allocation by reference to the cost of a similar facility which lacks the pollution abatement features.

SECTION D - WASTEWATER CHARACTERISTICS (Water Pol- lution Control Facilities only)

Item 1 - Self-explanatory.

Item 2 - Self-explanatory.

Item 3 - Provide actual measured or design rates of the wastes (including heat) in wastewater stream as discharged without the pollution control facility and with the pollution control facility. (Such data. can be suitably illustrated on a process flow diagram with material balances of the process wastewater stream from input through outflow; or, in cases where actual data are not available, the design capacity or rates as given in an engineering report, catalogue, etc., may be used and such material appended to the application.)

Items 4, 5, 6, 7 and 8 - Self-explanatory.

Item 9 - If the degree of treatment performed by the facility is

Form Approved

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required by state or local law or regulation, describe the applicable standard, giving statutory references, if known.

SECTION E - EMISSION CHARACTERISTICS (Air Pollution

Control Facilities only)

Item 1 - Self-explanatory.

Item 2 - On lines designed (a) through (d), list the common name or chemical description of each pollutant the emission of which is to be controlled by the facility. All particulate emissions may be described in the aggregate as "particulates," unless an ap- plicable State or Federal air quality standard is in effect for a specific type of particulate (e.g., asbestos), in which case such specific type of particulate should be listed separately.

Item 3 - Self-explanatory.

Item 4 - Provide the indicated information for each type of gaseous emission listed in response to Item E-2, using for each the line prefixed by the letter corresponding to the line of Item E-2 on which it is listed.

Items 5 thru 7 - Self-explanatory.

Item 8 - If the degree of treatment performed by the facility is required by state or local law or regulation, describe the applicable standard, giving statutory references, if know.

Item 1 - Identify all by-products and materials recovered in the course of operation of the facility to which the application relates, including heat (if it is disposed of other than by dissipation to the atmosphere), whether or not such by-products and materials are recycled, and describe the methods used to dispose of each such by-product or material. Applications need not impute revenues from recovered by-products or materials used or reused by them in their own operation.

Item 2 - In part (a), provide the expected annual dollar amount of revenues from any sales of by products or materials identified in response to Item F-1. In part (b), provide the expected annual dollar amount of any other revenues derived from the facility (e.g., rentals, service charges to persons other than the applicant).

Item 3 - Provide estimates, if no prior history is available.

PREVIOUS EDITION IS OBSOLETE

ORIGINAL

1. FULL BUSINESS NAME OF APPLICANT

2. TYPE OF OWNERSHIP

o o o

3. PERSON TO CONTACT REGARDING THIS APPLICATION (Name and Title)

TEl.EPHONE

ADDRESS (Street, City, State, Zip Code)

5.BUSINESS NAME OF PLANT (If different from Item 1 ) (Street, City, State, Zip Code)

6. APPLICANT'S

EMPLOYER IDENTIFICATION NO.

2. IS FAC'LITY IN OPERATION?

DYESo NO

A.IF "YES" DATE FACILITY WAS PLACED IN OPERATION

B.IF "NO" DATE FACILITY IS EXPECTED TO BE PLACED IN OPERATION

3.IF FACILITY CONSISTS OF A BUI LDING, IS IT EXCLUSIVE- LY FOR CONTROL OF POLLU-

TION?o

DYESNO

A.

B.

C.

EPA Form 3300-1 (Rev. 8-77)

PLANT OR PROPERTY

DATE

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4A.

4B.

F arm Approved

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SECTION C • DESCRIPTION OF COMMERCIAL PROCESS OR ACTIVITY

IF FACILITY IS OR WILL BE USED IN CONNECTION WITH MORE THAN ONE PLANT OR PROPERTY, AND IF ONE OR MORE OF THE PLANTS OR PROPERTIES IN CONNECTION WITH WHICH THE FACILITY IS OR WILL BE USED WAS NOT IN OPERATION PRIOR TO JANUARY 1, 1976, STATE THE PERCENTAGE OF THE COST OF FACILITY WHICH IS ALLOCABLE TO THE PLANT(S) OR

DESCRIBE THE REASONING AND FURNISH THE DATA USED TO ARRIVE AT THE PERCENTAGE GIVEN IN RESPONSE TO ITEM 4(A).

3.VOLUMETRIC FLOW RATE OF EMIS- SION (actual cubic

feet/minute)

4. CONCENTRATION

(in volume %of gaseous components)

5. CONC,NTRATION

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aI particulate maiter)

d.

WITHOUT POLLUTION CONTROL FACILITY

M in. __ Max. ___ Avg._,__ at _____ OF

a.Min. __ Max. __ Avg. __ at ___ OF

b.Min. ___ Max. __ Avg __ at ___ OF

c.Min. __ Max. __ Avg. ___ at ___ OF

d. Min. __ Max. ___ Avg. ___ at ___ OF

Min. __ Max. __ Avg. __ at __ OF

WITH POLLUTION CONTROL FACILITY

Min. ___ Max. ___ Avg. ___ at __ OF

Min. __ Max. __ Avg. __ at ____ OF

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Min. __ Max. ___Avg. __ at ___ OF

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Min. ___ Max. ___ Avg. __ at __ OF

6. CONC"NTRATION

Min. __ Max. __ Avg. __ at ___ OF

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