Form 5900-303 PBMS Non VCSB Method Defined and Reference Installation

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Overview

Independent Third Party Review
NON VCSB Method Precision
NON VCSB Reference Installation
NON-VCSB Method Defined Data
Reference Installation Raw Data
Non-VCSB Method Accuracy

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Sheet 1: Independent Third Party Review

Non VCSB Test Method Independent Third Party Review
OMB Control No. 2060-NEW
Approval Effective August 30, 2015 Approval Expires on August 30, 2018
EPA Form  5900-303
Test Method
Method Defined Fuel Parameter Type:
Name of Method:
Laboratory Identification
Laboratory Name:
Laboratory Street Address:
Laboratory City:
Laboratory State:
Laboratory Zip code:
Laboratory Contact Person:
Laboratory Contact Phone Number
Laboratory Contact Facsimile Number
Laboratory Contact E-mail Address
Confidential Business Information Claim. A company may assert a business confidentiality claim covering the information contained in this submission. If no such claim is made the information may be made available to the public by EPA without further notice. All questions of confidentiality will be handled pursuant to 40 CFR Part 2. Is confidentiality claimed for the information in this submission? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)
Non VCSB Method Defined Criterion - the submiter attests the test facility has conducted an independent third-party scientific review and written report and verification of the information provided in 40 CFR 80.47(m)(1) through 40 CFR 80.47(m)(9). (See 80.47(m)(13))
Has 40 CFR 80.47 (m)(13) criterion been met? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)
Non VCSB Method Defined Criterion - the submiter attests the test facility had a site visit where review of relevent documents was conducted with regards to the requirements of 40 CR 80.47 and that this information has been provided to the Agency for review. (See 80.47(m)(13))
Has 40 CFR 80.47 (m)(13) criterion been met? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)
Paperwork Reduction Act Notice
The public reporting and recordkeeping burden for this collection of information is estimated to average 6 hours per response.  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, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.  Include the OMB control number in any correspondence.  Do not send the completed Form 5900-91 to this address.

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Sheet 2: NON VCSB Method Precision

Non-VCSB Method Defined Precision Demonstration
OMB Control No. 2060-NEW
Approval Effective August 30, 2015 Approval Expires on August 30, 2018
EPA Form  5900-303
Test Method
Method Defined Fuel Parameter Type:	0
Name of Method:	0
Laboratory Identification
Laboratory Name:	0
Laboratory Street Address:	0
Laboratory City:	0
Laboratory State:	0
Laboratory Zip code:	0
Laboratory Contact Person:	0
Laboratory Contact Phone Number	0
Laboratory Contact Facsimile Number	0
Laboratory Contact E-mail Address	0
Confidential Business Information Claim. A company may assert a business confidentiality claim covering the information contained in this submission. If no such claim is made the information may be made available to the public by EPA without further notice. All questions of confidentiality will be handled pursuant to 40 CFR Part 2. Is confidentiality claimed for the information in this submission? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)				0
Method Defined Precision Criterion - the submiter attests that the maximum allowable standard deviation computed from the results of a minimum of 20 tests made over 20 days (tests may be arranged into no fewer than five batches or fewer tests each, with only one such batch allowed per day over the minimum 20 caldendar days) on samples using good laboratory practices take from a single homogenous commercially available gasoline meets the appliable method defined precision criterion for its respective fuel parameter as defined at 40 CFR 80.47
Is the applicable 80.47 Method Defined Precision Criterion Met? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)
standard deviation	REQUIRED DATA MISSING
Laboratory Test Sample Identification Number	Date	Time	Test Result	Data Entry QC Check on Test Result
				DATA REQUIRED IN CELL D20
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D22
				DATA REQUIRED IN CELL D23
				DATA REQUIRED IN CELL D24
				DATA REQUIRED IN CELL D25
				DATA REQUIRED IN CELL D26
				DATA REQUIRED IN CELL D27
				DATA REQUIRED IN CELL D28
				DATA REQUIRED IN CELL D29
				DATA REQUIRED IN CELL D30
				DATA REQUIRED IN CELL D31
				DATA REQUIRED IN CELL D32
				DATA REQUIRED IN CELL D33
				DATA REQUIRED IN CELL D34
				DATA REQUIRED IN CELL D35
				DATA REQUIRED IN CELL D36
				DATA REQUIRED IN CELL D37
				DATA REQUIRED IN CELL D38
				DATA REQUIRED IN CELL D39
Paperwork Reduction Act Notice
The public reporting and recordkeeping burden for this collection of information is estimated to average 6 hours per response.  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, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.  Include the OMB control number in any correspondence.  Do not send the completed Form 5900-91 to this address.

