Document MGxqD5LNOwjag7KxGKZ5eE0dy
DEPARTMENT of labor
jjvisior. of Induetriel Hygiene
, Engineering Sectioo
EXHAUST SYSTEM PUN
PLAN NO. DATE REC'D. FEE RECD.
//
FILING INSTRUCTIONS - ONE COMPLETED COPY OF THIS FORM MUST BE FILED FOR EACH FAN SYSTEM IN THE EXHAUST PLANS BEING SUBMITTED. Forward exhaust system plans IN TRIPLICATE, together with one completed copy of this farm for each fan system, to the Engineering Section of the Division of Industrial Hygiene at one of the following Department of Lobar Offices. Plans for exhaust systems to be installed in the counties of Cataraugus, Chautauqua, Erie, Genesee, Livingston, Monroe, Niagara, Ontario, Orleans, Woyne, Wyoming ond Yates should be sent to: 2447 SHERIDAN DRIVE, TONAWANDA, N.Y. 14150. Plans for exhaust systems to be installed in counties other than those listed above, should be submitted to: 80 CENTRE STREET, NEW YORK, N.Y. 10013.
IMPORT ANT: Effective June 1, 1963, the Industrial Commissioner is required by section 204-a of the Labor Law to charge a FEE
FOR THE EXAMINATION OF EXHAUST PLANS. Please forward with the plans a check or money order payable to the Industrial
Commissioner, in accordance with the following fee schedule FOR EACH FAN SYSTEM:
......
CATEGORY A
CATEGORY B
"Simple single booths and enclosures, such as spray booths; canopy
All systems other than category A.
hoods; dilution, general and natural draft ventilation systems".
Design CFM
Fee
Design CFM
Fee
less than 250 250 or more but less than 1,000
$10 20
less than 5,000 5,000 or more
510
20
1,000 or more but less than 5,000 5,000 or more but less than 10,000 10,000 or more
30 40 50
1. FIRM NAME
Georgia-Pacific Corporation_____________________________________
2. MAILING ADDRESS
900 S.W. 5th Avenue, Portland, Oregon 97204
3. PLANT LOCATION (Straat and Number. City, Town, Villaga; County)
Bloomingdale Road, Akron, Erie County, New York 14001
4*. PLANT REPRESENTATIVE TO BE CONTACTED REGARDING EXHAUST SYSTEM PLANS 4b. TITLE
George Turner
Project Engineer
5. NUMBER OF IN-PLANT EMPLOYEES AT THE ABOVE PLANT LOCATION:
TOTAL
135
MALE
131
FEMALE
4
6. NO. OF EMPLOYEES AT OPERATIONS OR MACHINES
70
7. AUTHORIZED AGENT (It any) SUBMITTING PLANS (Eng.. Daaignar, Consulting Film, Etc.) LETTER OF AUTHORIZATION MUST ACCOMPANY PLANS
None
8. BUSINESS ADDRESS OF AGENT
9. NO. OF FAN SYSTEMS SHOWN ON PLAN (Fan Syatama Should Ba Numborod)
One (1)
10. SUBMITTED FOR COMPLIANCE
WITH INDUSTRIAL CODE RULE NO. 10NYCRR-80
GENERAL DATA
FAN SYSTEM NO___ AMOUNT OF FEE FMri o<;rn None * $30.00 previously sent for this system
li. LOCATION OF SYSTEM
. building Joint Cement Manufacturing
b. PLOOR
one
Bagc. department Packing
d. NUMBER OF FLOORS IN BLDG. One
12. IS PROPOSED INSTALLATION NEW?
_ _ _ _ _ _ _ YES
J NO
12b. ADDITION TO OR RECONSTRUCTION OF EXISTING SYSTEM
YES
HN0
13. DOES THIS PLAN AMEND
SYES
PREVIOUSLY SUBMITTED PLAN?
! NO
IF YES. GIVE PREVIOUS PLAN NO. AND AMOUNT OF FEE PAID
BPA-218-73 ($30.00)
14. IS THIS INSTALLATION TO COMPLY WITH ORDERS OR SPECIFIC RECOMMENDATIONS ISSUED BY THIS DEPARTMENT?
YES
NO
IF YES. GIVE DATE OF ISSUANCE
October 27, 1972
YES'.5. IS DISCHARGE OF SYSTEM TO BE RECIRCULATED TO THE WORKROOM' |___ 1
j_X l\Q
(Dt f charged Atr Hhtch Contain* Dangaroua Alt Contaminant 5ftM Not Ba Racircutatad.** Rut a tS~8.3) l "DISCHARGE POINT: I I ABOVE ROOF i I OUT OF WINDOW I ^ THROUGH SIDE WALL I I OTHER~
20 FEET TO NEAREST FIRE ESCAPE OR EXIT
XKXSOCOXaCXDOC
17 MAKE-UP AIP. EQUAL IN VOLUME TO THAT EXHAUSTED. TO BE SUPPLIED BY
Natural Draft
5 FEET TO NEAREST WINDOW MEANS FOR HEATING MAKE-UP AIR
None
SGP 0021906
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DIVISION OF AIR RESOURCES
BUREAU OF AIR OUALITY CONTROL 41 STATE STREET
ALBANY, NEW YORK 12207
ENVIRONMENTAL ANALYSIS REPORT - SUMMARY OF SOURCES
t
For completion by opplicont (in triplicate)
Report_No.
Use one copy of this form at a cover sheet for each copy of the Environmental Analysis Report submitted in triplicate
1. Name ef firm or owner ,
Georgia-Pacific Corporation
BAQC Assign.
2. Address of installation ,
Bloomingdale Road, Village of Akron, Erie
3. Person to contact in reference to this submission
4e Proposed Environmental Roting(s)
mi ssion Point No.
Not Assigned
Process, Exhaust or Ventilofing System
Bag Packer, Joint Cement Manufactur ing
Georae Turner. Project Engineer
Nam. 9QQ g
5th Avenue
Portland, Oregon 97204
Address
Proposed Env. Rat.
Emission | Point No.
Process, Exhaust or Ventiloting System
Proposed Env. Rat.
Continue on reverse side lor listing of proposed ER*s.
5. Dote Align gt- ft
1
1 Q71A. Signature
i ./ t-w? --^
por completion by field representative
I recommend (acceptance) (deniol) of the proposed environmentol roting(s)
Remarks
_________________
7. Title
Prnjprh Knginppr
__ SGP 0021907
t. De. ______________ 9. Signotwre
10. Title
Vontilotinq Sytttm
ER
Point No.
Vowtiloting Sytm
ER
SGP 0021908