PAPERWORK
REDUCTION
ACT
SUBMISSION
Please
read
the
instructions
before
completing
this
form.
For
additional
forms
or
assistance
in
completing
this
form,
contact
your
agency's
Paperwork
Clearance
Officer.
Send
two
copies
of
this
form,
the
collection
instrument
to
be
reviewed,
the
Supporting
Statement
and
any
additional
documentation
to:
Office
of
Information
and
Regulatory
Affairs,
Office
of
Management
and
Budget,
Docket
Library,
Room
10102,
725
17th
Street
NW
Washington,
DC
20503.

1.
Agency/
Subagency
originating
request
EPA/
OECA/
OC/
METD
2.
OMB
control
number
b.
G
None
a.
2060
­
0172
3.
Type
of
information
collection
(
check
one)
a.
G
New
collection
b.
G
Revision
of
a
currently
approved
collection
c.
X
Extension
of
a
currently
approved
collection
d.
G
Reinstatement,
without
change,
of
a
previously
approved
collection
for
which
approval
has
expired
e.
G
Reinstatement,
with
change,
of
a
previously
approved
collection
for
which
approval
has
expired
f.
G
Existing
collection
in
use
without
an
OMB
control
number
4.
Type
of
review
requested
(
check
one)
a.
X
Regular
b.
G
Emergency
­
Approval
requested
by:
/
/
c.
G
Delegated
5.
Small
entities
Will
this
information
collection
have
a
significant
economic
impact
on
a
substantial
number
of
small
entities?
G
Yes
G
No
For
b­
f,
note
item
A2
of
Supporting
Statement
Instructions
6.
Requested
expiration
date
a.
X
Three
years
from
approval
date
b.
G
Other
Specify:
/
/___

7.
Title
NSPS
40
CFR
Part
60,
Subpart
QQQ
­
Standards
of
Performance
for
VOC
Emissions
form
Petroleum
Refinery
Wastewater
Systems
­
Reporting
and
Recordkeeping
8.
Agency
form
number(
s)
(
If
applicable)
1136.06
9.
Keywords
Clean
Air
Act,
Air
Pollution
Control,
Environmental
Protection
10.
Abstract
Owners
and
operators
of
petroleum
refinery
wastewater
systems
are
required
to
keep
records
of
design
and
operating
specifications
of
all
equipment
installed
to
comply
with
the
standards
such
as
water
seals,
roof
seals,
control
devices,
and
other
equipment.
This
information
is
necessary
to
ensure
that
equipment
design
and
operation
specifications
are
met,
and
the
source
is
in
compliance
with
NSPS
Subpart
QQQ.

11.
Affected
public
(
Mark
primary
with
"
P"
and
all
others
that
apply
with
"
X")
a.
Individuals
or
households
d.
Farms
b.
P
Business
or
other
for­
profit
e.
Federal
Government
c.
Not­
for­
profit
institutions
f.
State,
Local
or
Tribal
Government
12.
Obligation
to
respond
(
Mark
primary
with
"
P"
and
all
others
that
apply
with
"
X")
a.
G
Voluntary
b.
G
Required
to
obtain
or
retain
benefits
c.
P
Mandatory
13.
Annual
reporting
and
recordkeeping
hour
burden
a.
Number
of
respondents
160
b.
Total
annual
responses
320
1.
Percentage
of
these
responses
collected
electronically
0
%
c.
Total
annual
hours
requested
36,866
d.
Current
OMB
inventory
36,866
e.
Difference
0
f.
Explanation
of
difference
1.
Program
Change
2.
Adjustment
14.
Annual
reporting
and
recordkeeping
cost
burden
(
in
thousands
of
dollars)

a.
Total
annualized
capital/
startup
costs
1
b.
Total
annual
costs
(
O&
M)
56
c.
Total
annualized
cost
requested
57
d.
Current
OMB
inventory
57
e.
Difference
0
f.
Explanation
of
difference
1.
Program
change
2.
Adjustment
15.
Purpose
of
information
collection
(
Mark
Primary
With
"
P"
and
all
others
that
apply
with
"
X")
a.
__
Application
for
benefits
e.
__
Program
planning
or
management
b.
__
Program
evaluation
f.
__
Research
c.
__
General
purpose
statistics
g.
_
P_
Regulatory
or
compliance
d.
__
Audit
16.
Frequency
of
recordkeeping
or
reporting
(
check
all
that
apply)
a.
Q
Recordkeeping
b.
Q
Third
party
disclosure
c.
X
Reporting
1.
X
On
occasion
2.
Q
Weekly
3.
Q
Monthly
4.
Q
Quarterly
5.
X
Semi­
annually
6.
Q
Annually
7.
Q
Biennually
8.
Q
Other
(
describe)

17.
Statistical
methods
Does
this
information
collection
employ
statistical
methods?

Q
Yes
X
No
18.
Agency
contact
(
person
who
can
best
answer
questions
regarding
the
content
of
this
submission)
Name:
Dan
Chadwick
Phone:
(
202)
564­
7054
OMB
83­
I
10/
95
