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Illinois Environmental Protection Agency

"Green Environment, Green Energy, and Green Economics for a Green Illinois"
Pat Quinn, Governor  









ILLINOIS GREEN FLEET DESIGNATION SURVEY

If you prefer to fax or mail your application, click here for an Adobe Acrobat version of the form. You can get the free Acrobat Reader software here.
Fleet Name
Address
City Zip Code
Contact Person Phone

 

1. Please indicate how many alternative fuel vehicles (AFVs) are currently in your fleet by fuel-type:
85% Ethanol (E-85)
Propane
Biodiesel
Natural Gas
Electricity
Note: Only count a vehicle as an AFV if it uses the indicated clean, alternative fuel at least 20% of the time.


2. The number of AFVs that are dedicated vehicles (use a clean, alternative fuel 100% of the time).


3. Use of Alternative Fuel Infrastructure (check all that apply)
Our fleet has its own alternative fuel site (private refueling).
Our fleet uses retail alternative fuel sites (public refueling).
Our fleet uses another fleet's alternative fuel site.
Our fleet's commitment resulted in the implementation of new public retail alternative fuel infrastructure (briefly explain).

Our fleet shares its alternative fuel site with one or more other fleets
(please identify other fleets that use your fuel site).

Our fleet makes its alternative fuel site available to the general public.

4. The average percentage of refueling in which clean, alternative fuels are used in your AFVs as compared with using gasoline or diesel (in bi-fuel or flexible-fuel vehicles). Dedicated vehicles should be counted as 100% towards the average. Check the range representing the average percentage of "fill-ups" where clean, alternative fuels are used in your AFVs.

75-100%
50-74%
25-49%
less than 25%

5. Please provide the volume of alternative fuels used in your AFVs during the past year (e.g., gallons, therms).

6. The number of AFVs acquired or converted during the past year:

7. The total number of conventional gasoline or diesel vehicles currently in your fleet that is based or domiciled where the AFVs are located:

8. The number of conventional gasoline or diesel vehicles from #7 above that are over 12,000 lbs. GVWR, are assigned to employees and do not routinely return to the fleet location, or travel routes and distances such that they are often away from the primary fleet location.

9. The number of conventional gasoline or diesel vehicles acquired during the past year that is based or domiciled where the AFVs are located:

10. The number of conventional gasoline or diesel vehicles in your fleet from #9 above (acquired during the past year) that are over 12,000 lbs. GVWR, are assigned to employees and do not routinely return to the fleet location, or travel routes and distances such that they are often away from the primary fleet location.

11. Do you have any incentives, promotional or educational campaigns where your organization provides information to the employees on alternative fuels, encourage employees to purchase an AFV for their personal vehicle, to use alternative fuels at a nearby retail site, or allow employees to refuel their personal vehicles at your alternative fuel site?

If yes, please briefly explain below or in attachment:


12. Please provide a concise overview of future AFV plans and your organization's commitment in using clean, alternative fuels (provide attachment if needed).

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