Additives in Canadian fuels: appendix C

Appendix C: sample of form, "Report on fuel additives in petroleum fuels"

This report should be submitted:

1. each time a new additive has been introduced into a fuel produced in Canada or imported into Canada and when the quantity of the fuel produced or imported exceeds 400 cubic meters,
2. within 60 days of selling the fuel,
3. when concentration of reported additive has been changed,
4. by mail to:

Oil, Gas and Energy Branch/EPS
Environment Canada
10th Floor, 351 St. Joseph Blvd,
Hull, Québec K1A 0H3

Company Name:
Name of Refiner or Importer:
Address:

If importer, state Name and Location of Petroleum Fuel Storage Tanks:
Additive Manufacturer:
Address:

1. Type of fuel: __________________________
   Brand name of Additive: __________ Quantity of Additive used annually (kg)
   Purpose of Additive: _____________________
2. Fuel Additive Concentration (mg/L)
   Highest ________ Lowest _________ Weighted Average _________
3. Composition of Fuel Additive (Complete A, B or C)
   1. Chemical Name _________________ Percent by _________________
      of Constituent _________________ by weight _________________
   2. Elements: carbon, hydrogen, oxygen
      Total percent by weight_________________

      List all other elements which are present in concentration greater than 0.1 weight % in the fuel additive.

   3. Attach copy of confirmation letter from the fuel additive manufacturer that the information required under A or B has been forwarded to Environment Canada

Signature of Official _______________________
Title _______________________
Date _______________________