Name of Owner or Operator __________

Address of Mine or Mill __________

Unit or Process __________

Volume of Inlet Gas (norm. m³/min)__________

Temperature of Inlet Gas (°C) __________

Type of Air Pollution Control Equipment __________

Supplier of Air Pollution Control Equipment __________

Schedule of Installation     

Engineering Design Initiated (date) __________

Air Pollution Control Equipment Ordered (date) __________

Air Pollution Control Equipment Delivery (date) __________

Field Construction Initiated (date) __________

Field Construction Completed (date) __________

Installation of Air Pollution Control Equipment Completed (date) __________

Start-up of Air Pollution Control Equipment (date) __________

(Attach copy of air pollution control equipment specifications and purchase order when order is placed or amended)