Form 3520-13b Supplemental fuel additive manufacturer annual report

EPA Form 3520-13 - Fuel Additive Manufacturer Notification Instructions (05-02-2018)

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Fuel Additive Manufacturer Notification Instructions

GENERAL INFORMATION
A manufacturer of an additive for use in motor vehicle gasoline or motor vehicle diesel fuel may not sell, offer for sale, or
introduce into commerce such additive unless it has been registered by the United States Environmental Protection Agency (EPA)
in accordance with the regulations at 40 CFR 79. These regulations and a list of registered fuel additives are available
at www.epa.gov/fuels-registration-reporting-and-compliance-help/registered-fuels-fuel-additives-under-part-79. Please note the following
definitions:
“Additive” means any substance, other than one composed solely of carbon and/or hydrogen, that is intentionally added to a
fuel (including any substance added to a motor vehicle’s fuel system) and that is not intentionally removed prior to sale or use.
“Additive manufacturer” means any person who produces, manufactures, or imports an additive for use as an additive and/or
sells or imports for sale such additive under the person’s own name.
“Bulk fuel additive” means an additive which is added to fuel before introduction into the fuel tank of a motor vehicle.
“Aftermarket fuel additive” means an additive which is added directly to fuel in a motor vehicle.
“Aerosol additive” means an additive in aerosol form generally used as a motor vehicle engine starting aid or carburetor cleaner
and not recommended to be placed in the fuel tank.
“Relabeled additive” means a fuel additive which is registered for its original manufacturer and is also registered and sold,
unchanged in composition, under a different label and/or by a different entity.
The registration process is initiated by submitting a Fuel Additive Manufacturer Notification, EPA Form 3520-13, to:
Via U.S. Postal Service
U.S. Environmental Protection Agency
William Jefferson Clinton Building
Mail Code - 6405A
1200 Pennsylvania Ave, NW
Washington, DC 20460

or

Via Courier
U.S. Environmental Protection Agency
William Jefferson Clinton Building – North
Room 5512D; (202) 343-9038
1200 Pennsylvania Ave, NW
Washington, DC 20004

Program Support and Registration Contact Form
(https://www.epa.gov/fuels-registration-reporting-and-compliance-help/forms/fuels-program-helpdesk#contactform)
Telephone: (202) 343-9648
Fax: (202) 343-2825
Jim Caldwell: (202) 343-9303 or [email protected]
Jose Solar: (202) 343-9027 or [email protected]
Specific instructions for completing the form follow. For additional information see the regulations entitled "Registration of Fuels
and Fuel Additives" at 40 CFR 79, or contact the office above.
The EPA is responsible for assessing the impact on public health and welfare from exposure to automotive emissions.
Knowledge of fuel additive composition, as reported by each manufacturer, is an important aspect of this program.
SPECIFIC INSTRUCTIONS
Please type (best results are obtained using standard fonts such as Courier or Arial) or print the information using a dark-colored
ink. If using a photocopied version of the form, please ensure the copy is clean and has been copied to 100% of the original page
size.
Item 1.

Additive (Commercial Name): Enter the commercial name(s) of the additive being registered. The first name listed will be
considered the primary name.

Item 2.

Company Name: Enter the company’s legal name.

Item 2a.

Company ID : Enter the EPA assigned four-digit ID. Leave blank if this is your first manufacturer notification.

Item 3.

Address: Enter the address of the company office primarily responsible for managing compliance with EPA’s fuel additive
regulations.

EPA Form 3520-13 - Fuel Additive Manufacturer Notification Instructions (05-02-2018)

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Item 4.

Method of Use: Check the appropriate box(es).

Item 5.

Recommended Usage and Range of Concentration: Check the kind of fuel in which the use of the fuel additive is
recommended, indicate the recommended lowest, average, and highest concentrations of the fuel additive in that fuel.
Concentration units are preferred in milligrams of additive per liter of fuel (mg/l). If the additive is an oxygenate (alcohol
or ether) a percent volume (% vol.) figure should be used. If the fuel additive is in a consumer-sized package, give an
example, such as fluid ounces per gallon, and indicate "fl. oz/gal" in the units blank. Certified detergents must be
expressed as gallons of detergent additive package per thousand gallons of gasoline (gal/kgal). Please indicate if this
is an aerosol and enter appropriate value.

Item 6.

Recommended Purpose-In-Use : Check as many as apply.

Item 7.

Chemical Composition: The chemical composition of the additive must be provided. It is defined as the name and
percentage by weight of each compound in an additive and the name and percentage by weight of each element in an
additive. If part of an additive package is a purchased component, for example, a proprietary additive from another
manufacturer, then only the EPA registered name and weight percent are required for that portion of the package. If the
chemical composition is not known, full disclosure of the chemical process of manufacture must be provided. Chemical
formulae are acceptable in lieu of the names of compounds. The Chemical Abstract Service number is also useful in
identifying a compound or component, but its use is not mandatory. The methods of analysis for determining the
presence of each compound/component and element in the additive must also be provided.

