5900-392 Manufacturer Request for Pre-Approval of Using Certified

	Manufacturer Request for Pre-approval of Using Certified Data In-lieu of New Tests Form to assist manufacturer to comply with 40 CFR 86.421-78(d) EPA Form No. 5900-392 (Rev: March 2015)
	Requestor Name		Agency Use Only
	Submission Date (MM/DD/YYYY)		EPA Determination:
	Requester Signature
	Note : An official letter from the data owner to authorize data use must be attached for this request.
		Certified Engine Family	New Engine Family	Comparative Results/Notes
	Engine Family
	Model Name(s)
	Engine Manufacturer
	Vehicle Assembly Manufacturer
	Combustion Cycle
	Cooling Mechanism
	Number of Cylinders
	Cylinder Configuration
	Engine Displacement (cc)
	Bore Size
	Stroke Size
	Transmission Type
	Prechamber Characteristics
	Combustion Chamber Configuration
	# of Intake and Exhaust Valve or Port Sizes
	Intake and Exhaust Timing of Actuation
	Fuel System
	Exhaust System
	Engine Oil
	Air Aspiration Method
	Spark Timing
	Air/Fuel Ratio
	Curb Mass of Vehicle (kg)
	Equivalent Inertia Mass (kg)
	Overall Gear Ratio (Top Gear)
	N/V Ratio
	Tire Diameter
	Catalytic Converter Information
	Converter Manufacturer
	Converter Manufacturer Part #
	Vehicle Manufacturer Converter Part #
	Precious Metals
	Ratio of Precious Metals
	Minimum Active Material Loading (g/L)
	Catalytic Converter Type (honeycomb, mesh, etc.)
	Quantity
	Location (e.g., in muffler, etc.)
	Substrate Material (ceramic, metallic, etc.)
		Honeycomb Type
	Outside Container Diameter
	Outside Container Length
	Inside Substrate Diameter
	Inside Substrate Length
	Cell Density
		Mesh Type
	Type of Mesh (grate, wire knit/woven brick,etc.)
	Outside of Container Length
	Outside of Container Width
	Outside of Container Depth
	Minimum Brick Weight(g), if wire knit/woven brick
	Minimum Wire Diameter
	Aperture Size (if grate type)
		Other Type
	Type Description
	Active Material Dimensions
	Active Material Composition
	Container Dimensions
	Description of Other Exhaust Emission Control Equipment (If Any)