                                       
      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 https://www.ecfr.gov/current/title-40/chapter-I/subchapter-U/part-1090/subpart-J/section-1090.925).


Reporting deadlines 

 Independent surveyors must submit quarterly reports by the following deadlines:

                                Calendar Quater
                              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.


Field Instructions
Field No.
Field Name
Units
Field Formats, Codes & Special Instructions
1
Report Form ID

AAAAAA; Character. 
Enter STR0400

2
Report Type

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

3
CBI

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

4
Report Date 

MM/DD/YYYY; Character. Enter the date the original or resubmitted report is created. 

5
Compliance Period 

YYYY; Character. Enter the compliance period the report covers. 

6
Compliance Period Quarter 

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 

7

Reporting ID


AAAA; Character. Enter the EPA-assigned four-character ID of the independent surveyor submitting the report. 

8

Retail Outlet Geographic Area

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 

9

Retail Outlet ID 

AAAAA; Character. Enter the independent surveyor assigned identification number for the retail outlet 

10

Retail Outlet Street Address 


AAAAAAAAA; Character. Enter the street address of the retail outlet 

11

Retail Outlet City 


AAAAAAAAA; Character. Enter the city of the retail outlet 

12

Retail Outlet  -  State 

AA; Character. Enter the two-character state abbreviation of the retail outlet 

13

Retail Outlet  -  Zip 

AAAAA; Zip Code. Enter the zip code of the retail outlet 

14
Retail Outlet  -  Brand Name 


AAAAAAAAA; Character. Enter the displayed fuel manufacturer brand name at the retail outlet, if any 

15
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. 

16
Fuel Dispenser Grade 


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 
 
If "Other", enter a description of the gasoline grade in the "Comments" field. 

17
Sample Collection Date 


MM/DD/YYYY; Character. Date the reported sample was collected. 

18
Sample Collection time 


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) 

19
Sulfur 

ppm
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. 

20
Sulfur Parameter Test Method 
N/A 
AAAAAAAAA; Character. Identify the ASTM Method number (e.g., D5191). If sample was un-tested, state "Untested". 

21
ETOH Oxygenate - Volume 
volume % 
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. 

22
ETOH Oxygenate  -  Weight 
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. 

23
ETOH Oxygenate Parameter Test Method 
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  
 
24
MTBE Oxygenate - Volume 
volume % 
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. 

25
MTBE Oxygenate  -  Weight 
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. 

26
MTBE Oxygenate Parameter Test Method 
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  
 
27
ETBE Oxygenate - Volume 
volume % 
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. 

28
ETBE Oxygenate  -  Weight 
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. 

29
ETBE Oxygenate Parameter Test Method 
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  
 
30
Isobutanol Oxygenate  -  Volume 
volume % 
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. 

31
Isobutanol Oxygenate  -  Weight 
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. 

32
Isobutanol Oxygenate Parameter Test Method 
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  
 
33
TAME Oxygenate - Volume 
volume % 
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. 

34
TAME Oxygenate  -  Weight 
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. 

35
TAME Oxygenate Parameter Test Method 
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  
 
36
Methanol Oxygenate  -  Volume 
volume % 
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. 

37
Methanol Oxygenate  -  Weight 
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. 

38
Methanol Oxygenate Parameter Test Method 
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  
 
39
Tert-butanol Oxygenate - Volume 
volume % 
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. 

40
Tert-butanol Oxygenate  -  Weight 
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. 

41
Tert-butanol Oxygenate Parameter Test Method 
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  
 
42
Other Oxygenate - Volume 
volume % 
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. 

43
Other Oxygenate  -  Weight 
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. 
 
If "other" is reported, enter the name of the oxygenate in the comments field. 

44
Other Oxygenate Parameter Test Method 
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  
 
45
Benzene 
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 
 
46
Benzene Parameter Test Method 
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  
 
47
RVP 
psi 
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. 
 
48
RVP Parameter Test Method 
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  
 
49
API Specific Gravity 
°API 
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. 
 
50
API Specific Gravity Parameter Test Method 
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  
 
51
Aromatics 
Vol % 
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.  
 
52
Aromatics Parameter Test Method 
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  
 
53
Olefin 
Vol % 
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. 
 
54
Olefin Parameter Test Method 
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  
 
55
E200 
Vol % 
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. 
 
56
E200 Parameter Test Method 
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  
 
57
E300 
Vol % 
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. 
 
58
E300 Parameter Test Method 
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  
 
59
T50 
°F 
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. 
 
60
T50 Parameter Test Method 
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  

61
T90 
°F 
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. 
 
62
T90 Parameter Test Method 
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  
 
63
Comments 
N/A 
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 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. 


