5900-479 Instructions for STR0400: Independent Surveyor Reporting

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Instructions for STR0400: Independent Surveyor Reporting for Fuels
Who must report
Any independent surveyor must report on test results for gasoline and diesel on a per-sample basis. A
separate report must be submitted for each retail outlet surveyed during the averaging period.
Reporting requirements
•

40 CFR 1090 subpart J provides key requirements and reporting information (available at [link to
ECFR.gov]).

Reporting deadlines
•

Independent surveyors must submit quarterly reports by the following deadlines:

Calendar Quarter

Time Period Covered

Quarterly Report Deadline

Quarter 1

January 1-March 31

June 1.

Quarter 2

April 1-June 30

September 1.

Quarter 3

July 1-September 30

December 1.

Quarter 4

October 1-December 31

March 31.

How to submit reports
• EPA maintains report templates, electronic submission procedures and additional support options
at https://www.epa.gov/fuels-registration-reporting-and-compliance-help/reporting-fuelprograms.

EPA Form 5900-479

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Field Instructions
Field Field Name
No.
1
Report Form ID
2

Report Type

3

CBI

4

Report Date

5

Compliance Period

6

Compliance Period
Quarter

7

Reporter ID

8

Retail Outlet
Geographic Area

9

Retail Outlet ID

10
11

Retail Outlet Street
Address
Retail Outlet City

12

Retail Outlet – State

13

Retail Outlet – Zip

14

Retail Outlet – Brand
Name

EPA Form 5900-479

Units

Field Formats, Codes & Special Instructions
AAAAAA; Character.
Enter STR0400
A; Character. Specify if the data submitted in this
report is original or if it is being resubmitted. Submit
only one original report; any corrections or updates
should be marked as a resubmission.
O = Original
R = Resubmission
A; Character. Specify if the data contained within the
report is claimed as Confidential Business Information
(CBI) under 40 CFR Part 2, subpart B:
Y = Confidential Business Information
N = Non-Confidential Business Information
MM/DD/YYYY; Character. Enter the date the original
or resubmitted report is created.
YYYY; Character. Enter the averaging/compliance
year the report covers.
AA; Character. Enter the quarter of the compliance
period the report covers.
Q1 – January 1 – March 31
Q2 – April 1 – June 30
Q3 – July 1 – September 30
Q4 – October 1 – December 31
AAAA; Character. Enter the EPA-assigned fourcharacter ID of the independent surveyor submitting
the report.
AAA; Character. Enter the geographic area (strata)
code associated with this sample location per the
approved sample plan.
DPA – Densely Populated Area
TCR – Transportation Corridor
RRL – Rural Area
NAT - National
AAAAA; Character. Enter the independent surveyor
assigned identification number for the retail outlet
AAAAAAAAA; Character. Enter the street address of
the retail outlet
AAAAAAAAA; Character. Enter the city of the retail
outlet
AA; Character. Enter the two-character state
abbreviation of the retail outlet
AAAAA; Zip Code. Enter the zip code of the retail
outlet
AAAAAAAAA; Character. Enter the displayed fuel
manufacturer brand name at the retail outlet, if any

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Field
No.
15

Field Name

16

Fuel Dispenser Grade

17
18

Units

Fuel Dispenser Label

AAAA; Character. Enter the code representing the fuel
dispenser label by selecting one of the codes below
E0 – E0 gasoline
E10 – E10 gasoline
E15 – E15 gasoline
E85 – E85 gasoline
ULSD – Ultra Low Sulfur Diesel fuel
UNK - Unknown
OTH – Other
If “Other”, enter a description of the fuel in the
“Comments” field.
AAA; Character. Enter the grade of gasoline
REG – Regular
MID – Mid-grade
PRM – Premium
OTH – Other
NA – Use “NA” for diesel, e85, unknown, or
other non-gasoline fuels sampled

Sample Collection
Date
Sample Collection
time

19

Sulfur

ppm

20

Sulfur Parameter Test
Method

N/A

21

ETOH Oxygenate Volume

volume %

22

ETOH Oxygenate –
Weight

Weight %

23

ETOH Oxygenate
Parameter Test
Method

EPA Form 5900-479

Field Formats, Codes & Special Instructions

N/A

If “Other”, enter a description of the gasoline grade in
the “Comments” field.
MM/DD/YYYY; Character. Date the reported sample
was collected.
AAAA; Character. Enter the local time the sample was
collected in military/24 hour formated time. (e.g. 7:15
AM = 0715, and 9:30 PM = 2130)
999; Number. Enter the measured value. Use “NA” if
this field is not applicable. Note only enter a
zero if testing resulted in 0 value on a test method that
is validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”.
99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable

