Form 3520-20E Reformulated Gasoline and Anti-Dumping Annual Compliance

OMB 2060-0277 expires 3/31/97 (see instructions)

2730

Reformulated Gasoline and Anti-Dumping
Annual Compliance Designation

United States
Environmental Protection Agency
Washington DC 20460

1.0) Identification Information:
1.1) Company Name:

1.2) Facility Name:

1.3) Company ID#:

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1.4) Facility ID#:

1.5) Reporting Year (YY):

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Mail To:
U.S. E.P.A.
Attn: REFGAS (6406J)
1200 Pennsylvania Ave, NW
Washington, DC 20460

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Commercial Delivery:
U.S. E.P.A.
Attn: REFGAS; 202-343-9038
1310 L Street, NW
Washington, DC 20005

2.0) Designations
The following designations apply to all gasoline or blendstock produced by a single refinery, oxygenate blending facility
or importer for an entire calendar year.

2.1) Compliance Method (reformulated and conventional gasoline - shade one)
Simple Model

Alternative Simple Model

Complex Model

2.2) Compliance Parameters Indicators (reformulated gasoline only - shade one for each parameter that applies):

a)

Toxics Emissions Performance:

Average

Per Gallon

b)

Benzene Content:

Average

Per Gallon

c)

Oxygen Content (does not apply to RBOB):

Average

Per Gallon

d)

RVP (simple model):

Average

Per Gallon

e)

VOC Emissions Performance (complex model):

Average

Per Gallon

f)

NOx Emissions Performance (complex model):

Average

Per Gallon

EPA Form 3520-20E (Rev. 02-96)

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