Draft

Supporting Statement

for

Information Collection Request

EPA’s Light-Duty In-Use Vehicle Testing Program (Renewal)

EPA ICR 0222.09

OMB Control No: 2060-0086

August, 2010

Compliance and Innovative Strategies Division 

Office of Transportation and Air Quality

Office of Air and Radiation 

U.S. Environmental Protection Agency

Part A SUBMISSION
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Section 1: Identification of the Information Collection

1(a) Title and Number of the Information Collection

EPA’s Light-Duty In-Use Vehicle Testing Program (Renewal), EPA ICR Number 

0222.09, OMB Control Number 2060-0086. This ICR was formerly titled “EPA’s In-Use 

Vehicle and Engine Testing Programs.” This renewal includes only the light-duty vehicle portion 

of the prior ICR. The heavy-duty and off-road vehicle and engine programs will henceforth be 

included in the ICR 1684, OMB 2060-0287. 

1(b) Short Characterization/Abstract

The Environmental Protection Agency (EPA), Office of Transportation and Air Quality,

Compliance and Innovative Strategies Division, conducts an integrated motor vehicle and engine 

emission compliance program. Motor vehicles and engines are first evaluated as prototypes prior 

to production; those designs that meet applicable criteria are licensed for introduction into 

commerce. EPA also has discretion to conduct assembly line testing of new vehicles and engines 

as well as to test emissions of in-use vehicles and engines. This Information Collection Request 

covers inquiries directed at the owners/lessees of in-use light-duty motor vehicles to see if their 

specific vehicles are suitable for an EPA in-use testing investigation and the paperwork burdens 

attendant upon election to participate. The prior ICR had a light-duty vehicle component and a 

heavy-duty and nonroad component. This ICR renews only the light-duty portion. 

The light-duty program can be broken down into three closely-related headings. The first 

is the surveillance testing program, with the possibility of an add-on compliance testing phase. 

Only three compliance phases have been conducted in the last five years, but it remains an 

information collection in this request. The second is a small ongoing program testing the 

functioning of onboard diagnostics (OBD) systems on in-use vehicles, which is simply additional 

testing on a subset of vehicles already recruited for the surveillance program. Finally, budget 

permitting, there are other occasional one-time “special investigations” spot-check tests of

vehicles to address specific issues. An example of a special investigation might be procurement 

of a class of vehicles to test compatibility with a particular portable emissions monitoring (PEM) 

unit. Special investigations are similar to testing of the portion of surveillance classes has have 

been selected to address a specific informational need. Because they use the same procurement 

system as the surveillance and OBD programs, these special investigations should be accounted 

for in this collection request, although the number of such tests will vary.

Light-duty testing typically includes standard emissions test cycles and standard OBD 

tests performed at EPA’s facility in Ann Arbor. The primary purpose of these programs is 

informational: to give EPA and manufacturer engineers intelligence regarding emissions 

performance for in-use vehicles. Manufacturers are involved at every step of the ongoing lightduty programs: they are informed of the surveillance tests, can be present during vehicle 

preparation and testing, are given test results, and participate in post-failure investigations. The 
3

testing supplements information from the manufacturers’ own discretionary in-use testing 

programs as well as the mandatory reporting under the manufacturers’ In-Use Vehicle Program 

(IUVP) under 40 CFR 1845–1847.

The light-duty program entail two formalized information collections. Participation in the 

information collections, as well as the vehicle evaluation, is strictly voluntary. (The actual 

solicitation of information is conducted by EPA’s contractor, URS, at its Michigan Procurement 

Facility.) First, 25 to 50 owners/lessees of the vehicles of interest who are within about 70 miles 

of Ann Arbor are randomly selected from the owner list of vehicles obtained from the Michigan 

Secretary of State and sent a letter with a card and return envelope to accept or decline the 

invitation to participate (Attachments II, III, and IV). After a suitable time for response, all 

positive respondents are considered for inclusion and called in order from the list. If the 

owner/lessee is reached and willing, a telephone questionnaire is conducted that asks about a 

half-dozen questions concerning vehicle condition and maintenance (see Attachment V). The 

first three who successfully complete the telephone questionnaire provide the vehicles for the 

surveillance class. If there are any test failures in the first three, then two more are recruited in 

the same manner. Additional groups of potential participants will be contacted if necessary until 

the required three or five vehicles have been obtained.

