Form 3520-20C Reformulated Gasoline Program and Anti-Dumping Batch Rep

OMB 2060-0277 expires 04/30/2004 (see instructions)

45213

EPA

United States
Environmental Protection Agency
Washington DC 20460

1.0) Identifying Information

Reformulated Gasoline and Anti-Dumping
Batch Report

1.3) Reporting ID

1.4) Company ID

1.5) Facility ID

1.6) RY

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0

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0

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1.7) Batch No.

1.1) Report type (shade one)

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

/

/

2.0) Batch Volume (gallons)
See Instructions for use of PCG, Export,
and Negative Volume markers.

PCG

-

3.0) Production Date

Export

,

4.0) Product Type (shade one)

(mm/dd/yy)

/

,

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) Conventional blendstock (EEP Report)
I) Both F and H
J) Gasoline treated as blendstock (GTAB)

/

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9
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5.0) Tier 2 Sulfur Reporting
Is this batch GPA gasoline?
(Registered GPA refiners and
importers ONLY. For use
during the 2004, 2005 & 2006
averaging periods.)

Yes

6.0) Batch Grade
(shade one)

Regular
Mid-grade
Premium
Mix of Grades

No

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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

Region 1

(CG Summer
Southern)

Winter)

Region 2

Adjusted VOC

(CG Summer
Northern)

(Region 2 Only)

8.0) Gasoline Properties (units are volume percent unless otherwise shown)
8.1) Oxygen (WT%) 8.2) Sulfur (ppm) 8.3) Aromatics

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8.4) Olefins

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EPA Form 3520-20C (Rev. 01-2004)

8.5) Benzene

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8.6) Methanol

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8.7) MTBE

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Page 1 of 2

OMB 2060-0277 expires 04/30/2004 (see instructions)

45213

EPA

United States
Environmental Protection Agency
Washington DC 20460

Reformulated Gasoline and Anti-Dumping
Batch Report

8.0 Gasoline Properties Continued
8.8) Ethanol

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/

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/

Reporting ID
Company
Facility
RY

8.17) API Gravity
8.12) RVP (psi)

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9
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Report
Date

.

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8.11) t-butanol

(from page 1)

8.10) TAME

8.9) ETBE

Batch No.

Identifying Information

(units are volume percent unless otherwise shown)

8.13) T50 (°F)

8.14) T90 (°F)

.

.

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8.16) E300

8.15) E200

.

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(°API)

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

-

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9
0

.

9.2) VOCs (%)

-

.

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Completed Forms are US Mail:
to be submitted to
one of the following
addresses.
EPA Form 3520-20C (Rev. 01-2004)

9.3) NOx (%)

-

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0

.

9.4) Exhaust Toxics
Emissions
(mg/mi)

-

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9
0

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

.

9.5) NOx Emissions
(mg/mi)

-

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0

.

9.6) NOx Emissions
Oxygen Backout
(mg/mi)

-

.

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

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