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D5d 0CU:N B* wJEN4Pd^ s m D+ 0JU@))1 B 0D< 0L A AMio@ P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5P5 ASp55 0D66 0D66 AO7`7 0D&8 Aj8 AY8D9 0F : AMP:: 0Jc;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;c;f;a;f;a;f;a;f;a;f<a <HP LaserJet 6MP,,,,0(9 Z 6Times New Roman RegularX($M:\APPS\WPWIN61\TEMPLATE\STANDARD.WPT+xA`Univers(2C$ !  )!dxdx(2C$ !  +pAZ"Arial Regular&P d d u/88P3|x,/ U'dxd Level 1 Level 2 Level 3 Level 4 Level 5("$ Figure     w (E Z(Times New Roman    C'  _ ҀXXUnitedStates  ЀEnvironmentalProtectionAgency0 " 0z " %" %0z %z %0*%%0*%*%0%%02%%02%2%0%% : OMBNo.20600445%% A) xddEc $A%%P% d6b$Triangle0 >c$"Small Circle"0   I&mage <=8C HKKKK A<< cWPC``9513`KK }U D C C C B B                                                                                                                   y              ~ ~ ~ ~                          x  `  `  `  `  `                  ~   ~                                               ~         ~~                                                                                                8 @ A A B BU0MON1-01A.PCX]^ `E<<CLevel 1Level 2Level 3Level 4Level 5(3$ !  ($$   1  c dC<< CLevel 1Level 2Level 3Level 4Level 5($$   1   {  <<= 8Cg hO  , deUULevel 1Level 2Level 3Level 4Level 5(n$ (  1  ) j kC<<BLevel 1Level 2Level 3Level 4Level 5(P$ Table  1  Table_XTable_YTable_ZTable_AATable_AB !  _ QLmJXXL 6JJLm/1WGCz|2< ``@ Pr@Ep]2<Zr~ j %j %%%AccountCertificateofRepresentation#XXXJL 6# l XXX# t   l# l   t s  #XXX  l# XXX#p  # p  Ӏ#p ##X}Xpd#XX}ThisformisrequiredtoestablishanAuthorizedAccountRepresentativeforcomplianceaccountsunder + Ѐthe_NOx_ԀBudgetTradingProgram.Formoreinformation,seeinstructionsonthereversesideoftheform. | Ӏ @ ЀThissubmissionis:$9]9New   %%j %j % 8      @     H      P    8      @     f  8      @  ]Revised    z ; ЀCheckthisboxifyouarealsotheDesignatedRepresentativeforthisplantundertheAcidRainProgram:$#]p p##p # p#Vd # Vd  * ddd Xdd Xdd X%%,d , t ,t( ,d ,t( +  8.P P u8#Vd <##Vd#e8 STEP1 e  Identifythebudget    source(s)byplantname, <   State,and,ifapplicable,  {  _ORISPL_Ԁcode.#Vd ##Vd# #VdVd ND2 - 99 N <2$8  <  9/!8  9 LB,8  u   uL#Vd ##Vdn #p p =*Y  = ԀPlantName @/$ [ @ԀState ?,! [ ?Ԁ_ORIS_ԀCode I?, [ u   ue I % O  % M<  A  e u  u M #Vd ) #Vd#H #STEP2 M  Enterrequested   informationforthe >  AuthorizedAccount c  Representative(AAR). <) <#Vd# Vd#p # p ԀName F3$ <  FAARIDNumber(ifknown) LB/  u   u L . ~  .   ԀAddress C9&  u  e C . `  . LB/R ! e  e L . m ! . LB/_" e  uL ( z" (PhoneNumber#Vd # Vd#p -# p C0!|# CFaxNumber#Vd # Vd#p B# p LB/|$ u   eL . p$ .  ԀEmailAddress#Vd # Vd#p # pԀ(ifavailable) QG/s& e   e Q " X' "Ѐ M< X( e   u M #Vd  #Vd#M#STEP3 u) Enterrequested '* informationforthe L+ AlternateAuthorized , AccountRepresentative, =- ifapplicable. <)b.VV  <#Vde# Vd#p # p ԀName F3$0 FAARIDNumber(ifknown)#Vd # Vd#p 4# p LB/u1 u   uL ( i1 ( ԀPhoneNumber C0!