Item 8.

Chemical Structure: If a compound name or formula provided in Item 7 does not adequately specify its chemical
structure, then such structure, if known, must be provided. Chemical structure is defined as the molecular structure of the
compound. Nominal identification is adequate if mixed isomers are present. If the particle size of the additive is less than
1,000 nanometers or if the manufacturer has utilized nanotechnology in production of the additive, this information
should be attached to this notification.

Item 9.

Impurities: Provide information on impurities. An impurity is defined as any chemical element present in an additive that
is not included in the chemical formula or identified in the breakdown by an element in the chemical composition of the
additive.

Item 10.

Detection: Provide a description (or identification, in the case of a generally accepted method) of a suitable
analytical technique (if known) that can be used to detect the presence and/or concentration of the additive in the fuel.

Item 11.

Mechanisms of Action: Self-explanatory.

Item 12.

Relabeled: Check the appropriate box. Indicate the full commercial identifying name and additive manufacturer's full
name.

Item 13.

Annual Volume: Self-explanatory

Item 14.

Market Distribution: Self-explanatory

Item 15.

Conventional source: Check the appropriate box.

Item 16.

Small Business Provision:
A baseline gasoline additive is an additive which, when added to gasoline, results in a baseline gasoline.
A baseline gasoline:
(1) contains no elements other than carbon, hydrogen, oxygen, nitrogen, and/or sulfur,
(2) contains less than 1.5 percent oxygen by weight,
(3) possesses the physical and chemical characteristics of unleaded gasoline, as specified by American Society for
Testing and Materials (ASTM) standard D 4814-93a, in at least one Seasonal and Geographical Volatility Class, and
(4) is derived only from conventional petroleum, heavy oil deposits, coal, tar sands, and/or oil sands.
A nonbaseline gasoline additive is an additive which, when added to gasoline, results in a nonbaseline gasoline.
A nonbaseline gasoline meets the requirements for baseline gasoline, with the following exceptions:
(1) contains 1.5 percent or greater oxygen by weight, and/or
(2) is derived from sources other than conventional petroleum, heavy oil deposits, coal, tar sands, and/or oil sands.
An atypical gasoline additive is an additive which, when added to gasoline, results in an atypical gasoline.
An atypical gasoline does not meet the requirements for a baseline gasoline or a nonbaseline gasoline. For example, it
could contain an additive which has an element other than carbon, hydrogen, oxygen, nitrogen, and sulfur.
A baseline diesel fuel additive is an additive which, when added to diesel fuel, results in a baseline diesel fuel.
A baseline diesel fuel:
(1) contains no elements other than carbon, hydrogen, oxygen, nitrogen, and/or sulfur,

EPA Form 3520-13 - Fuel Additive Manufacturer Notification Instructions (05-02-2018)

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(2) contains 0.05 percent or less sulfur by weight,
(3) contains less than 1.0 percent oxygen by weight,
(4) possesses the characteristics of diesel fuel as specified by ASTM D 975-93, and
(5) is derived only from conventional petroleum, heavy oil deposits, coal, tar sands, and/or oil sands.
A nonbaseline diesel fuel additive is an additive which, when added to diesel fuel, results in a nonbaseline diesel fuel.
A nonbaseline diesel fuel meets the requirements for baseline diesel fuel, with the following exceptions:
(1) contains 1.0 percent or more oxygen by weight, and/or
(2) is derived from sources other than conventional petroleum, heavy oil deposits, coal, tar sands, and/or oil sands.
An atypical diesel fuel additive is an additive which, when added to diesel fuel, results in an atypical diesel fuel.
An atypical diesel fuel contains 0.05 percent or less sulfur by weight and does not meet the requirements for a baseline
diesel fuel or a nonbaseline diesel fuel. For example, it could contain an additive which has an element other than
carbon, hydrogen, oxygen, nitrogen, and sulfur.
Item 17.

Aerosol: Self-explanatory

Item 18.

Grouping: Self-explanatory

Item 19.

Confidentiality: Please check Yes or No for each item indicating its confidentiality.

Item 20.

Attachments: Check the appropriate box. List the description for each item attached for notifications.

Item 21.

Certification: The notification form must be signed and dated by the fuel additive manufacturer or its authorized agent.
The printed name of the signer and the signer's telephone number should be given. If the form is signed by an
authorized agent, the company must provide a letter authorizing such agent.

OMB Control; No. 2060-0150
Approval expires 01-31-20
The public reporting and recordkeeping burden for this collection of information is estimated to
average 8 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. 20406. Include the OMB control number in any correspondence. Do not send the
completed form to this address.

NOTE:

This office is operated by a contractor, CSRA LLC, a General Dynamics Information Technology company for
the EPA. Information submitted with this form will be provided to the contractor for processing into a database
at the registration office.