### OMB Control No. 2060 - 0308 Expires January 31, 2016

EPA Form 5900 - 325



### Facility MVNRLM Diesel Fuel Reporting Instructions Designate & Track Handoff Report Report Form ID: DSF0504 Han d of f repo rts m u s t be s ub m i tted s epa ra t e l y b y ea c h fa c ili t y i n t h e De si gn a te & T ra c k ( D &T ) s y s tem whe re d e s i g na t ed d i s t i l l ate i s d e l i ve re d to an d /or re c e iv ed f rom another fa c ili t y , s e pa rate l y b y t ra d i n g pa rtner and s e pa ra t e l y b y T a x/ D ye /Ma r k er s tatu s . T h i s fo rm has qua rte r l y a nd a n n ual re po rt i ng requ i re m ents . E a c h q ua rte r , p ro v i de the vo l u m e tota l s of the t ran s a ct i ons c o m p l e t ed d u r i n g t h e q u a rte r . A n n u a l l y , p ro v i de the v o l u m e tota l s of the e nt i re c o m p l i an c e ye a r . In the fou rth qua rte r , bo t h a qua rt e r l y ( 4 th qua rt e r ) and an a n nu a l repo rt m u s t be s ub m i tted. N O T E : Tr u c k Load i ng T e r m i na l s , i n cl ud i ng m u l ti - u s e fa c ili t i e s , t h at, i n a d d i t i on t o a t r u c k ra c k , ha ve re f i n i ng a n d/or p a s s - th rou g h a ct i v i t i e s , m u s t s ub m i t th i s repo rt for a l l de s i g n ated d i s t i l l a t es re c e i ve d. Vo l u m e of ta x ed or d ye d / m a r k ed, de s i g n at e d, d i s t i ll a te s de l i ve red o ver the t r u c k ra c k ( l ea vi n g D &T ) a re not re p o rted on th i s fo r m a nd a re c o ve red b y t he D e si gna t e & T ra c k T otal Vo l u m e Re p o rt ( D S F 06 0 0 )
. A l l other vo l u m es of un - ta x ed / un - d ye d / un - m a rk ed d i s t i ll at es l e a v i ng m u l ti - u s e fa c il i t i e s and c o n t i n u i ng o n i n D &T m u s t be repo rte d as d e l i ve r i e s . Repo rts u s i ng th i s fo r m m u s t be s ub m i tted qua rt e r l y w i th d u e d ates of N o v e m ber 3 0 t h , F e b r ua r y 2 8 t h , May 31 st , a nd A u gu s t 3 1 st

. Pl e a s e c he c k the D i e s el F u el R epo rt i ng F o r m s web s i t e for upda t ed i n s t r u ct i ons a nd re p o rt fo rm te m p l ate s : htt p://e pa . g o v/o t aq/ reg s /f ue l s / d i e s e l fm s .h t m F or i n fo rm at i on on s u b m i tt i ng t h i s repo rt u s i n g E P A’ s Cent ra l D a ta E xc han g e ( C D X ) vi s i t: http:/ / e p a.g o v/ota q / reg s /f u e l s /c d x i n fo.htm F i e ld No. F i e l d N a m e U n i ts F i e l d F o r m a ts , C o d e s , & S p e c i a l I n s t r u c t i o n s 1. Repo rt F o r m ID AAAAAA A ; C h a ra c te r . E n t er the D S F 0 50 4 for t h is De s i g n ate & T ra c k Hando f f Repo rt 2. Repo rt T yp e A ; C h a ra c te r . S ub m i t o n l y one o r i g i n a l re po rt, s ub m i t a n y c o rre ct i ons or u pd a tes as re s ub m i ss i on (s) : O : Or i g i nal R : Re s u b m i ss i on 3. C BI A ; C h a ra c te r . S pe c i fy i f the data c onta i n ed w i t h i n t he r epo rt i s c l a i m ed as C o n f i de n t i a l B u s i n e s s In fo rm at i on ( C B I) under 40 C F R P a rt 2, s u b pa rt B : Y : Con f i de n t i al B u si ne s s In fo r m at i on N : Non - C on f i d e nt i al B u s i n e s s In fo rm at i on 4. Repo rt D ate MM /D D / Y Y Y Y ; C h a ra c t