Information collected is used to insure that vehicles procured meet relevant criteria. For 

example, the vehicle should not have been tampered with or have other overt problems. Special

testing investigations and particular vehicle types may have additional or alternative criteria.

Those who elect to participate are asked if they are willing to bring in their maintenance 

records for copying when they deliver their vehicles. Doing so is voluntary and has no effect on 

eligibility. At the time of delivery, participants go over the telephone questionnaire answers and 

sign a notarized statement that the answers are correct. They sign for either URS’s cash incentive 

or a loaner car agreement, and a URS test agreement. Upon delivering their vehicle, they sign a 

vehicle release.

As part of the surveillance process, EPA attempts to determine the cause of any test 

failures. Post-test “special maintenance” involves close examination of the vehicle, nearly always 

with manufacturer participation. This may produce relevant information about the cause of the 

failure. Surveillance test data are also supplemented with information from manufacturer 

application test data, EPA confirmatory test rest results, defect reports, service bulletins, CARB 

(California Air Resources Board) warranty reports, state Inspection/Maintenance (I/M) 

information, manufacturer service technician bulletins, and the results of the manufacturers’ 

IUVP tests submitted to EPA and their own in-use testing results. Manufacturers/importers are 

involved in the process from the outset, and receive all test results, including test failures. The 

process of identifying problems is collaborative and cooperative in nearly all cases. If EPA 

believes that a recall is indicated, and the manufacturer/importer agrees that EPA's conclusion is 

valid, it will agree to conduct a voluntary recall. However, if questions remain, EPA has 

procedures in place to run the compliance test phase with continued manufacturer involvement.

Even at this stage the inferences are informational rather than statistical: to identify, based on 
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engineering judgment, the appropriate population to which the problem applies, identify the 

cause of the problem, resolve issues regarding the testing protocols and results, etc. The process 

has not been adversarial in recent years. There have only been three compliance classes in the last 

five years, and they were or are being amicably resolved without any recall. 

Based on information gathered from all sources, EPA can make an administrative finding 

mandating recall and repair of in-use vehicles if it determines that “a substantial number” of 

vehicles in a class or category do not comply with the emissions requirements as a result of its 

own in-use testing program. In reality, such a determination will be based on information from a 

variety of sources that may or may not include EPA in-use testing. Such findings are subject to 

the Administrative Procedures Act and are reviewable in court under the “substantial evidence” 

test (5 USC 706(2)(E)), which is restated in the “substantial evidence” standard in the Clean Air 

Act for ordering recalls.

Procurement of light duty vehicles for a compliance testing phase is similar to that for the 

surveillance phase, except that EPA may make several attempts to contact an owner/lessee by

telephone or mail; participants in the surveillance phase are screened out.

In the last fiscal year an estimated 185 vehicle in-use testing actions were conducted by

EPA, counting OBD add-ons as separate actions. Adding an allowance for about 25 special 

investigation vehicles (the number is expected to vary from year to year) and the possibility of a 

confirmatory class, the estimate here is 210 procured vehicle actions, corresponding to 3673

contacts and 164 telephone interview and/or other followup participant contacts. Assuming that 

4,285 respondents spend an average of 7.3 minutes, this collection imposes a burden of 521

hours annually. This collection has no recordkeeping requirements. 

Section 2: Need for and Use of the Collection

2(a) Need/Authority for the Collection

Under Title II of the Clean Air Act, (42 U.S.C. 7521 et seq.), manufacturers of motor 

vehicles and engines are required to design and build vehicles which will comply with emission 

standards throughout their useful lives. ("Useful life" is defined by statute and regulation; it 

varies by type of vehicle or engine.) Pursuant to section Clean Air Act section 207(c) (42 USC 

7541, see Attachment I), EPA is responsible for monitoring compliance and investigating 

possible noncompliance with emission standards. 

