Fillable Printable Form 51605
Fillable Printable Form 51605
Form 51605
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OAQ GENERAL SOURCE DATA APPLICATION
GSD-02: Plant Layout Diagram
State Form 51605 (R3 / 1-10)
INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
IDEM – Office of Air Quality – Permits Branch
100 N. Senate Avenue, MC 61-53 Room 1003
Indianapolis, IN 46204-2251
Telephone: (317) 233-0178 or
Toll Free: 1-800-451-6027 x30178 (within Indiana)
Facsimile Number: (317) 232-6749
www.IN.gov/idem
NOTES:
•The purpose of GSD-02 is to provide a diagram of the entire plant site. This form and a Plant Layout diagram are required for all
air permit applications. If you do not provide the necessary information, applicable to your source, the application process may be
stopped.
•IDEM, OAQ has provided detailed instructions for this form and an example of a basic plant layout diagram on the Air Permit
Application Forms website.
•All information submitted to IDEM will be made available to the public unless it is submitted under a claim of confidentiality.
Claims of confidentiality must be made at the time the information is submitted to IDEM, and must follow the requirements set out
in 326 IAC 17.1-4-1. Failure to follow these requirements exactly will result in your information becoming a public record, available
for public inspection.
Part A: Basic Plant Layout
Part A provides IDEM, OAQ with the appropriate information about all buildings and access-limiting features in and
around the plant site. Please use this table as a checklist. You must provide scaled drawings, with the actual scale
shown. All dimensions and units must be clearly indicated with a brief explanation of what is being shown. Include the
following (All measurements should be given in feet.):
1.
Building Location and Dimensions
2.
Property Lines and Access-Limiting Features
3.
Surrounding Building Location and Dimensions
4.
Distances to Property Lines and Access-Limiting Features
5.
UTM Location Coordinates
6.
Compass (pointing North)
7.
Scale
Part B: Stack Information
Part B provides IDEM, OAQ with the appropriate information about all stacks, roof monitors, control devices, and process
vents at the plant site. Please use this table as a checklist. You must show the location of all applicable emission
points and include all relevant stack and emissions unit identification numbers for each. In addition, you will need to
identify each of these emission points under "Stack Identification" on form GSD-04, Stack/Vent Information. Include the
following (All measurements should be in feet.):
8.
Exhaust Stacks
9.
Process Vents
10.
Roof Monitors
No Roof Monitors
11.
Control Devices
No Control Devices
12.
Interior Vents No Interior Vents Doors and Windows (for processes vented inside a building)
Part C: Roadway Information
Part C provides IDEM, OAQ with the appropriate information about the roadways in and around the plant site. Please
use this table as a checklist. Include the following (All measurements should be in feet.):
13.
Adjacent Roadways Interior Roadways
14.
Roadway Surface Description (gravel, dirt, paved, etc.)
15.
Number of Lanes
Reset Form
Indiana Department Of Environmental Management Air Permit Application
Office Of Air Quality FORM GSD-02
State Form 51605 (R3 / 1-10) Page 2 of 4
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Part D: Source Building Information
This table provides detailed information about each building at the plant site that is part of the source. If additional space is needed, you may make a copy of this
table. (All measurements should be given in feet.)
16. Building
ID
17. Building
Description
18. Building Dimensions 19. Distance & direction to the nearest property
line or access limiting feature
(feet & compass coordinate)
20. Distance & direction to
the nearest residence
(feet & compass coordinate)
Length
(feet)
Width
(feet)
Height
(feet)
Indiana Department Of Environmental Management Air Permit Application
Office Of Air Quality FORM GSD-02
State Form 51605 (R3 / 1-10) Page 3 of 4
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Part E: Surrounding Building / Residence Information
This table provides detailed information about each building or residence surrounding the plant site. If additional space is needed, you may make a copy of this
table. (All measurements should be given in feet.)
21. Surrounding
Building /
Residence
Description
22. Surrounding Building /
Residence Property Dimensions
23. Distance & direction to the
nearest property line or access
limiting feature
(feet & compass coordinate)
24. Building ID of
nearest building
on the plant site
25. Distance & direction to
the nearest building on
the plant site
(feet & compass coordinate)
Length
(feet)
Width
(feet)
Height
(feet)
Indiana Department Of Environmental Management Air Permit Application
Office Of Air Quality FORM GSD-02
State Form 51605 (R3 / 1-10) Page 4 of 4
Part F: Plant Layout Diagram
This space provides a place for a hand drawn plant layout diagram. It is optional to use this space to create your plant layout, but you must include the diagram
with your application. If you choose to submit the plant layout in a different format, state “plant layout attached” in the space provided, and submit the information
with your completed application. IDEM, OAQ has provided an example of a basic plant layout diagram on the Air Permit Applications Forms website.
