Mark Signature Pag 5900-489

Mark Signature Page
Tractors and Trailers
OMB No: 2060-0663, Expiration Date: 04/30/2021
EPA’s SmartWay Transport® Partnership is an innovative program that recognizes Partners for setting and achieving
greenhouse gas (GHG) reduction goals in freight transport.
By signing this agreement,

signifies that it has read and will comply

Company or Organization Name

with the SmartWay® Graphic Standard and Usage Guide. I further certify that my organization has or plans to purchase
number(s) of U.S. EPA Designated SmartWay Tractors
number(s) of U.S. EPA Designated SmartWay Trailers:
as part of my fleet. I also commit to maintain the SmartWay Tractors and SmartWay Trailers per the manufacturer’s
recommendations or replace them as necessary.
Indicate needed logo:

q

q SmartWay Trailer

Briefly state the SmartWay logo
dimensions and placement on
fleet vehicles.

SmartWay Tractor Logo Dimensions:

SmartWay Tractor

SmartWay Tractor Logo Placement:
SmartWay Trailer Logo Dimensions:
SmartWay Trailer Logo Placement:

AUTHORIZED PARTNER OFFICIAL:
The undersigned, on behalf of

, understands and agrees to the terms

of the U.S. EPA SmartWay Graphic Standards and Usage Guide for use of the applicable SmartWay logo(s).
Signature:

Title:

Print Name:

Date:

KEY PARTNER/ORGANIZATION CONTACT FOR SMARTWAY: (may be different from above individual)
Name:
Title:
Address:
City :
E-mail:

State:
Phone:

Zip:
Fax:

Burden Statement: This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-0663). Responses to this collection of
information are voluntary (Energy Policy Act of 2005; citation 109-58). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. The public reporting and recordkeeping burden for this collection of information is estimated to take a maximum of 2.75 hours to compile and
submit the SmartWay Equipment Checklist, and 0.25 to review and complete the Mark Signature Form. Send comments on the Agency’s need for this information, the accuracy of the provided
burden estimates and any suggested methods for minimizing respondent burden to the Regulatory Support Division Director, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania
Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

U.S. EPA Office of Transportation & Air Quality • smartway_transport@epa.gov • (734) 214-4767 phone • (734) 214-4052 fax • www.epa.gov/smartway

Sleeper Tractor Equipment

~

- US EPA Designated

....;z,smartWay®

COMPANY NAME:
OMB No: 2060-0663, Expiration Date: 04/30/2021

3 CHECKLIST FOR SMARTWAY TRACTOR “SLEEPER”
Equipment
BASE SMARTWAY TRACTOR*

□3

Quanity

□--

(Documentation for SmartWay Brand Manager)

Manufacturer, Model, Model Year

Required

Must be equipped with the following technology components:

■
■
■
■
■
■
■

Current model year certified engine
Integrated cab w/ high roof fairing
Cab side extenders
Aero bumper
Aero mirrors
Fuel tank fairing
Low rolling resistance tires

Manufacturer, Model, Model Year

Required

Required

*Note: Indicate only one tractor manufacturer and model per page. Use mulitiple pages if necessary.

TRACTOR STEER TIRES (Indicate tire models)

□--

Manufacturer, Model

TRACTOR DRIVE TIRES (Indicate tire models)
Manufacturer, Model
Manufacturer, Model

TRACTOR ALUMINUM WHEELS (Optional)
Manufacturer, Model

Required: Select either an equipment or strategy option

SELECT AN IDLING CONTROL EQUIPMENT OR STRATEGY:
IDLING CONTROL EQUIPMENT
Auxiliary Power Unit or Generator Set
Fuel Operated Heater
Battery Operated Air Conditioning
and/or Heating System
Thermal Storage System
Double Drivers
Driver Overnight hotel stay
Connects to Electrified Parking Space
(Truck Stop Electrification)

Other strategy

□-­
□-­
□-­
□-□-­
□-­
□-­
□--

Manufacturer, Model
Manufacturer, Model
Manufacturer, Model
Manufacturer, Model

Please attach copy of company policy
Please attach copy of company policy

Describe or indicate idle-control strategy

SmartWay I Tractor Equipment Check List 1

Day Cab Tractor Equipment

~

- US EPA Designated

....;z,smartWay®

COMPANY NAME:
OMB No: 2060-0663, Expiration Date: 04/30/2021

3 CHECKLIST FOR SMARTWAY TRACTOR “DAY CAB”
Equipment
BASE SMARTWAY TRACTOR*

3
□

Quanity

□--

(Documentation for SmartWay Brand Manager)

Manufacturer, Model, Model Year

Required

Must be equipped with the following technology components:

■
■
■
■
■
■
■

Current model year certified engine
Integrated cab w/ high roof fairing
Cab side extenders
Aero bumper
Aero mirrors
Fuel tank fairing
Low rolling resistance tires

Manufacturer, Model, Model Year

Required

Required

*Note: Indicate only one tractor manufacturer and model per page. Use mulitiple pages if necessary.