In order to fulfill this function, it is necessary for EPA to test actual "in-use" vehicles;

these vehicles must be obtained from their owners/lessees. As part of the procurement process, 

EPA must determine that the vehicle is within the useful life and that it has been “properly

maintained and used”. In order to do this, EPA must make a limited inquiry of the owner/lessees 

who are willing to participate; see Attachment V for an example telephone questionnaire. 

2(b) Practical Utility/Users of the Data
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EPA needs the information from the vehicle owner/lessee to determine that the vehicle is 

within its “useful life” and that it has been “properly maintained and used.” EPA’s Compliance 

and Innovative Strategies Division, Office of Transportation and Air Quality, is the prime user of 

this information. Manufacturers whose models are being tested receive a copy of the file on the 

vehicle to be tested, identified by a “vehicle control number.” Manufacturers are informed of pretest maintenance and test dates and receive all test results. They also participate in post-test 

“special maintenance” to investigate failures.

Section 3: Nonduplication, Consultations, and Other Collection Criteria

3(a)Nonduplication

The information obtained from the vehicle owner/lessee is unique to that specific vehicle; 

it is not obtainable from any other source. There is no information available, in either public or 

private databases, that will adequately serve the program purposes. (Some vehicle maintenance 

information, such as warranty repairs and scheduled maintenance done at dealers’ outlets, is 

available from manufacturers and commercial automotive data services, and such information 

may be supplied by manufacturers in their own interests or as queried by EPA. However, it is not 

a substitute for owners’/lessees’ own records.) Additionally, there are no other similar 

government programs which would allow sharing of data. 

3(b) Public Notice Prior to ICR Submission to OMB

EPA solicited public comment by means of a Federal Register Notice published on 

_____, 2010, __ Federal Register _____. 

3(c) Consultations

In preparing this ICR, EPA consulted with Ms. Kim Cieslak and John White, URS

Michigan Procurement Facility, (734) 214-4568. (URS is EPA’s contractor that procures and 

maintains in-use passenger cars and light duty trucks.) Ms. Cieslak mails out the procurement 

letters and conducts the telephone interviews; she was asked to monitor how much time the 

interviews required. She determined the average to be 20 minutes. John White is her supervisor. 

The two went over how the program operates from start to end. 

3(d) Effects of Less Frequent Collection

Information is collected only once per vehicle evaluation; less frequent collection is not 

possible.

3 (e) General Guidelines

This information collection activity complies with the requirements of 5 CFR 
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1320.5(d)(2).

3 (f) Confidentiality

Information gathered from light-duty respondents is stored in contractor files. These 

paper records, including names and social security numbers needed for those who accept 

payment over $600 in lieu of loaner cars, are completely segregated from test results, which are 

separately handled and stored by EPA. Respondent information is handled and stored exclusively

by the contractors URS. It is not available to the public. Non-personal information (such as 

maintenance record data) may occasionally be queried by EPA staff, who convey the request to 

URS, who in turn retrieve the information from respondent files and answer the EPA query. Test 

results are tracked by vehicle control number and are shared with manufacturers by email 

automatically; they are available to the public. This information collection complies with the 

Privacy Act of 1974 and OMB Circular A-130. 

3(g) Sensitive Questions

No sensitive questions are asked in this information collection.

Section 4. Respondents and Information Requested

4(a) Respondents/SIC & NAICS Codes

The respondents are individual vehicle owners/lessees of any regulated vehicle or engine 

regulated by EPA under the Clean Air Act (No NAICS code).

4(b) Information Requested

(i) Data items

Respondents who receive EPA’s initial request (see Attachments II and III and IV) are 

asked to supply the following information on a card via a postage paid return envelope;

participation is entirely voluntary:

Do they own/lease the desired vehicle; verify the make and model

Current odometer reading

Are they the original owner/lessee

Transmission type

Are they interested in participating; how EPA should contact them.

