Document 3eqMNN572OxG4YLGwN7g06wmn

Version: 2/2/2023 General Field Inspection Worksheet Instructions: This worksheet is for inspection of all engines certified that an inspector will encounter in the field Fill it in as much as possible in the field during the inspection. It can be completed electronically after the inspection. General Inspection Information Insp. No: 20230616 1000 01 Insp. Date: 6/16/2023 Inspection photo numbers: 19 Inspector(s): Nathan Dancher and Mario Jorquera Insp. Time Start/End: 10:00 10:20 Photographer: Mario Jorquera CBP Facility Name: CBP Address 1: CBP Address 2: CBP City/State/Zip: Port Of Baltimore 1601 Finishing Mill Road Sparrows Point, MD 21219 Location of Inspection Location of Goods (e.g., warehouse #1): CBP POC: CBP Email: East Coast Warehouse CES Entry Docs Collected from CBP Entry/Immediate Delivery (CBP Form 3461) Invoice Declaration Form Imp of Motor vehicles/Engines (CBP Form 3520 1) Packing List Importation of Engines, Vehicles, and Equipment subject to Air Pollution Regulations (CBP Form 3520 21) EPA Certificate of Conformity Other: Other: Other: Name: Address: City/State/Zip: POC: ID Number: Check one: Importer Information (from Entry Documents) Importer Check one: Consignee Yancheng K Sintai Machinery Co. NO 88 Guahua East Road Jianhu Economic Development Zone, Yancheng, China Name: Address: City/State/Zip: POC: ID Number: Consignee Buyer Seller Manufacturer Check one: Consignee Buyer Seller AGT Industrial 11 Windarbor Lane Irvine, CA 92602 Buyer Seller Manufacturer Manufacturer Name: Address: City/State/Zip: POC: ID Number: Name: Address: City/State/Zip: POC: ID Number: Entry Number: Entry Date: HS Number: Product/Entry Information (from Entry Documents) 847 23059071 Description of Product: 18 May 23 Quantity and Units: 8429.52.5010 Total Value: Digger 9 7,353 Exemption Claims/Applicability Observations Engines Permanent label for "DELEGATED ASSEMBLY" (1068.261) Engines Permanent label for manufacturer owned and, pre certification, test engines (citing 1068.210 or 1068.215) Engines Permanent label for "REPLACEMENT ENGINE" (new engine to replace in service engine) (1068.240) Other: Recreational Permanent label for competition use under 40 CFR 1051.620 Small Nonroad Spark Ignition Engines Permanent label titled "EMISSION CONTROL INFORMATION" citing "THIS ENIGNE IS FOR COMPETITION USE ONLY" (40 CFR 1054.620) Engines Permanent label for test engine (1068.210) Engines Permanent label for "SOLEY FOR EXPORT" (1068.230) HWY MCs Permanent label for MCs for display use only under 40 86.407 78(c) HWY MCs Interim personal use exemption claim (86.407 78(b)) Notes: General Information (as needed) Manual or instruction document observed? Listed Model(s): Emissions Warranty? If Yes, how long?: Equipment Weight: User Manual/Instructions Did you photograph the document(s):? Engine Displacement: Rated Power: Rated Power RPM: Type of Fuel: (specify units) (specify units) (e.g., @ 7,000 rpm) (e.g., 91 octane, ULSD) Page 1 of 2 Version: 2/2/2023 General Field Inspection Worksheet Emission Control Information Label Check Yes (Y) or No (N) ECI Label Present: Y Company Information on ECI: Briggs & Stratton, LLC Can ECI label be removed without destroying: Y Engine Family: PJDGS.4202UA Did you obtain a photo of the ECI label: Y Evap./Perm. Family: PJDGPNHEQ003 Emission Control Devices Listed: EM Tune up Specs Listed (Y/N): Yes, on label Compliance Period (i.e., useful life): Date of MFG: 250 Hours Feb 23 Refers to user manual Displacement: 420cc Not referenced on label Type of Fuel: Notes: Compliance statement observed? (yes/no and whether exhaust, evap, both): Yes, lists US EPA, CA Exh/EVP SORE ECI label should be permanent and not removeable without being destroyed or defaced. See 40 CFR 1060.135 for more information. MY(s) in statements: 2023 Other Info on ECI: (as needed) Type of Equipment: Model name: VIN/ESN: Build Date: Was Part on Engine? Check Yes (Y) or No (N) Fuel Tank: PAIR: Intake Assembly/Filter: Muffler/Catalyst: Carburetor: Fuel Injector: Spark Plug: TWC: Oxygen Sensor: DOC/OC: EGR: SCR/DEF: DPF/PTOX: Throttle Body: Other (specify): Other (specify): Other (specify): Visual Inspection Information Mini Excavator Crankcase Ventilation KAT 12 KAT1223040501A 2023 Observed Part Number Populate part numbers if visible. Mark "not visible" if not visible and include brand name if possible. Obtain photos of each part. Crankcase vented to atmosphere?: (4 stroke engines only, check Yes(Y) or No(N) Evaporative Checks Fuel Tank Material (Plastic/Metal): Metal Running loss line observed(Y/N)? (gasoline engines only): Are all sections of the Fuel lines marked? Fuel Line Markings (from tank to stop valve): Metal Fuel Line Markings (from stop valve to carburetor): Metal Visual Inspection Notes: Some models in entry had the EPA logo prominently displayed on the equipment. VINs of the equipment observed with EPA logo were QH1223040502A and QH1223040501A Evidence taken (indicate how it was marked): Field Inspection