| 3 CԀFaxNumber QG/| 5 u   PeQ 4!Q6 4#Vd # VdEmailAddress#Vd # Vd#p 2# pԀ(ifavailable)#p # p#Vd H# Vd6,*8 e P  6* d dd  t t( d t( %%,dd ,}dd +  $F8F $  79 #Vd # l Vd# t   l# l   t 7: *x dddd }dd }%%x,TT ,?dd ,?TT ,dd ,eTT ,7dd ,HTd +  # t   l##  t#p p <+;:; Pf+ <#Vd  #Vd# # STEP4 S< Providethenameof x= everyownerand * > operatorofthe  i? budgetsourcesat !@ theplant.Identify @"A thebudgetsources " B theyownand/or #1!C operatebyboilerID#. #Vd^!# Vd#p !# p 8)V$!D   8Name#Vd '## Vd#p i## p 5&?F 5#Vd ## Vd# q *$#  q]#Vd $# Vd#p $# pԀ}Owner#Vd )%# Vd#p k%# p 6#}G 6#Vd %# Vd# q  &#  q]#Vd &# Vd#p &# pԀ}Operator#Vd  '# Vd#p L'# p @6#}H f+ P  Pf+@ * {H *ID##Vd '# Vd#p '# p 0# J 0ID##Vd (# Vd#p (# p 6# L 6ID##Vd V)# Vd#p )# p 0# N 0ID##Vd *# Vd#p V*# p 6# P 6ID##Vd *# Vd#p +# p 6# R 6ID##Vd +# Vd#p +# p @6# T f+ P  Pf;@ * H!T *ID##Vd H,# Vd#p ,# p 4#L"V 4ID##Vd :-# Vd#p |-# p 6#L"X 6ID##Vd -# Vd#p 8.# p 4#L"Z 4ID##Vd .# Vd#p .# p 6#L"\ 6ID##Vd p/# Vd#p /# p 6#L"^ 6ID##Vd .0# Vd#p p0# p ;1#L"` f; P  V+; % %# ` % ! {#!a !  {#!b  ,"{#!c V+ Pf+, * D$!c *Name 5&H%"e 5#Vd 0# Vd# q .1#  q]#Vd 2# Vd#p 2# pԀ$"$7"Owner#Vd '3# Vd#p i3# p 6#$"f 6#Vd 3# Vd# q 4#  q]#Vd 4# Vd#p 4# pԀ$"$7"Operator#Vd 5# Vd#p J5# p @6#$"g f+ P  Pf+@ * &#g *ID##Vd 5# Vd#p 5# p 0#'$i 0ID##Vd 6# Vd#p 6# p 6#'$k 6ID##Vd T7# Vd#p 7# p 0#'$m 0ID##Vd 8# Vd#p T8# p 6#'$o 6ID##Vd 8# Vd#p  9# p 6#'$q 6ID##Vd 9# Vd#p 9# p @6#'$s f+ P  Pf;@ * 'k%s *ID##Vd F:# Vd#p :# p 4#(o&u 4ID##Vd 8;# Vd#p z;# p 6#(o&w 6ID##Vd ;# Vd#p 6<# p 4#(o&y 4ID##Vd <# Vd#p <# p 6#(o&{ 6ID##Vd n=# Vd#p =# p 6#(o&} 6ID##Vd ,># Vd#p n># p @6#(o& f; P  PV+@ % )H' % ! *' !  *'  ,"*' V+ P f+, * *g( *Name 5&+k) 5#Vd ># Vd# q ,?#  q]#Vd @# Vd#p @# pԀ+(@+(Owner#Vd *A# Vd#p lA# p 6#+( 6#Vd A# Vd# q  B#  q]#Vd B# Vd#p B# pԀ+(@+(Operator#Vd  C# Vd#p MC# p ;1+( f+  Pf+; * ,4* *ID##Vd C# Vd#p C# p 0#-8+ 0ID##Vd D# Vd#p D# p 6#-8+ 6ID##Vd RE# Vd#p E# p 0#-8+ 0ID##Vd F# Vd#p RF# p 6#-8+ 6ID##Vd F# Vd#p  G# p 6#-8+ 6ID##Vd G# Vd#p G# p E;#-8+ f+ P  Pf;E ' .g, 'ID##Vd DH# Vd#p H# p 4#x/- 4ID##Vd 8I# Vd#p zI# p 6#x/- 6ID##Vd I# Vd#p 6J# p 4#x/- 4ID##Vd J# Vd#p J# p 6#x/- 6ID##Vd nK# Vd#p K# p 6#x/- 6ID##Vd ,L# Vd#p nL# p3)'x/- f; P  3 8    1/ _* d  dTT ?dd ??TT ?dd eTT e7dd 7HTd H%%,Sd ,t ,_ d +  1' Pt 1 ' <t '#Vd L# Vd#p ,M# pPlantName(fromStep1)#Vd fO# l Vd# t   lO# l   t -#x -#Vd  lP##VdDP#VdԀ VdAccountCertificateof <t ЀRepresentationPage2#Vd Q# l Vd# t   lP# l   t$> t P $* ddSd St _ d _ %%,d ,t ,t +  # t   lQ# l   t -#,, 8-#Vd  lQ#Vd#!S#STEP5 X Readthecertification,  B  sign#VdS#Vd#S#Ԁanddate.#Vd_T# l Vd# t   lT# l   t    %n  %#Vd  lT##Vd/U#IcertifythatIwasselectedastheNOxauthorizedaccountrepresentativeoralternateNOxauthorized X  accountrepresentative,asapplicable,byanagreementbindingontheownersandoperatorsoftheNOx @  BudgetsourceandeachNOxBudgetunitatthesource.IcertifythatIhaveallthenecessaryauthorityto  carryoutmydutiesandresponsibilitiesundertheNOxBudgetTradingProgramonbehalfoftheowners h andoperatorsoftheNOxBudgetsourceandofeachNOxBudgetunitatthesourceandthateachsuch P ownerandoperatorshallbefullyboundbymyrepresentations,actions,inactions,orsubmissionsandby  anydecisionororderissuedtomebythepermittingauthority,theAdministrator,oracourtregardingthe x