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Sheet 3: NON VCSB Reference Installation

Non-VCSB Method Defined Reference Installation Criteria
OMB Control No. 2060-NEW
Approval Effective August 30, 2015 Approval Expires on August 30, 2018
EPA Form  5900-303
Test Method
Method Defined Fuel Parameter Type:
Name of Method:
Laboratory Identification
Laboratory Name:
Laboratory Street Address:
Laboratory City:
Laboratory State:
Laboratory Zip code:
Laboratory Contact Person:
Laboratory Contact Phone Number
Laboratory Contact Facsimile Number
Laboratory Contact E-mail Address
Confidential Business Information Claim. A company may assert a business confidentiality claim covering the information contained in this submission. If no such claim is made the information may be made available to the public by EPA without further notice. All questions of confidentiality will be handled pursuant to 40 CFR Part 2. Is confidentiality claimed for the information in this submission? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)
Method Defined Reference Installation of the Designated Test Method Precision Criterion - the submiter attests that the maximum allowable standard deviation computed from the results of a minimum of 20 tests made over 20 days (tests may be arranged into no fewer than five batches or fewer tests each, with only one such batch allowed per day over the minimum 20 caldendar days) on samples using good laboratory practices take from a single homogenous commercially available gasoline meets the appliable method defined precision criterion for its respective fuel parameter as defined at 40 CFR 80.47
Is the applicable 80.47 Method Defined Precision Criterion Met for Reference Installation of Designated Test Mehod? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)
Reference Installation Criterion - the submiter attests the reference installation of the applicable designated test method has been shown to stay within the middle 50 percent distribution of an industry or commercially avaiable monthly inter-laboratory crosscheck program for 3 out 5 successive exchanges for at least a period of 5 months using good laboratory practices (See 80.47(k)(2))
Has 40 CFR 80.47 (k)(2) criterion been met? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)
Reference Installation Criterion - the submiter attests the reference installation of the applicable designated test method has been shown to be in statistical quality control for a minimum time period of 5 months using good laboratory practices (See 80.47(k)(3))
Has 40 CFR 80.47 (k)(3) criterion been met? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)
Exemption from Reference Installation Criterion at 80.47(k)(2) and 80.47(k)(3) - the submiter attests voluntary consensus standard body or commercially available industry interlaboratory crosscheck program that the number of non-outlying results is greater than 16 for both the reference installation of the desingated test method and alternative test method (See 80.47(k)(4))
Has 40 CFR 80.47(k)(4) been met? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)
Paperwork Reduction Act Notice
The public reporting and recordkeeping burden for this collection of information is estimated to average 6 hours per response.  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, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.  Include the OMB control number in any correspondence.  Do not send the completed Form 5900-91 to this address.

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Sheet 4: NON-VCSB Method Defined Data

NON VCSB Method Defined Test Method Raw Data used in conjunction with D6708 to establish necessity for Correlation Equation
OMB Control No. 2050-NEW
Approval Effective August 30, 2015 Approval Expires on August 30, 2018
EPA Form  5900-303
Test Method
Method Defined Fuel Parameter Type:	0
Name of Method:	0
Laboratory Identification
Laboratory Name:	0
Laboratory Street Address:	0
Laboratory City:	0
Laboratory State:	0
Laboratory Zip code:	0
Laboratory Contact Person:	0
Laboratory Contact Phone Number	0
Laboratory Contact Facsimile Number	0
Laboratory Contact E-mail Address	0
Confidential Business Information Claim. A company may assert a business confidentiality claim covering the information contained in this submission. If no such claim is made the information may be made available to the public by EPA without further notice. All questions of confidentiality will be handled pursuant to 40 CFR Part 2. Is confidentiality claimed for the information in this submission? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)				0
Laboratory Test Identification Number	Date	Time	Test Result	Data Entry QC Check on Test Result
				DATA REQUIRED IN CELL D20
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D22
				DATA REQUIRED IN CELL D23
				DATA REQUIRED IN CELL D24
				DATA REQUIRED IN CELL D25
				DATA REQUIRED IN CELL D26
				DATA REQUIRED IN CELL D27
				DATA REQUIRED IN CELL D28
				DATA REQUIRED IN CELL D29
				DATA REQUIRED IN CELL D30
				DATA REQUIRED IN CELL D31
				DATA REQUIRED IN CELL D32
				DATA REQUIRED IN CELL D33
				DATA REQUIRED IN CELL D34
				DATA REQUIRED IN CELL D35
				DATA REQUIRED IN CELL D36
				DATA REQUIRED IN CELL D37
				DATA REQUIRED IN CELL D38
				DATA REQUIRED IN CELL D39
Paperwork Reduction Act Notice
The public reporting and recordkeeping burden for this collection of information is estimated to average 6 hours per response.  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, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.  Include the OMB control number in any correspondence.  Do not send the completed Form 5900-91 to this address.