Summary Inspector Signature: Supervisor Signature: Date: Date: Page 2 of 2 Version: 2/2/2023 General Field Inspection Worksheet Instructions: This worksheet is for inspection of all engines certified that an inspector will encounter in the field Fill it in as much as possible in the field during the inspection. It can be completed electronically after the inspection. General Inspection Information Insp. No: 20230616 1030 01 Inspector(s): Nathan Dancher and Mario Jorquera Insp. Date: 6/16/2023 Inspection photo numbers: 10 16 Insp. Time Start/End: 10:30 10:50 Photographer: Mario Jorquera CBP Facility Name: CBP Address 1: CBP Address 2: CBP City/State/Zip: Port Of Baltimore 1601 Finishing Mill Road Sparrows Point, MD 21219 Location of Inspection Location of Goods (e.g., warehouse #1): CBP POC: CBP Email: East Coast Warehouse CES Entry Docs Collected from CBP Entry/Immediate Delivery (CBP Form 3461) Invoice Declaration Form Imp of Motor vehicles/Engines (CBP Form 3520 1) Packing List Importation of Engines, Vehicles, and Equipment subject to Air Pollution Regulations (CBP Form 3520 21) EPA Certificate of Conformity Other: Other: Other: Name: Address: City/State/Zip: POC: ID Number: Check one: Importer Information (from Entry Documents) Importer Check one: Consignee Yancheng K Sintai Machinery Co. NO 88 Guahua East Road Jianhu Economic Development Zone, Yancheng, China Name: Address: City/State/Zip: POC: ID Number: Consignee Buyer Seller Manufacturer Check one: Consignee Buyer Seller AGT Industrial 11 Windarbor Lane Irvine, CA 92602 Buyer Seller Manufacturer Manufacturer Name: Address: City/State/Zip: POC: ID Number: Name: Address: City/State/Zip: POC: ID Number: Entry Number: Entry Date: HS Number: Product/Entry Information (from Entry Documents) 847 23059071 Description of Product: 18 May 23 Quantity and Units: 8465.91.0027 Total Value: Sawing Machine 1 $676 Exemption Claims/Applicability Observations Engines Permanent label for "DELEGATED ASSEMBLY" (1068.261) Engines Permanent label for manufacturer owned and, pre certification, test engines (citing 1068.210 or 1068.215) Engines Permanent label for "REPLACEMENT ENGINE" (new engine to replace in service engine) (1068.240) Other: Recreational Permanent label for competition use under 40 CFR 1051.620 Small Nonroad Spark Ignition Engines Permanent label titled "EMISSION CONTROL INFORMATION" citing "THIS ENIGNE IS FOR COMPETITION USE ONLY" (40 CFR 1054.620) Engines Permanent label for test engine (1068.210) Engines Permanent label for "SOLEY FOR EXPORT" (1068.230) HWY MCs Permanent label for MCs for display use only under 40 86.407 78(c) HWY MCs Interim personal use exemption claim (86.407 78(b)) Notes: General Information (as needed) Manual or instruction document observed? Listed Model(s): Emissions Warranty? If Yes, how long?: Equipment Weight: User Manual/Instructions Did you photograph the document(s):? Engine Displacement: Rated Power: Rated Power RPM: Type of Fuel: (specify units) (specify units) (e.g., @ 7,000 rpm) (e.g., 91 octane, ULSD) Page 1 of 2 Version: 2/2/2023 General Field Inspection Worksheet Emission Control Information Label Check Yes (Y) or No (N) ECI Label Present: Y Company Information on ECI: Briggs & Stratton, LLC Can ECI label be removed without destroying: Y Engine Family: NJDGS.4202UA Did you obtain a photo of the ECI label: Y Evap./Perm. Family: NJDGPNHEQ003 Emission Control Devices Listed: EM Tune up Specs Listed (Y/N): Yes, on label Compliance Period (i.e., useful life): Date of MFG: 250 Hours Feb 23 Refers to user manual Displacement: 420cc Not referenced on label Type of Fuel: Notes: Compliance statement observed? (yes/no and whether exhaust, evap, both): Yes, lists US EPA, CA Exh/EVP SORE ECI label should be permanent and not removeable without being destroyed or defaced. See 40 CFR 1060.135 for more information. MY(s) in statements: Other Info on ECI: 2022 CARB EVP Family: JDGCM4202SN (as needed) Type of Equipment: Model name: VIN/ESN: Build Date: Was Part on Engine? Check Yes (Y) or No (N) Fuel Tank: PAIR: Intake Assembly/Filter: Muffler/Catalyst: Carburetor: Fuel Injector: Spark Plug: TWC: Oxygen Sensor: DOC/OC: EGR: SCR/DEF: DPF/PTOX: Throttle Body: Other (specify): Other (specify): Other (specify): Visual Inspection Notes: Visual Inspection Information Sawing Machine Crankcase Ventilation PSM031G PSM031G23040501A 2023 Observed Part Number Populate part numbers if visible. Mark "not visible" if not visible and include brand name if possible. Obtain photos of each part. Crankcase vented to atmosphere?: (4 stroke engines only, check Yes(Y) or No(N) Evaporative Checks Fuel Tank Material (Plastic/Metal): Metal Running loss line observed(Y/N)? (gasoline engines only): Are all sections of the Fuel lines marked? Fuel Line Markings (from tank to stop valve): Metal Fuel Line Markings (from stop valve to carburetor): Metal Evidence taken (indicate how it was marked): Inspector Signature: Supervisor Signature: Field Inspection Summary Date: Date: Page 2 of 2