An application requesting the use of minor permit modification procedures shall:

1. (1) Meet the standard part 70 permit application requirements; and

2. (2) Additionally include the following:

   1. (A) A description of the change, the emissions resulting from the change, and any new applicable requirements that will apply if the change occurs;
   2. (B) The source's suggested draft permit conditions;
   3. (C) Certification by a responsible official that the proposed modification meets the criteria for use of minor permit modification procedures and a request that such procedures be used; and
   4. (D) Completed forms for the Division of Environmental Quality to use to notify the Administrator of the Environmental Protection Agency and affected states as required under Subpart 5 of this part.