e r . E nter the da t e y

o u cre a te t h i s repo rt. If re s ub m i tt i n g, u s e the c u rrent da t e a nd n ot th e da t e on t h e o ri g i n a l re p o rt. 5. Repo rt Ye ar Y Y Y Y ; C h a ra c t e r . T he re p o rt ye ar i s d ete r m i ned b y th e ann u al c o m p l i an c e p e r i o d. I f an an n ual c o m p li an c e pe ri od s pans two ye a rs , en t er the s e c ond year ( e . g. for the c o m p li a n c e ye ar J u n e 1, 2 0 06 th ro u g h M a y 31, 20 0 7 u s e 2007 )
.

### OMB Control No. 2060 - 0308 Expires January 31, 2016

EPA Form 5900 - 325



### Facility MVNRLM Diesel Fuel Reporting Instructions Designate & Track Handoff Report Report Form ID: DSF0504 F i e ld No. F i e l d N a m e U n i ts F i e l d F o r m a ts , C o d e s , & S p e c i a l I n s t r u c t i o n s 6. Co m pa n y

/ E nt i t y ID AAA A ; C h a ra c t e r . E n t er t h e fou r- d i g i t, E P A- a ss i g n ed I D for the c o m pa n y

/ en t i t y (re f i ne r , i m po rte r , et c . )
. 7. F a c il i t y ID AAAA A ; C h a ra c t e r . E n t er t he f i v e - d i g i t, E PA- a ssi gn e d ID for the fa c ili t y . P l ea s e i n cl u de an y p re c e d i ng z e ro s . 8. Co m p li an c e P e ri od Code A A ; C h a r a c t e r . C o m p li an c e P e r i od Co d e s . G e n e ral m onth ranges a re p ro v i ded b e l o w to a ss i s t i n l ab e l i ng qua rt e rs . S ee the li s t of s pe c i f i c c o m pl i an c e pe ri ods i n 40 C F R 80. 5 99 : Q u a r te r ly Q 1 : F i rs t Q ua rter (J u l y – S ep t e m be r ) Q 2 : S e c o n d Q ua rt er (October – De c e m be r ) Q 3 : T h i rd Q u a rter (J an u a ry – Ma rc h) Q 4 : F o u rth Q u a rter (A p r i l – J une) A n n u a l T o ta l A 1 : A n nu a l H an d of

f T ota l s 9. Han d of

f T ype A A ; C h a r a c t e r . S e p a rate l y repo rt d e l i ve r i es and re c e i pts . S pe c i fy whe t her t h i s s u mm a ry i s for p ro d u ct d e l i ve red to or p rodu ct re c e i ved f rom the i den t i f i ed pa rt n e r . T X : De l i ve red T o P a rt ner R X : R e c e i v e d From P a rtn e r 10. P a rt n er E n t i t y ID AAA A ; C h a ra c t e r . E n t er t h e fou r- d i g i t, E P A- a ss i g n ed I D for y o ur t rad i ng pa rt n e r . F or re c e i pt of d i s t i ll a te f rom an ent i t y that does n ot h a v e a n ID p er 80. 6 01 ( a )( 3) u s e “ 88 8 8 ”
. 11. P a rt n er F a c i l i t y ID AAAA A ; C h a ra c t e r . E n t er t he f i v e - d i g i t, E PA- a ssi gn e d ID for y o ur t ra d i n g pa rt ne r’ s fa c ili t y . P l ea s e i n c l u d e p re c e d i n g z e ros i f a p p l i c a b l e. F or re c e i pt of d i s t i l l ate f rom a fa c ili ty that does n ot h a v e a n ID p er 80. 6 01 ( a )( 3) u s e “ 88 8 8 8 ”
. 12. T a x/ D y