sourceorunit. ( ` IamauthorizedtomakethissubmissiononbehalfoftheownersandoperatorsoftheNOxBudget    sourcesorNOxBudgetunitsforwhichthesubmissionismadeIcertifyunderpenaltyoflawthatIhave   personallyexamined,andamfamiliarwith,thestatementsandinformationsubmittedinthisdocumentall 8 p  itsattachments.Basedonmyinquiryofthoseindividualswithprimaryresponsibilityforobtainingthe   information,Icertifythatthestatementsandinformationaretothebestofmyknowledgeandbelieftrue,   accurate,andcomplete.Iamawarethattherearesignificantpenaltiesforsubmittingfalsestatementsand H  informationoromittingrequiredstatementsandinformation,includingthepossibilityoffineor  0  imprisonment#U#.   UVd :0&@ d 8  t: ! F~ ! VdSignature(AuthorizedAccountRepresentative)#Vd ]# l Vd# t   lU]# l   t 0Bz! 0#Vd  l@^# VdDate#Vd ^# l Vd# t   l^# l   t 2(Bz$ t  t2 ' d% '#Vd  l<_# Vd ԀSignature(AlternateAuthorizedAccountRepresentative) -`( -Date#p ~_# p#Vd `# 2(`+ t  t2  ,  '#[. '#Vd`#.$"/ t   .   Q;INSTRUCTIONS#Q;a#  5/ aVd$G!VdUnderthestateregulationstoimplementtheNOxBudgetTradingProgram,theownersandoperatorsforeachbudgetsourcemust d1 designatearepresentative,andmaydesignateanalternate,toactontheirbehalf.Theownersandoperatorsshouldchoosethe "2 representativethroughaprocessthatensuresthatallownersandoperatorshavenoticeregardingtheselection.Allbudgetsourcesata p3 plantmusthavethesameAuthorizedAccountRepresentative.TheAuthorizedAccountRepresentative#Vd!$Gb#$G!Vd#u#!$Gmb#$G!#uԀisresponsibleforallsubmissions .4 andallowancetransactionsrelatingtothebudgetsourcesatthatplant.TheAuthorizedAccountRepresentative#u#!$GBe#$G!#u#Vd!$Ge#$G!VdԀandtheAlternate |5 AuthorizedAccountRepresentative#Vd!$Glf#$G!Vd#u#!$G*f#$G!#uԀareliableforactsoromissionswithinthescopeoftheirresponsibilitiesundertheNOxBudgetTrading :6 Program#u#!$G>g#$G!#u#Vd!$Gf#$G!Vd.EPAwillnotrecordanallowancetransactionuntilithasreceivedacompleteAccountCertificateofRepresentation. 7 #Vd!$GMh# f    #Vd h#(Ku@ % %(Pleasetypeorprint.Ifmorespaceisneeded,photocopythe ; firstpage.Indicatethepageorderandtotalnumberofpages 3k< (e.g.,1of4,2of4,etc.).Note:AnAccountCertificateof = Representationamendinganearliersubmissionsupersedes Y> theearliersubmissioninitsentirety.ArevisedAccount $? CertificateofRepresentationmustthereforebecomplete,  @ includingsignatureanddatingbytheAuthorizedAccount !J A Representative(andtheAlternate,ifapplicable). ! B \iSubmitoneAccountCertificateofRepresentationformwith 8"p!C originalsignatures.RememberthattheAuthorizedAccount ""D Representativeshouldnotifyeachownerandoperatorofall ^#"E NOxBudgetProgramsubmissions. #)#F  Forassistance,calltheEPAsCleanAirMarketsDivision $#G Hotlineat(202)3439620.  %O$H    STEP1: Ifanybudgetsourceattheplantisaffectedbythe %$I AcidRainProgram,theORISPLcodeisembeddedinthe =&u%J firstsixdigitsoftheunitaccountnumberforthatsource &&K undertheAcidRainProgram.Iftherearenotanybudget c'&L sourcesattheplantaffectedbytheAcidRainProgram,a '.'M budgetsourceshouldusetheplantorfacilitycode ('N registeredwiththeDepartmentofEnergy(DOE)toobtainan )T(O ORISPLcode.