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Field
No.
24

Field Name

Units

Field Formats, Codes & Special Instructions

MTBE Oxygenate Volume

volume %

25

MTBE Oxygenate –
Weight

Weight %

26

MTBE Oxygenate
Parameter Test
Method

N/A

99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable

27

ETBE Oxygenate Volume

volume %

28

ETBE Oxygenate –
Weight

Weight %

29

ETBE Oxygenate
Parameter Test
Method

30

Isobutanol Oxygenate
– Volume

volume %

31

Isobutanol Oxygenate
– Weight

Weight %

32

Isobutanol Oxygenate
Parameter Test
Method

N/A

33

TAME Oxygenate Volume

volume %

34

TAME Oxygenate –
Weight

Weight %

EPA Form 5900-479

N/A

99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable
99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable
99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
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Field
No.
35

Field Name

36

Field Formats, Codes & Special Instructions

N/A

AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable

Methanol Oxygenate –
Volume

volume %

37

Methanol Oxygenate –
Weight

Weight %

38

Methanol Oxygenate
Parameter Test
Method

N/A

99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable

39

Tert-butanol
Oxygenate - Volume

volume %

40

Tert-butanol
Oxygenate – Weight

Weight %

41

Tert-butanol
Oxygenate Parameter
Test Method

N/A

42

Other Oxygenate Volume

43

TAME Oxygenate
Parameter Test
Method

Units

Other Oxygenate –
Weight

volume %

Weight %

99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable
99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
If “other” is reported, enter the name of the oxygenate
in the comments field.
99.99; Number. Enter the measured value. Use “NA”
if this field is not applicable. Note only enter a zero if
testing resulted in 0 value on a test method that is
validated down to zero.
If “other” is reported, enter the name of the oxygenate
in the comments field.

EPA Form 5900-479

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Field
No.
44

Field Name

45

Benzene

46

Benzene Parameter
Test Method

N/A

47

RVP

psi

48

RVP Parameter Test
Method

N/A

49

API Specific Gravity

°API

50

API Specific Gravity
Parameter Test
Method

N/A

51

Aromatics

52

Aromatics Parameter
Test Method

53

Olefin

Other Oxygenate
Parameter Test
Method

EPA Form 5900-479

Units

Field Formats, Codes & Special Instructions

N/A

AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable

volume %

99.99; Number. Enter the measured
or presumed value under 1090.1710(g) as
appropriate. Use “NA” if this field is not applicable
(e.g. for diesel samples). Note only enter a
zero if testing resulted in 0 value on a test method that
is validated down to zero
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable
99.99; Number. Enter the measured value, if tested.
Use “NA” if this field is not applicable (e.g. for diesel
samples). Note only enter a zero if testing resulted in 0
value on a test method that is validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable
99.99; Number. Use “NA” if this field is not applicable
(e.g. for diesel samples); use “ND” if “not detected” by
the reported test method. Note only enter a
zero if testing resulted in 0 value on a test method that
is validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable
99.9; Number. Use “NA” if this field is not applicable
(e.g. for diesel samples); use “ND” if “not detected” by
the reported test method. Note only enter a
zero if testing resulted in 0 value on a test method that
is validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable
99.9; Number. Use “NA” if this field is not applicable
(e.g. for diesel samples); use “ND” if “not detected” by
the reported test method. Note only enter a
zero if testing resulted in 0 value on a test method that
is validated down to zero.

Vol %

N/A

Vol %

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Field
No.
54

Field Name

55

E200

56

E200 Parameter Test
Method

57

E300

58

E300 Parameter Test
Method

59

T50

60

T50 Parameter Test
Method

61

T90

62

T90 Parameter Test
Method

N/A

63

Comments

N/A

Olefin Parameter Test
Method

Units
N/A

Vol %

N/A

Vol %

N/A

°F

N/A

°F

Field Formats, Codes & Special Instructions
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable
999.9; Number. Use “NA” if this field is not applicable
(e.g. for diesel samples); use “ND” if “not detected” by
the reported test method. Note only enter a
zero if testing resulted in 0 value on a test method that
is validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable
999.9; Number. Use “NA” if this field is not applicable
(e.g. for diesel samples); use “ND” if “not detected” by
the reported test method. Note only enter a
zero if testing resulted in 0 value on a test method that
is validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable
999.9; Number. Use “NA” if this field is not applicable
(e.g. for diesel samples); use “ND” if “not detected” by
the reported test method. Note only enter a
zero if testing resulted in 0 value on a test method that
is validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable
999.9; Number. Use “NA” if this field is not applicable
(e.g. for diesel samples); use “ND” if “not detected” by
the reported test method. Note only enter a
zero if testing resulted in 0 value on a test method that
is validated down to zero.
AAAAAAAAA; Character. Identify the ASTM
Method number (e.g., D5191). If sample was un-tested,
state “Untested”. Use “NA” if this field is not
applicable
AAAA…; Character. Optional. Enter any additional
information or recordkeeping specific to this sample as
needed.

Paperwork Reduction Act 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-XXXX). Responses to this collection of
EPA Form 5900-479

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information are mandatory (40 CFR part 1090). 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 range from five to 10 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.

EPA Form 5900-479

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