Form 3520-20F Reformulated Gasoline and Anti-Dumping Reports for Batch

OMB 2060-0277 expires 12/31/2001 (see instructions)

45228

EPA

Reformulated Gasoline and Anti-Dumping
Report for Batches Containing PreviouslyCertified Gasoline

United States
Environmental Protection Agency
Washington DC 20460

1.0) Identifying Information
1.1) Report type (shade one)

Previously-Certified
Blended (Final)
Calculated

Re-submission
1.2) Report Date (mm/dd/yy)

/

1.8) Previously Certified
Batch No. (Blended and
Calculated batches only)

2.0) Batch Volume

1
2
3
4
5
6
7
8
9
0

1
2
3
4
5
6
7
8
9
0

1
2
3
4
5
6
7
8
9
0

1.7) Batch No.

/

,

Is this batch GPA gasoline?
(Registered GPA refiners and
importers only. For use
during the 2004, 2005, &
2006 averaging periods.)

A) Reformulated Gasoline
B) RBOB - any oxygenate
C) RBOB - ethers only
D) RBOB - refiner specified
E) Conventional gasoline
F) Conventional gasoline (Oxygen Backout)
G)Conventional blendstock
H) Gasoline treated as blendstock(GTAB)

/

1
2
3
4
5
6
7
8
9
0
6.0) Batch Grade
(shade one)

Regular
Mid-grade
Premium
Mix of Grades

No

1
2
3
4
5
6
7
8
9
0

4.0) Product Type (shade one)

(mm/dd/yy)

1
2
3
4
5
6
7
8
9
0

5.0) Tier 2 Sulfur Reporting

1
2
3
4
5
6
7
8
9
0

3.0) Production Date

(gallons)

,

Yes

1.6) RY

1.3) Batch Type (shade one)

Original

/

1.4) Company ID 1.5) Facility ID

7.0) Laboratory Testing and Seasonal Information
7.1) Waived from independent lab testing
(RFG and RBOB only -- shade one)

Yes

No

7.2) VOC controlled (shade one)
Not (or CG
Winter)

Region 1

Region 2

Adjusted VOC
(Region 2 Only)

8.0 Gasoline Properties (units are volume percent unless otherwise shown)
8.1) Oxygen

8.2) Sulfur

(WT%)

1
2
3
4
5
6
7
8
9
0

(ppm)

.

8.3) Aromatics 8.4) Olefins

1
2
3
4
5
6
7
8
9
0

1
2
3
4
5
6
7
8
9
0

EPA Form 3520-20F (Rev. 07-2001)

.

1
2
3
4
5
6
7
8
9
0

.

8.5) Benzene

1
2
3
4
5
6
7
8
9
0

.

8.6) Methanol

1
2
3
4
5
6
7
8
9
0

.

8.7) MTBE

-

.

1
2
3
4
5
6
7
8
9
0
Page 1 of 2

OMB 2060-0277 expires 12/31/2001 (see instructions)

45228

EPA

Reformulated Gasoline and Anti- Dumping
Report for Batches Containing PreviouslyCertified Gasoline

United States
Environmental Protection Agency
Washington DC 20460

Identifying Information
8.0 Gasoline Properties Continued
(units are volume percent unless otherwise shown)
8.8) Ethanol

8.9) ETBE

-

-

.

1
2
3
4
5
6
7
8
9
0

Batch Type (shade one):
8.10) TAME

-

.

1
2
3
4
5
6
7
8
9
0

Batch No.

(from page 1)

1
2
3
4
5
6
7
8
9
0

Previously-Certified
Blended (Final)
Calculated

.

1
2
3
4
5
6
7
8
9
0

Report
Date

/

/

Company
Facility
RY

8.17) API Gravity
8.11) t-butanol

-

.

1
2
3
4
5
6
7
8
9
0

8.12) RVP (psi)

-

8.13) T50 (°F)

.

1
2
3
4
5
6
7
8
9
0

-

8.14) T90 (°F)

.

1
2
3
4
5
6
7
8
9
0

-

8.15) E200

8.16) E300

-

.

1
2
3
4
5
6
7
8
9
0

.

1
2
3
4
5
6
7
8
9
0

-

9.1) Toxics (%)

1
2
3
4
5
6
7
8
9
0

.

9.2) VOCs (%)

-

.

1
2
3
4
5
6
7
8
9
0

Completed Forms are US Mail:
to be submitted to
one of the following
addresses.
EPA Form 3520-20F (Rev. 07-2001)

9.3) NOx (%)

1
2
3
4
5
6
7
8
9
0

.

9.4) Exhaust Toxics
Emissions (mg/mi)

1
2
3
4
5
6
7
8
9
0

.

-

.

1
2
3
4
5
6
7
8
9
0

9.5) NOx Emissions

9.6) NOx Emissions
Oxygen Backout

(mg/mi)

1
2
3
4
5
6
7
8
9
0

.

1
2
3
4
5
6
7
8
9
0

9.0) Emissions Performance Calculations
(9.1 - 9.3 are % reduction from baseline)

(°API)

(mg/mi)

.

-

.

1
2
3
4
5
6
7
8
9
0

Commercial U.S. E.P.A.
U.S. E.P.A.
Delivery:
Attn: REFGAS (6406J)
Attn: REFGAS; (202) 343-9038
1200 Pennsylvania Avenue NW
1310 L Street, NW
Washington, DC 20460
Washington, DC 20005
Page 2 of 2