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General Information <br />1. Has the Emission Factor for any Permited Unit changed in the previous year (source test or modified / <br />corrected permit emission factor)? Please List: kj © <br />Permit Number: Pollutant : Emission Factor: Units : <br />2. Were any malfunctions or breakdowns of process or control equipment experienced which effect emissions ? <br />❑ Yes Duration of Event(s) <br />X No <br />Describe malfunction/breakdown uant' of emission and Pollutant emitted <br />Questionnaire Answered By, Title <br />Signature <br />Telephone Number J209) <br />369- 74 <br />Contact Person <br />Telephone Number <br />c <br />