The DEQ's Environmental Assistance Program created "Air Quality Requirements for Hospitals" to provide hospitals a road map to following these air quality requirements, with a focus on equipment common to most hospitals: boilers, emergency generators, and sterilizers.

STATE REQUIREMENTS

Permit to Install Exemption Handbook

General Permit - The use of general permits provides a streamlined permitting alternative for processes that meet the eligibility requirements. For hospitals, this includes:

• Natural Gas-Fired Boilers with a Maximum Rated Heat Input of 100 million Btu/Hour
• Diesel Fuel-Fired Engine Generators with a Maximum Nameplate Capacity of 5 Megawatts
• Ethylene Oxide (EtO) Sterilizers

Permit to Install - If you have determined that your equipment does not meet the permit exemption criteria and does not meet the eligibility requirements for a general permit, then you should apply for an individual Permit to Install. The application form and associated instructions are available at the Michigan Air Permits Systemwebsite.

Renewable Operating Permit (ROP) - Most hospitals are not subject to the ROP program. Only major sources are required to apply for a ROP. For information on how to calculate your potential to emit (PTE) and determine if you are a major source, go to DEQ's PTEand ROPwebsites.

Michigan Air Emissions Reporting System (MAERS) - Facilities that have been sent a MAERS reporting package by late January must submit their completed MAERS report to the DEQ by March 15. Since most hospitals are subject to the NSPS for boilers, most are subject to air emission reporting.

FEDERAL REQUIREMENTS

NSPS Subpart Dc for Boilers - Boilers at healthcare facilities, especially those with heat input capacities equal to or greater than 2.9 megawatts or 10 million Btu/hr may be subject to the New Source Performance Standards (NSPS) Subpart Dc.

NSPS Subpart IIII for Compressed Ignition Emergency Generators- Compressed Ignition (diesel-fired) emergency generators are subject to the NSPS Subpart IIII if the engine is ordered after 7/11/05 and manufactured after 4/1/06; or if the engine is modified or reconstructed after 7/11/05.

NSPS Subpart JJJJ for Spark Ignition Emergency Generators- This Subpart establishes minimum requirements for new or modified spark ignition (gas, propane, etc.) engines with requirements based on size, type, and date of manufacture.

NESHAP Subpart ZZZZ for RICE- Emergency generators have limited requirements under this subpart, depending on date of construction and size.

NESHAP WWWWW for EtO Sterilizers- Ethylene oxide (EtO) sterilizers are commonly used at hospitals to sterilize and fumigate medical equipment. All hospital EtO sterilizers are subject to this subpart and are required to submit an Initial Notification Formto the DEQ and U.S. EPA.

ADDITIONAL LINKS/RESOURCES

• Code of Federal Regulations 
• DEQ Environmental Assistance Program 
• Practice Greenhealth 
• U.S. EPA
• Michigan Clean Air Consultant Directory, click on "Clean Air Assistance," then "Environmental Consultant Assistance." The directory assists in determining when an air quality consultant might be needed, describes the various types of air quality consultants, and gives an overview of some of the more common air quality activities performed by consultants.
• Hazardous and Liquid Industrial Waste, click on "Generators" for generator resources or "Disposal of Hazardous and Liquid Industrial Waste Types" for resources specific to hospital wastes. See the "Universal Waste" guidance on details specific to universal waste pharmaceuticals or "Mixed Medical Waste" for information on managing hazardous waste or liquid industrial waste mixed with medical waste.
• Medical Waste