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Sheet 5: Reference Installation Raw Data

Reference Installation Designated Test Method Raw Data used in conjunction with D6708 to establish necessity for Correlation Equation
OMB Control No. 2060-NEW
Approval Effective August 30, 2015 Approval Expires on August 30, 2018
EPA Form  5900-303
Test Method
Method Defined Fuel Parameter Type:	0
Name of Method:	0
Laboratory Identification
Laboratory Name:	0
Laboratory Street Address:	0
Laboratory City:	0
Laboratory State:	0
Laboratory Zip code:	0
Laboratory Contact Person:	0
Laboratory Contact Phone Number	0
Laboratory Contact Facsimile Number	0
Laboratory Contact E-mail Address	0
Confidential Business Information Claim. A company may assert a business confidentiality claim covering the information contained in this submission. If no such claim is made the information may be made available to the public by EPA without further notice. All questions of confidentiality will be handled pursuant to 40 CFR Part 2. Is confidentiality claimed for the information in this submission? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)				0
Laboratory Test Identification Number	Date	Time	Test Result	Data Entry QC Check on Test Result
				DATA REQUIRED IN CELL D20
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D21
				DATA REQUIRED IN CELL D22
				DATA REQUIRED IN CELL D23
				DATA REQUIRED IN CELL D24
				DATA REQUIRED IN CELL D25
				DATA REQUIRED IN CELL D26
				DATA REQUIRED IN CELL D27
				DATA REQUIRED IN CELL D28
				DATA REQUIRED IN CELL D29
				DATA REQUIRED IN CELL D30
				DATA REQUIRED IN CELL D31
				DATA REQUIRED IN CELL D32
				DATA REQUIRED IN CELL D33
				DATA REQUIRED IN CELL D34
				DATA REQUIRED IN CELL D35
				DATA REQUIRED IN CELL D36
				DATA REQUIRED IN CELL D37
				DATA REQUIRED IN CELL D38
				DATA REQUIRED IN CELL D39
Paperwork Reduction Act Notice
The public reporting and recordkeeping burden for this collection of information is estimated to average 6 hours per response.  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, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.  Include the OMB control number in any correspondence.  Do not send the completed Form 5900-91 to this address.

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Sheet 6: Non-VCSB Method Accuracy

Non-VCSB Method Defined Accuracy Criterion
OMB Control No. 2060-NEW
Approval Effective August 30, 2015 Approval Expires on August 30, 2018
EPA Form  5900-303
Test Method
Method Defined Fuel Parameter Type:	0
Name of Method:	0
Laboratory Identification
Laboratory Name:	0
Laboratory Street Address:	0
Laboratory City:	0
Laboratory State:	0
Laboratory Zip code:	0
Laboratory Contact Person:	0
Laboratory Contact Phone Number	0
Laboratory Contact Facsimile Number	0
Laboratory Contact E-mail Address	0
Confidential Business Information Claim. A company may assert a business confidentiality claim covering the information contained in this submission. If no such claim is made the information may be made available to the public by EPA without further notice. All questions of confidentiality will be handled pursuant to 40 CFR Part 2. Is confidentiality claimed for the information in this submission? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)				0
Non VCSB Method Defined Criterion - the submiter attests the test facility has tested both the candidate method defined Non-VCSB test method and its respective designated test method on a range of fuels or locally-named reference materials that are typical of those analyzed by the facility using good laboratory practices (See 80.47(m)(3))
Has 40 CFR 80.47 (m)(3) criterion been met? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)
Non VCSB Method Defined Criterion - the submiter attests the facility used the candidate method defined non-VCSB test method and statistically established through application of ASTM D6708 that the candidate test method measures the same aspect of samples as applicalbe to its respective designated test method using good laboratory practices (see 40 CFR 80.47(m)(4))
Has 40 CFR 80.47 (m)(4) criterion been met? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)
Non VCSB Method Defined Criterion - the submiter attests the facility used the candidate method defined non-VCSB test method and statistically established through use of ASTM D6708 that the candidate NON VCSB test method has sample-specific biases due to matrix effects that cannot be determiend as random (See 40 CR 80.47(m)(5))
Does the Non VCSB test method have biases as determined through ASTM D6708 that cannot be determined as random? (see 40 CFR 80.47 (m)(5)) (Note: Please answer by typing "Yes" or "No" in the adjacent cell, If Yes, Stop, method is disqualified, if No, then go on to next cell.)
Non VCSB Method Defined Criterion - the submiter attests the facility used the candidate method defined non-VCSB test method precision qualificaiton was conducted in the form of cross-method reproducibility (Rcm) of the candidate test method and the applicable designated test method as required in ASTM D6708, where the Rcm must be equal or less than 70 percent of the published reproducibility of the applicable designated test method using good laboratory practices (See 40 CR 80.47(m)(5))
Does the Non VCSB test method have a cross method reproducibilty as derived from ASTM D6708 that is equal to or less than 70 perecent of the published reproducibility of the applicable designated test method? (see 40 CFR 80.47(m)(6)) (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)
Non VCSB Method Defined Criterion - the submiter attests the facility used the candidate method defined non-VCSB test method to demonstrate through the use of ASTM D6708 whether a correlation to the applicable designated test method is necessary (see 40 CFR 80.47(m)(7))
Does the Non-VCSB test method require a correlation equation as determiend by ASTM D6708? (Note: Please answer by typing "Yes" or "No" in the adjacent cell.)
If "Yes" to question above, indicate the correlation equation used to as the output to obtain measurement results for regulatory purposed using good laboratory practices:
Paperwork Reduction Act Notice
The public reporting and recordkeeping burden for this collection of information is estimated to average 6 hours per response.  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, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.  Include the OMB control number in any correspondence.  Do not send the completed Form 5900-91 to this address.