e / Ma r k er S ta t us AA A ; C h a ra c t e r . S e p a rate l y re p o rt T a x ed/ D ye d and Unta x ed C l ear d i s t i ll a te s . S pe c i fy i f the p rodu ct d e l i ve red was e i t her ta x ed, d ye d or m a rk ed ( e.g. p rodu ct l e a v i n g a t r u c k ra c k ) o r unta x ed and c l ear ( p ro d u ct e n te r i n g D & T )
. T D M : T a x ed/ D yed / Ma r k ed ( non - D &T f uel or f uel l e a v i ng D &T ) F U N : Unta x e d /C l ear ( f uel e nte r i n g D &T or c on t i n u i n g on i n D &T )

### OMB Control No. 2060 - 0308 Expires January 31, 2016

EPA Form 5900 - 325



### Facility MVNRLM Diesel Fuel Reporting Instructions Designate & Track Handoff Report Report Form ID: DSF0504 F i e ld No. F i e l d N a m e U n i ts F i e l d F o r m a ts , C o d e s , & S p e c i a l I n s t r u c t i o n s 13. 500 ppm NRLM ga l l ons 999 9 99 9 99 ; Nu m be r . T otal vo l u m e of 500 p pm NRLM de l i ve red/ re c e i v ed for the p e r i od. If th i s p r odu c t t yp e was not re c e i v ed or d e l i ve re d, e nter “ 0 ”
. 14. 500 ppm NR ga l l ons 999 9 99 9 99 ; Nu m be r . T otal vo l u m e of 500 p pm NR de l i ve red/ re c e i v ed for the p e r i od. If th i s p r odu c t t yp e was not re c e i v ed or d e l i ve re d, e nter “ 0 ”
. 15. 500 ppm LM ( Ma r k ed) ga l l ons 999 9 99 9 99 ; Nu m be r . T otal vo l u m e of 500 p pm LM de l i ve red/ re c e i v ed for the p e r i od. T he T a x/ D ye/ M a r k er S ta t us f i e l d s h o u l d i n d i c ate T DM. If th i s p rodu ct t yp e was not re c e i v ed or d e l i ve re d, e nter “ 0 ”
. 16. 500 ppm LM ( Un m a rk ed) ga l l ons 999 9 99 9 99 ; Nu m be r . T otal vo l u m e of 500 p pm LM de l i ve red/ re c e i v ed for the p e r i od. T h i s p ro d u ct w i l l h a v e no m a rk e r and t h e T a x/ D ye/M a r k er S tatus F i e l d s h ou l d i n d i c ate F UN. If th i s p rodu ct t yp e was not re c e i v ed or d e l i ve re d, enter “ 0 ”
. 17. H i gh S u l f ur NR L M ga l l ons 999 9 99 9 99 ; Nu m be r . T otal vo l u m e of H i gh S u l f ur NR L M de l i ve red/ re c e i v ed for the p e r i od. If th i s p rodu ct t yp e was not re c e i v ed or d e l i ve re d, e nter “ 0 ”
. 18. Hea t i ng O i l ( Ma r k ed) ga l l ons 999 9 99 9 99 ; Nu m be r . T otal vo l u m e of Ma r k ed Heat i ng O i l de l i ve red/ re c e i v ed for the p e r i od. T h i s p ro d u ct t yp i c a l l y w il l on l y b e l e a v i ng D &T and re qu i res b oth a d ye a n d m a rk er outs i d e t h e N E M A (s ee 4 0 C F R 80
. 510 )
. T he T a x/ D y e / Ma r k er S tatus f i e l d s ho u l d i n d i c ate T DM. If th i s p rodu ct t yp e was not re c e i v ed or d e li v e red, en t er “ 0 ”
. 19. Hea t i ng O i l ( U n m a rk ed) ga l l ons 999 9 99 9 99 ; Nu m be r . T otal vo l u m e of Un - m a rk ed Hea t i ng O i l d e l i v e red/ re c e i ved for the pe ri od. T h i s p rodu ct w i l l ha ve no m a rk er and the T a x/ D ye /Ma r k er S tatus Fi e l d s h o u l d i n d i c ate F UN. If t h i s p ro du ct t yp e was n ot re c e i v ed or de l i ve red, en t er “ 0 ”
. El e ct ro n i c S ub m i ss i on S a m p l e Re c o rd: D S F 0 5 04, O , Y , 0 2/2 1/2 0 11 , 201 1 ,1 2 34, 1 2 3 45, Q 3, T X ,4321 , 54 3 21, F U N ,0, 2 00 0 ,0, 0 ,0,0 , 0