Those who indicate they wish to be considered for participation are asked for additional 

information:

Has the odometer malfunctioned and, if so, for how long was it inoperative
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Has the vehicle catalyst ever been replaced

Do they have maintenance records; would they allow EPA to review and copy them

There are no recordkeeping requirements associated with this collection.

(ii) Respondent Activities

Responses to the request for participation and information collection are strictly

voluntary.

Those wishing to participate are asked to fill out a postage-paid information card. Some

are then contacted by telephone to obtain the additional information listed above. Vehicles that

will be evaluated are brought to EPA’s facility for testing. The owners/lessees receive either a 

cash incentive for each day EPA keeps the vehicle or a lesser cash incentive and a late model 

loaner car with a full tank of gas and unlimited mileage for the duration of the testing, which may

take two to three weeks. 

Most of the information requested is known by the owner/lessee; some information might 

have to be obtained by simple vehicle or engine inspection or by reference to maintenance 

records (if available).

Section 5: The Information Collected--Agency Activities, Collection Methodology, and 

Information Management

5(a) Agency Activities

Agency staff typically have no involvement in gathering the information, as that task is 

done by an EPA contractor. However, on occasion, staff are required to answer specific 

questions that arise during the information gathering process. Agency staff do review the final 

telephone questionnaire for completeness as well as potential issues relevant to the vehicle being 

evaluated. Agency staff select the vehicle class to be tested, view test results, and participate in 

discussions with manufacturers relating to the testing preparations and results. 

5(b) Collection Methodology and Management

Information is obtained via mailed responses and telephone interviews; it is stored on 

paper in a vehicle file. The information is reviewed to see if the specific vehicle or engine meets 

the criteria for evaluation. The file is typically maintained for five years and then destroyed

Due to the limited amount of information collected and its very limited use, electronic 

storage and processing are not employed.

5(c) Small Entity Flexibility
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The information requested is completely voluntary and imposes no mandatory burden on 

any respondent. The information collected is the minimum necessary to assure that vehicles meet

the criteria for evaluation. Therefore, there can be no process which reduces the burden on small 

entities.

5(d) Collection Schedule

Information is collected on a continuous basis. The number of solicitations mailed out in 

a given time frame is a function of available test capacity and how difficult a particular vehicle 

type is to procure. 

Section 6.Estimating the Burden and Cost of the Collection

6(a) Estimating Respondent Burden

As explained above, EPA’s contractor estimated that each telephone interview takes 

approximately 20 minutes on average. Subsequent information-related burdens for participants 

(such as reviewing and attesting to the telephone questionnaire answers and supplying 

maintenance records voluntarily) upon delivery of light-duty vehicles, is estimated at 40 minutes. 

We estimate that the initial contact burden (by postcard and letter) to averages 5 minutes. 

6(b) Estimating Respondent Costs

(i) Estimating labor costs.

The is no typical individual owner/lessee; they represent the average person who acquires 

or owns a vehicle or engine. For this analysis we assume a cost of $21.68 per hour, based on the 

mean annual income for people 25 years and older in 1965, from the U.S. Census Bureau, 

Current Population Survey, 2006 Annual Social and Economic Supplement

(http://pubdb3.census.gov/macro/032006/perinc/new03_001.htm , accessed August 5, 2010). The 

annual labor cost is therefore $11,295.

(ii) Estimating Capital and Operations and Maintenance Costs

This collection has no capital, operations or maintenance costs.

(iii) Start-up Costs 

This collection has no start-up costs.

6(c) Estimating Agency Burden

EPA uses contractor employees to collect essentially all the information covered by this 

information collection request. The most recent annual contractor costs for the light duty testing 
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component was approximately $697,000 plus $70,000 for the OBD portion. An estimated 1.5 

EPA employees oversee the programs at an annual cost of $150,000. The total estimated Agency

cost is $917,000 per year.

