Verified Technologies for SmartWay and Clean Diesel

Application for Verifying Clean Diesel Technology

Important Notes
		Completing and submitting this online application is only the first step in the application process. Upon receiving the online application, EPA will contact you for further actions to complete the process.
The person filling out this form must be an official manufacturer representative with detailed knowledge of: the technology, its manufacture, its in-use operation, its performance, its durability, and prior testing.
Do not include any Confidential Business Information (CBI) in this online application.

If you have questions or need help filling out this form, please email EPA at Tech_Center@epa.gov.

1. Information for Primary Contact

Name (Required)

Office Phone Number

Mobile Phone Number

Email Address (Required)

1a. Company Information for Primary Contact

Company Name (Required)

Mailing Address (Required)

Country (Required)

Address 1 (Required)

Address 2

Postal code (Required)

City (Required)

2. Information for Secondary Contact (Optional)

Is there a secondary contact that you would like to add?

Yes

Name

Office Phone Number

Mobile Phone Number

Email Address

2a. Company Information for Secondary Contact

Company Name

Mailing Address

Country (Required)

Address 1 (Required)

Address 2

Postal code (Required)

City (Required)

3. Manufacturer Information

Name(s) (Required)

Provide the name of the original equipment manufacturer(s) and a brief description of the company.

Manufacturing Facility Address (Required)

Country (Required)

Address 1 (Required)

Address 2

Postal code (Required)

City (Required)

4. Technology Type

Please identify your technology. The following can be applied to a light-, medium-, or heavy-duty diesel engine or equipment.

Technology Type (Required)

Exhaust After-Treatment Device: Diesel Oxidation Catalyst (DOC) or DOC Combination

Exhaust After-Treatment Device: Diesel Particulate Filter (DPF) or DPF Combination

Exhaust After-Treatment Device: Selective Catalytic Reduction (SCR)

Exhaust After-Treatment Device: Other type of after-treatment device

Engine Modification: Engine Overhaul (or upgrade kit)

Engine Modification: Other type of engine modification

5. Product Identification

Please provide the following specifics for your product.

Product Name (Required)

Please provide the specific name of the product, including product ID numbers and/or serial and part numbers.

Short Description of Product (Required)

Please provide a short description of the product for which you are requesting verification.

6. Additional Questions

1. Does your technology have regulatory requirements that supersede verification? (Required)

2. Is your technology beyond the research and development stage and currently available commercially? (Required)

3. If yes to the above question, does the technology have in-use experience in the intended market? (Required)

4. Does your technology have any existing durability, emissions, or overall performance data? (Required)

5. Does your technology have any health or safety concerns? (Required)

6. Is this the first time you have submitted this technology for EPA verification? (Required)

7. Are you currently pursuing verification with the California Air Resources Board (CARB) for this technology? (Required)

8. Does your company offer full warranty over the sale of this product? (Required)

Note:

* N/A = Not Applicable

7. Attest Accuracy of Information

Do you accept full responsibility in attesting to the EPA that all submitted information is correct? (Required)

Yes

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