GEOSPHERE MONITORING LOGSHEET

Facility Information
FACILITY NAME
LOCATION
PCO NAME
TELEPHONE/FAX NUMBER
MAINTENANCE SUPERVISOR/ENGINEER (Supplying Information)
DATE OF SAMPLING
STACK PERSONNEL

Source Determination
SOURCE TESTED (id or Name used by facility)
TOTAL STACK HEIGHT (to the emission point to atm in meters)
SOURCE TYPE (Genset, Boiler, etc.)
BRAND (Made by)
RATED CAPACITY (with units: BHP, MW, MT/hr. etc.)
DATE CONSTRUCT STARTED (on source) month/year
DATE OF ANY MODIFICATION (that increase emissions)
HAS THE SOURCE BEEN MOVED (Specify Date)
EXISTING (const. before 11/25/00) or NEW (or modified)
SOURCE
OPERATION (estimated hours per year for source)
IS THERE AN APCD (air pollution control device)
DATE OF APCD INSTALLED

* This item is critical to determining the standards that apply to the emission point
Fuel Information
TYPE OF FUEL USED, %S (during sampling)
ORIGINAL FUEL USED, %s
DATE FUEL CHANGED?
DAILY CONSUMPTION (LITERS/DAY)
IS FUEL ANALYSIS AVAILABLE?
IS FUEL ANALYSIS PROVIDED BY THE PLANT?

Process Information
OPERATING RATE DURING TEST?
IS THE APCD OPERATING DURING SAMPLING?
APCD PARAMETER? 9gpm, delta P, etc.)
IS PROCESS LOGSHEET AVAILABLE?
IS LOGSHEET PROVIDED BY THE PLANT?
PARAMETERS MONITORED BY THE PANT

SOURCE PERMIT PROVIDED BY THE PLANT

NOTES:

Information recorded/gathered by: Information supplied by:

____________________________________ ____________________________________
Name and Signature of GTI personnel on-site Name and Signature of facility representative