6(d) Estimating the Respondent Universe and Total Burden and Costs

From the above discussion the following total burden and cost estimates can be calculated 

as presented below.

6(e) Bottom Line Burden Hours and Cost

(i) Respondent Tally

Program Vehicles/

Engines

Initial 

Contacts 

 

Burden @ 

5 min 

ea.(min)

Participant 

Contacts

Burden @ 

60 min ea 

(min)

LD Surveillance 150 3673 18365 150 9000

LD Confirmatory 0 0 0 0 0

OBD 

Surveillance

35 0 0 0 0

Special 25 612 3061 14 840

Total 210 4285 21426 164 9840

Total burden 

(hrs)

521

There are no respondent operating, capital, or startup costs associated with this collection. 

(ii) Agency tally

EMPLOYEES 1.5 (directly involved in information collection) 

COST $ 150,000

6(f) Reasons for change in burden

The changes in burden, a decrease of 90 responses and 98 hours, are entirely due to 

separation of the heavy-duty and nonroad in-use testing programs into a separate ICR. 

6(g) Burden Statement

The annual public reporting and recordkeeping burden for this collection of information 

is estimated to average approximately 521 hours per year; 7.30 minutes on average for each 

owner/lessee who receives a solicitation to participate. This estimate includes the time to review 

the solicitation material, complete the reply correspondence, complete the telephone 

questionnaire for the subset contacted, and complete paperwork for delivery and pickup of 
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participating vehicles and for monetary compensation. Participation is completely voluntary. 

Burden means the total time, effort, or financial resources expended by persons to generate, 

maintain, retain, or disclose or provide information to or for a Federal agency. This includes the 

time needed to review instructions; develop, acquire, install, and utilize technology and systems 

for the purposes of collecting, validating, and verifying information, processing and maintaining 

information, and disclosing and providing information; adjust the existing ways to comply with 

any previously applicable instructions and requirements; train personnel to be able to respond to 

a collection of information; search data sources; complete and review the collection 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 OMB control numbers for EPA’s regulation are listed 

in 40 CFR part 9 and 48 CFR chapter 15.

To comment on the Agency's need for this information, the accuracy of the provided 

burden estimates, and any suggested methods for minimizing respondent burden, including the 

use of automated collection techniques, EPA has established a public docket for this ICR under 

Docket ID Number EPA-HQ-OAR-2010-0690, which is available for online viewing at 

www.regulations.gov, or in person viewing at the EPA Docket Center, EPA/DC, EPA West, 

Room 3334, 1301 Constitution Ave., NW., Washington, DC. The Public Reading Room is open 

from 8:30 a.m. to 4:30 p.m., Monday through Friday, excluding legal holidays. The telephone 

number for the Public Reading Room is (202) 566–1744. An electronic version of the public 

docket is available at www.regulations.gov. This site can be used to submit or view public 

comments, access the index listing of the contents of the public docket, and to access those 

documents in the public docket that are available electronically. When in the system, select 

“search,” then key in the Docket ID Number identified above. Also, you can send comments to 

the Office of Information and Regulatory Affairs, Office of Management and Budget, 725 17th 

Street, NW, Washington, D.C. 20503, Attention: Desk Officer for EPA. Please include the EPA 

Docket ID Number EPA-HQ-OAR-2010-0690 and OMB Control Number 2060-0086 in any

correspondence.
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Attachment I

Legal Authority

42 USC 7541. - Compliance by vehicles and engines in actual use 

* * * * *

(c) Nonconforming vehicles; plan for remedying nonconformity; instructions for

 maintenance and use; label or tag 

Effective with respect to vehicles and engines manufactured during model years beginning more 

than 60 days after December 31, 1970 -

(1) If the Administrator determines that a substantial number of any class or category of vehicles 

or engines, although properly maintained and used, do not conform to the regulations prescribed 

under section 7521 of this title, when in actual use throughout their useful life (as determined 

under section 7521(d) of this title), he shall immediately notify the manufacturer thereof of such 

nonconformity, and he shall require the manufacturer to submit a plan for remedying the 

nonconformity of the vehicles or engines with respect to which such notification is given. The 

plan shall provide that the nonconformity of any such vehicles or engines which are properly

used and maintained will be remedied at the expense of the manufacturer. If the manufacturer 

disagrees with such determination of nonconformity and so advises the Administrator, the 

