Clean Cities Vehicle Programs

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Overview

Summary
Clean Cities Coalitions
Fuel Use By Zipcode
Alternative Fueling Locations

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Sheet 1: Summary

OMB Control #1910-5171 Expires:XX/XX/XXXX
This data is being collected through the National Clean Fleets Partnership to enable DOE to measure the impact and progress of the Partnership. The data you supply will be will be used to establish a baseline for each fleet, which will be used for future comparisons and analysis of instituted programs and policies. Public reporting burden for this collection of information is estimated to average 1.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Office of the Chief Information Officer, Enterprise Policy Development & Implementation Office, IM-22, Paperwork Reduction Project 1910-5171, U.S. Department of Energy, 1000 Independence Ave SW, Washington, DC, 20585-1290; and to the Office of Management and Budget (OMB), OIRA, Paperwork Reduction Project 1910-5171, Washington, DC 20503. Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB control number. Submission of this data is voluntary.
Data Requested for Calendar Year 2015:
1. Number of vehicles by category and fuel type
2. Amount of fuel used by vehicle and fuel type
3. Annual miles traveled by vehicle and fuel type
4. Fuel use by zipcode (Tab #2)
5. Clean Cities Coalition involvement (Tab #3)
6. Fueling infrastructure (Tab #4)
7. Fuel economy technologies in use
1. Vehicle Data	Number of Vehicles
	Biodiesel	CNG	LNG	LPG	E85	HEV	PHEV	EV	Diesel	Gasoline
Light Duty (Class 1 & 2, <10,000 lbs GVWR)
Light Heavy Duty (Class 3, 10,001 to 14,000 lbs.)
Medium Heavy Duty (Class 4-6, 14,001 to 26,000 lbs.)
Heavy Heavy Duty (Class 7 and 8, >26,001 lbs)
2. Fuel Data	Quantity of fuel used in given vehicle categories
	Biodiesel*	CNG	LNG	LPG	E85	Electricity**		Diesel	Gasoline
						EV	PHEV
Light Duty (Class 1 & 2, <10,000 lbs GVWR)
Light Heavy Duty (Class 3, 10,001 to 14,000 lbs.)
Medium Heavy Duty (Class 4-6, 14,001 to 26,000 lbs.)
Heavy Heavy Duty (Class 7 and 8, >26,001 lbs)
Unit that fuel is reported in. Please write the unit in this row. Gallons, standard cubic feet, kWh, gasoline-gallon equivalent (GGE), and diesel-gallon equivalent (DGE) are all acceptable.
	*Please report biodiesel in gallons of B100 even if it was used as lower-level blends.
	**Please report the amount of electricity (kWh) used by EVs and PHEVs.
3. Annual Mileage Data	Number of miles traveled by this vehicle group annually
	Biodiesel	CNG	LNG	LPG	E85	HEV	PHEV	EV	Diesel	Gasoline
Light Duty (Class 1 & 2, <10,000 lbs GVWR)
Light Heavy Duty (Class 3, 10,001 to 14,000 lbs.)
Medium Heavy Duty (Class 4-6, 14,001 to 26,000 lbs.)
Heavy Heavy Duty (Class 7 and 8, >26,001 lbs)
4. Fueling Infrastructure	Number of fueling stations owned or operated by organization.
	Biodiesel	CNG	LNG	LPG	E85	EVSE***	Diesel	Gasoline
Indicate the amount of infrastructure owned or operated by your organization. Station locations can be provided in Tab #4.
On this line please indicate the number of EVSE outlets available for employee use only (workplace charging).
	***EVSE are counted once for each outlet available. For example, 5 charging posts with 2 outlets each = 10 EVSE.
5. Fuel Economy Improvements
On the lines below, describe each fuel economy technology being used by your organization (e.g. low rolling resistance tires, truck/trailer aerodynamics, telematics, etc.)	# of vehicles employing this fuel economy technology			Baseline/Starting Fuel Economy		Final Fuel Economy

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Sheet 2: Clean Cities Coalitions

Clean Cities Coalition Involvement
Please list the Clean Cities coalitions that are actively working with your organization on AFV deployment and/or reporting.	Approximately what percentage of your fleet is operating or refueling within the boundaries of this coalition? Note: If you are providing data on Fuel Use By Zipcode (Tab 2), you can leave this field blank because we will automatically assign petroleum displacement numbers to coalition(s) based on the zipcode data.

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Sheet 3: Fuel Use By Zipcode

If available, please provide alternative fuel use by zipcode. This information will be used to assign petroleum displacement numbers to local Clean Cities coalitions.
Zipcode (based on garage locations)	Fuel type	Amount (gge, dge, kWh, etc.)

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Sheet 4: Alternative Fueling Locations

Below is a list of organization-owned alternative fueling stations. Please confirm and/or add additional stations, and make special note of other public/private stations used by your fleet.
Address	City	State	Zipcode	Fuels Available