5900-130 LSI PLT Template

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Overview

Submission Template
Calculations
Notes
Instructions

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Sheet 1: Submission Template

United States
Environmental Protection Agency
Office of Transportation and Air Quality
Manufacturer Production Line Testing Report for Large Spark Ignition Engines
Last Revision: August 2010 Version Number: 4.6
Basic Information																															Submission Date
			Manufacturer:							Engine Family:																	Paperwork Reduction Act Notice					OMB No. 2060-0338
			PLT Test Contact:							Engine Fuel Type:												Current Quarter:					This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-0338). Responses to this collection of information are mandatory (40 CFR 1048). 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 be 12 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 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.					Approval Expires on
			Email Address:							Projected Annual Production Volume:																						1/31/2022
			Phone #:							Is this a carry-over engine family?																						EPA Form 5900-130
			Production Period			From:		To:		Pre-approved reduced required sample size*:						*If left blank, minimum required sample size = 8 (for projected production > 800)
										Are you required to test CO?						or 1% of projected production (for projected production <= 800).
			Comments:
PLT Engine Test Results
										DF (HC)	DF Type (HC)			DF (NOx)	DF Type (NOx)			HC+NOx Emission Limit			CO Emission Limit	DF (CO)	DF Type (CO)
								Service	Service	HC	HC	HC Final	HC Final	NOx	NOx	NOx Final	NOx Final	HC+NOx	HC+NOx Final		CO	CO	CO Final	CO Final
	Test	Final or	Test	Test	Test	Engine	Build	Hours	Hours	Initial	Initial	Rounded	Rounded	Initial	Initial	Rounded	Rounded	Initial	Rounded	Include in	Initial	Initial	Rounded	Rounded	Include in	Test	Test	Test	Invalid	Failure
	Number	Initial?	Date	Time	Quarter	ID	Date	Accumulation	Location	Result	Rounded Result	Result	Det. Result	Result	Rounded Result	Result	Det. Result	Rounded Result	Det. Result	CumSum?	Result	Rounded Result	Result	Det. Result	CumSum?	Location	Contact	Invalid?	Reason	Reason	Remedy	Repairs	Test Comments
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Sheet 2: Calculations

United States

Environmental Protection Agency

Office of Transportation and Air Quality

Manufacturer Production Line Testing Report for Large Spark Ignition Engines

Last Revision: August 2010 Version Number: 4.6

Calculated Results Data

Current PLT Test Status:

OMB No. 2060-0338

Approval Expires on

1/31/2022

Engine Family:

0

EPA Form 5900-130

HC+NOx (passing status?)

No test results entered

HC+NOx (N-met?):

No

CO (passing status?)

CO not Tested

CO (N-met?):

CO not tested

Maximum Tests:

30

PASSING STATUS:

OPEN

Notes:

* Number of included HC and NOx tests (n) is less than the required number (N).

HC+NOx - Calculations

CO - Calculations

Actual

Required

Sample

Actual

Required

Sample

Sample

Sample

Mean

Standard

Prior

Action

Requirement

HC+NOx

HC+NOx

Sample

Sample

Mean

Standard

Prior

Action

Requirement

CO

CO

Size (n)

Size (N)

Result

Deviation

CumSum

CumSum

Limit

Met?

Fail?

Pass?

Size (n)

Size (N)

Result

Deviation

CumSum

CumSum

Limit

Met?

Fail?

Pass?

Warnings

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Sheet 3: Notes

United States

Environmental Protection Agency

Office of Transportation and Air Quality

Manufacturer Production Line Testing Report for Large Spark Ignition Engines

Last Revision: August 2010 Version Number: 4.6

Manufacturer Notes

OMB No. 2060-0338

Approval Expires on

1/31/2022

EPA Form 5900-130

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Sheet 4: Instructions

United States

Environmental Protection Agency

Office of Transportation and Air Quality

Manufacturer Production Line Testing Report for Large Spark Ignition Engines

Last Revision: August 2010 Version Number: 4.6

Manufacturer Data Submission Template -- INSTRUCTIONS