TRACTOR STEER TIRES (Indicate tire models)

TRACTOR DRIVE TIRES (Indicate tire models)

TRACTOR ALUMINUM WHEELS (Optional)

□-□-­
□-□--

Manufacturer, Model

Manufacturer, Model
Manufacturer, Model

Manufacturer, Model

Optional: Select either an equipment or strategy option

SELECT AN IDLING CONTROL EQUIPMENT OR STRATEGY:
IDLING CONTROL EQUIPMENT Day cabs encouraged but not required to use idle control equipment or strategy. (Check applicable option)
Auxiliary Power Unit or Generator Set
Fuel Operated Heater
Battery Operated Air Conditioning
and/or Heating System
Thermal Storage System
Double Drivers
Driver Overnight hotel stay
Connects to Electrified Parking Space
(Truck Stop Electrification)

Other strategy

□-­
□-­
□-­
□-□-­
□-­
□-­
□--

Manufacturer, Model
Manufacturer, Model
Manufacturer, Model
Manufacturer, Model

Please attach copy of company policy
Please attach copy of company policy

Describe or indicate idle-control strategy

SmartWay I Tractor Equipment Check List 2

Trailer Equipment Check List

~

- US EPA Designated

....;z,smartWay®

COMPANY NAME:
OMB No: 2060-0663, Expiration Date: 04/30/2021

3 CHECKLIST FOR SMARTWAY TRAILER
Equipment
BASE TRAILER* (53 foot)

3
□

Quanity

(Documentation for SmartWay Brand Manager)

□--

Manufacturer, Model, Model Year

Required

* Note: Indicate only one trailer manufacturer and model per page. Use mulitiple pages if necessary.

SELECT WHICH TYPE OF TRAILER YOU’RE TRYING TO DESIGNATE:
TRAILER TYPE: (Check One)

□

Dry Van

□

Refrigerated

DESIGNATED TYPE: (Check One)

□

SmartWay Trailer

□

SmartWay Elite Trailer

(6% fuel savings or higher)

(10% fuel savings or higher)

The following types of technologies may be used for your trailer:

1. TRAILER FONT FAIRING

3. TRAILER REAR FAIRING
Tails or other types of devices

2. TRAILER UNDER FAIRING
Skirts or other types of devices

4. LOW ROLLING
RESISTANCE TIRES
(Aluminum wheels optional)

NOTE: Fleets are not required to have all four types of technologies to achieve the SmartWay Designation or the
SmartWay Elite Designation.
Low rolling resistance new tires or retreads must be maintained on SmartWay Designated Trailers.

SmartWay I Trailer Equipment Check List 3

Trailer Equipment Check List

~

- US EPA Designated

....;z,smartWay®

COMPANY NAME:
Indicate how fleet trailers are equipped in this section.
TIRES

Check all that apply

Verified % Fuel Savings

Required

(Circle One)

EPA Verified Device

□
□

Trailer Ties, New

Trailer Tires, Retreaded

Optional

Trailer Aluminum Wheels
(Optional)

Automatic Tire Inflation
(Optional)

AERODYNAMICS

1%
1%

□

Manufacturer, Model

Manufacturer, Model

□

Check all that apply

Manufacturer, Model

Manufacturer, Model

Verified % Fuel Savings
(Circle applicable option)

EPA Verified Device*
Required

1. Trailer Front Fairing
2. Trailer Under Fairing
3. Trailer Rear Fairing
4. Other Device Type
5. 9% Elite Package

□
□
□
□
□

1%
1%, 4%, or 5%
1%, 4%, or 5%
1%, 4%, or 5%
9%

Manufacturer, Model

Manufacturer, Model

Manufacturer, Model

Manufacturer, Model

Manufacturer Aero Package name

TOTAL PROJECTED FUEL SAVINGS %:
(Tires + Aerodynamics)

NOTE: *Gap reducer technologies (e.g. nose fairing, front fairing, etc.) are not appropriate for reefer trailers.
Any Elite Packages that include a gap reducer is ineligible for reefer trailers.
Fleets may select individual devices that add to a designation threshold (i.e. 6% or 10%) or choose a
single product from the 6% or 10% category.
SmartWay I Trailer Equipment Check List 4