Administrator shall afford the manufacturer and other interested persons an opportunity to 

present their views and evidence in support thereof at a public hearing. Unless, as a result of such 

hearing the Administrator withdraws such determination of nonconformity, he shall, within 60 

days after the completion of such hearing, order the manufacturer to provide prompt notification 

of such nonconformity in accordance with paragraph (2). 

* * * * *
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Attachment II

Sample Solicitation Letter (EPA)

Dear Vehicle Owner:

The Environmental Protection Agency and URS (under contract to EPA) are conducting 

an important program to help control air pollution, which involves analyzing vehicle exhaust 

emissions. You may be able to contribute significantly toward this program and be rewarded for 

your cooperation. If your vehicle qualifies, we will offer you a number of incentives to 

participate:

1. The use of a late-model, fully insured loaner car with a full tank of fuel, and 

$20.00 per day.

2. If you do not wish to use the loaner vehicle, you will receive $50.00 per day.

3. Your vehicle will be returned with a full tank of fuel.

The testing will be conducted in EPA's National Vehicle and Fuel Emissions Laboratory

(formerly known as the Motor Vehicle Emissions Laboratory) in Ann Arbor. Your vehicle will 

probably accumulate less than 300 miles under simulated driving conditions. No unusual 

operations will be performed on your vehicle and it will be fully insured for the entire test period, 

which will take approximately one to four weeks.

Please complete and return the enclosed reply card in the prepaid envelope to URS as 

soon as possible, even if you choose not to participate. If you are willing to participate, a 

representative of URS will be in touch with you to ask questions about your vehicle.

The enclosed information sheet answers some questions people often ask about this 

program. If you want to participate in this program or have any additional questions, please feel 

free to call URS toll free at (866) 665-1228. Some is available between 8 AM and 4 PM or leave 

a message for a return call. You can also call me at (734) 214-4851. I will be happy to answer 

any questions you may have related to this program. We look forward to receiving your reply

card or a telephone call very soon.

Sincerely,

Lynn Sohacki

Environmental Engineer

Compliance and Innovative Strategies Division

EPA Motor Vehicle Emissions Laboratory

2565 Plymouth Road

Ann Arbor, MI 48105
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Attachment III

Sample Solicitation Letter (EPA’s Contractor)

Dear Vehicle Owner:

EG&G Inc. is under contract with the United States Environmental Protection 

Agency to obtain privately owned vehicles for the test program explained in the 

enclosed message and to perform routine maintenance and inspection 

procedures on the selected candidate vehicles.

Additionally, it is our responsibility to provide you with the incentives which 

have been authorized by the Environmental Protection Agency.

We hope you will join us in this important project. Please complete and return 

the enclosed card in the prepaid envelope.

If you have any questions, an unlisted telephone number, or if it may be 

difficult to reach you by telephone, we would appreciate your calling us toll free 

at (866) 665-1228.

Sincerely,

John H. White

Program Manager
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Attachment IV

Example Return Card
2008 GM LDT 8GMXT06.2382 Control #N160/N161RXX-______

 Page 1 of 6

1

Attachment V

Example Telephone Questionnaire

TELEPHONE QUESTIONNAIRE OMB 

No. 2060-0086

For Surveillance Class N-160/N-161 Expires (02/08/2011)

VEHICLE CONTROL NUMBER DATE 

ADMINISTERED BY 

OWNER'S NAME 

STREET ADDRESS 

CITY STATE ZIP 

(CALL NUMBER BELOW THAT IS MARKED WITH AN "X")

TELEPHONE (Home) / / (Business) / / 

BEST TIME TO CALL 

"WE ARE AUTHORIZED BY FEDERAL LAW TO COLLECT THIS INFORMATION. WHILE 

YOU ARE NOT REQUIRED TO RESPOND, YOUR COOPERATION IS NEEDED TO MAKE 

THE RESULTS OF THIS INVESTIGATION VALID."

