ÐÏࡱá > þÿ n p þÿÿÿ m ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿì¥Á k ð¿ É bjbj®® "n }Ä }Ä • F í ÿÿ ÿÿ ÿÿ l d d d d Ø Ø Ø ì V V V 8 Ž ¢ \ ì e4 ª ( 2 2 2 ä3 æ3 æ3 æ3 æ3 æ3 æ3 $ 6 /8 € 4 Ø ? ^ 4 ¥" d d 2 2 4 ¥" ¥" ¥" F d R 2 Ø 2 ä3 ¥" ä3 ¥" ¥" »+ <. ¶ " Ø ˆ. 2 þ @,¨Äì j V ã Ð T. ˆ. \ 54 0 e4 \. , ¯8 ³ ò ¯8 ˆ. ¥" ì ì d d d d Ù Lkllklklklklkl If your facility performs any type of printing and/or publishing, check one of the following boxes. We are a photocopying/reprographic facility only. (Complete only sections I and V.) We currently have an air quality permit (Number ) and submit an annual emissions inventory. (Complete only sections I and V.) We currently use less than 200 gallons/month of all chemicals, including inks, washes, solutions and other solvents. (Complete only sections I and V.) All other facilities. (Complete sections I, II, III, IV and V.) Please type, or print legibly. Submit the completed form to the DEQ at the address listed below. I. GENERAL FACILITY INFORMATION Company Name: Street Address: City:State:Zip:Mailing Address: ( same as above City:State:Zip:Phone: Fax:E-mail:Technical Contact: Position: II. PRINTING PROCESSES PERFORMED AT THIS FACILITY (Check all that apply) Process typeCheck if “Yes”Lithography(Flexography(Gravure/Rotogravure(Letterpress(Other (please list):( III. PRINTING EQUIPMENT INVENTORY Please list the following information for each press. Please attach an additional sheet if necessary. PRINTING PRESS INFORMATIONPress NameModelEmissions Control Equipment1Date of Mfg.Web or Sheet-FedType of Ink (Heatset or Non-heatset)# of Print Units 1Examples include: thermal/catalytic incineration (burning) and carbon adsorption. IV. MATERIAL USAGE INFORMATION Please list the types and amount of inks, fountain solutions/washes, blanket cleaners, solvents or other chemicals used at the facility. MaterialSoy or Water Based Ink? (Yes/No)Annual Usage Pounds or Gallons% Volatile Organic Compound (VOC) by weight11Information can be obtained from the product MSDS (usually in Section 9). Attach an additional sheet if needed. V. SIGNATURE Based on information and belief formed after reasonable inquiry, I certify that the statements and information contained in this document are true, accurate, and complete. Printed name _________________________________________ Signature ____________________________________________Date ______________ RETURN TO: Oklahoma Department of Environmental Quality, AQD Permitting Section, P.O. Box 1677, Oklahoma City, OK 73101 DEQ Form #100-351 Page PAGE 1 of NUMPAGES 2 Adopted 3/25/04 PRINTING/PUBLISHING FACILITY REGISTRATION FORM Oklahoma Department of Environmental Quality Air Quality Division ASSISTANCE AVAILABLE @ DEQ Customer Assistance: (405) 702-9100 (800) 869-1400 Air Quality Division: (405) 702-4100 _ b Ñ à á ; < Q R p q Ï Þ ë ì í ú û ! " 8 9 ^ Å Æ á â e m n v w € ˆ ‰ ‘ ’ š › œ ð ˜ ™ Å Æ óë ç å ÙÐÙÐÙÁÙÐÙÐÙÐ ç »¸ » » »¸ » µ ¯ çªçµ µ µ µ µ µ ¦£¯µ çžç 5>*\CJ CJ H* 5H*\ 5CJ \ CJ CJ$ j ðCJ$ j ð5\fH qÊ ÿ ÿ fH qÊ ÿ ÿ 5\fH qÊ ÿ ÿ >*5\ CJ mH nH uj CJ UmH nH u= } ~ Ó f ÿ A B ¤ ¥ Ð Ñ ß ù ù ù ù ù ù ð ã Ù Ä Ä Ä Ä » ã ¹ ³ ± « $If Æ ´ $„˜þ^„˜þa$ $ &