### OMB Control No. 2060 - 0308 Expires January 31, 2016

EPA Form 5900 - 325



### Facility MVNRLM Diesel Fuel Reporting Instructions Designate & Track Handoff Report Report Form ID: DSF0504

P a p e rwo r k Redu ct i o n Act S tate m ent T he pub l i c repo rt i n g a n d re c o rd k eep i ng bu rd e n for th i s c o l l e ct i o n of i n fo rm at i on i s d i sc l o s ed i n the e s t i m ates of the i n d i v i du a l r epo rt fo r m i n s t r u ct i on s . Bu rden m eans the t ota l t i m e, e ffo rt, or f i nan c i al re s ou rc es e x pen d ed b y pe r s ons to g ene ra te, m a i nta i n, reta i n, or d i sc l o s e or p ro v i de i n fo rm at i on t o or for a F ede ral ag e n c y . T h i s i n cl udes t h e t i m e need e d to re v i e w i n s t r u ct i o n s ; d e ve l o p, a c qu i re, i n s ta l l , a nd ut i l i z e t e c hn o l og y a n d s y s tem s for the pu r p o s es of c o l l e ct i n g , va l i d a t i n g, a nd ve r i fyi n g i n fo r m at i on, p ro c e ss i ng and m a i n t a i n i n g i n fo rm at i on, a n d d i sc l o si ng and p ro v i d i n g i n fo rm at i on; adj u s t the e x i s t i ng wa y s t o c o m p l y w i th a n y p r e v i ou s l y ap p li c a b l e i n s t r u ct i ons a n d re q u i re m ents ; t ra i n pe rs on n el t o b e a b l e to re s pond t o a c o l l e ct i on of i nfo rm at i on; s ea rc h d ata s o u rc e s ; c o m p l ete and re v i e w t he c o l l e ct i on of i n fo rm at i on; a n d t ran s m i t or othe rw i s e d i sc l o s e t he i n fo rm at i on. A n ag e n c y m a y n o t c ondu ct or s pon s o r , and a pe rs o n i s n ot re q u i re d to re s p ond to, a c o l l e ct i on of i n fo rm at i on un l e s s i t d i s p l a y s a c u rre n t l y va l i d O MB c o n t rol nu m be r . S e n d c o m m ents on the Ag en c y's n e ed for t h i s i n fo r m at i o n , t h e a cc u ra c y of the p r o v i d e d bu r den e s t i m ate s , and a n y s ug g e s t ed m ethods for m i n i m izi n g re s pon d ent bu rd e n, i n c l u d i ng th ro u g h t h e u s e of auto m ated c o ll e ct i on te c h n i ques to the D i re ct o r , C o ll e c t i on S t ra te g i es D i v i s i o n, U
. S
. En vi ron m enta l P rote ct i on Ag en c y ( 28 2 2 ) , 1200 P e nn s yl va n i a Ave . , N W , W a s h i ngton, D.C. 20 46 0. In cl ude the O MB c ont rol nu m ber i n an y c o rre s pond e n c e. D o n o t s e n d t h e c o m p l eted fo r m to th i s a d d re ss .