DATE OF CONTACT _______________________ TIME OF CONTACT __________________

INDIVIDUAL CONTACTED_______________________________________________________

TO BE COMPLETED ___________________ DATE AND TIME OF COMPLETION___________

You have been selected from a list of vehicle owners living in the Detroit/Ann Ann Arbor metropolitan area to participate 

in a study of vehicle emissions being conducted by the U.S. Environmental Protection Agency.

EPA is authorized by law to conduct this study and to offer incentives to you for your cooperation should you decide to 

participate. Your participation in this program is strictly voluntary.

The accuracy of the information that you provide is important. The information that you provide will be used by EPA

along with emission results from your vehicle to determine whether the automobile manufacturer has complied with clean 

air standards established by Congress. The test results from your vehicle will not be used by EPA to take action against 

you. Your cooperation will help EPA's efforts to control air pollution due to motor vehicle emissions.
2008 GM LDT 8GMXT06.2382 Control #N160/N161RXX-______

 Page 2 of 6

2

Public reporting burden for this collection of information is estimated to vary from 1 to 60 minutes per response, with an 

average of 20 minutes per response, including time for reviewing instructions, searching existing data sources, gathering 

and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding 

the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to 

Chief, Information Policy Branch, PM-223, U.S. Environmental Protection Agency,40l M St., S.W. Washington, DC. 

20460; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC. 

20503.
2008 GM LDT 8GMXT06.2382 Control #N160/N161RXX-

______

 Page 3of 6

3

These are the conditions of the program:

- we ask that you bring your vehicle into our testing facility where you will receive either a cash 

incentive for each day we keep your vehicle or a late model loaner car which will have a full tank 

of gas and unlimited mileage. This vehicle is yours to use without charge for the duration of the 

testing, which may take approximately 2 to 3 weeks. During this time, we will be performing a 

series of tests on your vehicle to measure vehicle emissions.

At the time the vehicle is delivered to us for testing, you will be required to sign an affidavit 

stating that the answers to the questions you will be asked are true and accurate to the best of 

your knowledge.

We will provide you the following incentives for participating in our program:

- If your vehicle is accepted into the program, a full tank of gas and a cash incentive will be 

awarded. You will be receive $20 per day for each day your vehicle is at NVFEL, and the use of 

a fully-insured loan car; or $50 per day for every day your vehicle is at NVFEL in lieu of a loan 

car.

However, if your vehicle is rejected after you bring it to the lab, but before you leave, you will 

receive a $20 payment.

The compensation will be based upon whole days, beginning with the day your vehicle arrives. It 

will end one day after you are notified your vehicle is ready for return.

The maintenance performed on your vehicle will depend on program requirements. 

You will be given a list of any parts that are replaced.

Are you willing to participate? YES NO 

If you are not, may we ask why not? ______________________________________________
2008 GM LDT 8GMXT06.2382 Control #N160/N161RXX-

______

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4

FOR “URS PERSONNEL” ONLY

SENTENCES IN CAPITAL LETTERS ARE INSTRUCTIONS TO THE CLERK

AND ARE NOT INTENDED TO BE READ TO THE OWNER.

IF RESPONSE IS POSITIVE:

For the purpose of this study, I am going to ask you some questions about your vehicle's 

maintenance and usage history. Please have your maintenance records in front of you for 

reference during the following questions. You should answer these questions to the best of 

your knowledge and indicate when you are not sure of something.

1. a. What is the engine family of your vehicle? The engine family can be found on a Vehicle 

Emission Control Information decal located underside of the hood. The engine family should 

start with: 8 G M

/ / Owner is unable to locate.

/ / Owner located. EF# ________________________________________

 

/ / Engine family located when vehicle arrived at the Lab.