(ForutilitiesreportingontheEIA-767,-860, )(P and-861,theplantcodewouldbeusedastheORISPLcode. B*z)Q FornonutilitiesreportingontheEIA-867,thefacilitycode * *R wouldbeusedasthe(ORISPLcode).Ifthebudgetsource h+*S doesnotreporttoDOE,andthereforedoesnothavean +3+T ORISPLcode,thebudgetsourceshouldcalltheAcidRain ,+U ProgramHotlineforassistance. !-Y,V $n STEP2 :TheAuthorizedAccountRepresentativemust -,W beanaturalpersonandcannotbeacompany.Pleaseenterthe G.-X firmnameandaddressasitshouldappearonall ..Y correspondence#i#Vd. m/.Z #Vds#EPAForm762016Vd 0/\ #Vds#RepresentativemustrelyontheAuthorizedAccount &1^0] Representativetoforwardinformation 10^ mailedbyEPA. ^    STEP4 󀀀Theownersandoperatorsmaybecompaniesornatural 3k_ persons.Identifyeachbudgetsourceattheplantthatisownedor ` operatedbythenamedpartybyprovidingtheunitidentification Ya numberforthebudgetsource.Ifabudgetsourceisaffectedbythe $b AcidRainProgram,thesourceshould  c determineanappropriateID#thatitwilluseforallNOxBudget !J d TradingProgrampurposes.ThisID#mustbesixdigitsorless. ! e  STEP5 Notethecertificationstatement. 8"p!f  SUBMISSIONINSTRUCTIONS:  ^#"h FFSubmitthisformpriortosubmissionofthemonitoringplanforthe /$g#j NOxBudgetTradingProgram.Thisformmustbesubmittedbefore $#k participatingintransfersofallowances. _%$l SubmitarevisedAccountCertificateofRepresentationwhenany %/%m informationintheexistingAccountCertificateofRepresentation &%n changes.f.i ''_&o  MailingInstructions&%% 5(m'q  #%%&y#uMailthisformtoEPAatoneofthefollowingaddresses: C){(s   U.S.EPA }  ))t ЀNOxBudgetTradingProgram(6204J) Q*)u forregularorcertifiedmail:forovernightmail: _+*w 1200PennsylvaniaAve,NW1310LStreet,NW ++x Washington,DC20460 } Washington,DC20005 m,+y    % Phone:2023439620&%% ,,,z #&%%%%&Vt# #%%&9|#  {-,{ Q w   (Ku@ * *( PaperworkBurdenEstimate@*  w Thepublicreportingandrecordkeepingburdenforthiscollectionofinformationisestimatedtoaverage30hoursperresponse.Burdenmeans  thetotaltime,effort,orfinancialresourcesexpendedbypersonstogenerate,maintain,retain,ordiscloseorprovideinformationtoorfora   Federalagency.Thisincludesthetimeneededtoreviewinstructions;develop,acquire,install,andutilizetechnologyandsystemsforthe  purposesofcollecting,validating,andverifyinginformation,processingandmaintaininginformation,anddisclosingandproviding  information;adjusttheexistingwaystocomplywithanypreviouslyapplicableinstructionsandrequirements;trainpersonneltobeableto * respondtoacollectionofinformation;searchdatasources;completeandreviewthecollectionofinformation;andtransmitorotherwise ( disclosetheinformation.Anagencymaynotconductorsponsor,andapersonisnotrequiredtorespondto,acollectionofinformationunless 8 itdisplaysacurrentlyvalidOMBcontrolnumber. 6  SendcommentsontheAgency'sneedforthisinformation,theaccuracyoftheprovidedburdenestimates,andanysuggestedmethodsfor D  minimizingrespondentburden,includingthroughtheuseofautomatedcollectiontechniquestotheDirector,CollectionStrategiesDivision, T  U.S.EnvironmentalProtectionAgency(2822),1200PennsylvaniaAve.,NW.,Washington,D.C.20460.IncludetheOMBcontrolnumber R  inanycorrespondence.Donotsendthecompletedformtothisaddress ||'. b #' ||F# `  @*