ENGINE FAMILY 

Engine Family must be = 8GMXT06.2382

b. What is the vehicle identification number? _______________________

c. What is the model of your vehicle? _________________ 

d. What kind of transmission does your vehicle have?: AUTOMATIC MANUAL 

OTHER

 If other, 

describe:_________________________________________________________

e. Is your vehicle air conditioned? YES NO 

f. What mileage is indicated on your odometer? ____________________
2008 GM LDT 8GMXT06.2382 Control #N160/N161RXX-

______

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5

Has the odometer ever not functioned properly? YES NO 

If yes, approximately how long (months/miles) was it inoperable? 

________________ 

CONSULT EPA FOR ELIGIBILITY IF THE RESPONSE IS "YES" to f.

2. Has your vehicle’s catalyst ever been replaced or removed?

YES / / NO / / 

If yes, CALL EO.

3. a) Have you kept records of the maintenance and repairs performed on your vehicle?

YES / / NO / /

 b) To prepare for testing, the glove box and trunk will need to be opened during by URS and 

EPA personnel. Frequently, records pertaining to the vehicle's maintenance history are found in 

the vehicle. Will you allow all records (those provided by you and those found) to be reviewed 

and duplicated?

YES / / NO / /

4. EPA needs to share your maintenance records with the manufacturer to correctly test the 

vehicle. Do you agree to this?

YES / / NO / /

 IF RECORDS ARE AVAILABLE, INFORM OWNER THAT: It is important that they 

are brought to the lab for review and duplication. 

5. Have you ever used any fuel other than that recommended by the manufacturer in your 

vehicle? 

YES / / NO / /

If Yes, what have you used? 

___________________________________________________________

How often have you used it? 
2008 GM LDT 8GMXT06.2382 Control #N160/N161RXX-

______

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6

___________________________________________________________

When was the last time you used 

it?______________________________________________________

6. Has your vehicle: 

 

a) Been in an accident? YES / / NO / /

b) Had any engine repairs? YES / / NO / /

c) Any vehicle modifications? YES / / NO / /

If “yes” to any of the above, please describe: 

 

___________________________________________________________________________

___________________________________________________________________________

______________________

Has your vehicle had any: DATE:

d) Body work? YES / / NO / / ________________

e) Glass repair or replacement? YES / / NO / / ________________

f) Paintwork or detailing? YES / / NO / / ________________

g) Other? YES / / NO / / _________________

If “yes” to d – g above, please describe: 

 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________

IF “YES” TO ANY d) THROUGH f) ABOVE AND DATE IS LESS THAN 6 

MONTHS FROM THE TIME OF THIS QUESTIONNAIRE, THIS VEHICLE 

SHOULD BE PUT ON HOLD.

g) New tires? YES / / NO / /

Date and mileage of the most recent tire installed? Date_________ 

Mileage___________

HAS IT BEEN LESS THAN 6 MONTHS AND/OR 6,000 MILES SINCE A TIRE 

REPLACEMENT? IF YES, THIS VEHICLE SHOULD BE PUT ON HOLD.
2008 GM LDT 8GMXT06.2382 Control #N160/N161RXX-

______

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7

If a replacement part was installed, was it an original manufacturer part? Yes No

What was the approximate cost of the work done? 

Do you have any documentation of the work that was done? 

(NOTE TO URS: IF THE ANSWER TO ANY OF QUESTIONS a) THRU g) IS 

“YES”, PLEASE CONSULT WITH EPA STAFF BEFORE ACCEPTING THIS 

VEHICLE.)

7. Is your vehicle equipped with a trailer hitch ? Yes ____ No ____

Was the hitch installed by: dealer other

How much total weight has been hauled?: 

trailer + cargo = _____________________________________________

( IF YES, CONSULT WITH EPA STAFF BEFORE ACCEPTING THIS 

VEHICLE.)

INFORM THE OWNER THAT:

1) All valuables should be removed from the vehicle (including those in the glove box) 

prior to bringing the vehicle to the lab.