Ministerstvo dopravy Ćeskó republiky

Ministry of Transport of the Czech Republic

NóbieŹi L'Svobody 12, 11015 Praha 1, Czech Republic

OSVEDCENI o: COMMUN ICATION concerning:

UDELENi HOMOLOGACE APPROVAL GRANTED

RozŚinENi HoMotoG^eE APPROVAT EXTENNED
€DMiTN!Ęil{oMot€|€ĄcE ĄPPRoVAt REFUsED
oDEJMlLFlł{€Motoc^€E ĄPPRoVĄt W|THDRĄWN
UKoNĆENi VYRoBY PRODUCTION DEFI N ITETY DISEONTINUED

typu komponenĘ cNG podle Piedpisu ć. 110.00

of a type of GNG component pursuant to Regulation No. 110.00

Homologace Ć.:
Approval No.: 110 R-00 6300

1. Uvażovanó komponenta CNG:

CNG component considered d...:.
-'.'.__:.'''-'._...,

l' .i." ,,
1,1

Nódrż(e) nebe tlakevó(ó) lóhev(e) / Gentainer(s) er eylinder(s)

ii"
.'
rl'
\,,t,
\;;,.:
'

..'.
-,,,-.
-.--

ltąg

e triggered)
Ruónf ventil / Manual valve
ines

Elektreniekó iidieijednetka / Eleetrenie eentrel unit

Tlakovf(ó) a teplotni snimać(e) / Pressure and temperature sensor(s)
ffi
Pietlakevć zaiizenl (inieievanó tlakem) / Pressure relief deviee (pressure triggered)

2. obchodni nłzev nebo znaĆka:

Trade name or mark: LPGTECH

t yp: PTS-01
type:
3. Nózev a adresa vfrobce: LPGTECH Sp. Z o.o.
Manufacturer's name and address: ul. Dojnowska 67
15-557 Bialystok
Poland

4. Nózev a adresa zóstupce vyrobce

(pokud jsou potiebnó):
lf applicable, name and address N/A
of manufacturer's representative.

Piedlożeno k homologaci dne:

Submitted for approval on: 8 September 20l'l

6. Homologaćni zkuśebna: E8/G: TUV SUD Czech s.r.o.

Technical service responsible Novodvorskń 994/138
for conducting approval tests: 1422'l Praha 4
Czech Republic
7. Datum protokolu, vydanóho touto zkuśebnou:
Date of repoń issued by that service: 14 November 2011

8. Ćislo protokolu, vydanóho touto zkuśebnou:

Number of repoń issued by that service: 120969-11-TAC

9. HoMoLoGAcE UDELENA l gBlvlirrrlutł l RozŚlfur',ln l oocruutł

APPROVAL IS GRANTED /,REFUSED / EXTENDED / WITHDRAWN

10. D0vod(y) pro rozśiienihomologace:

Reason(s) for extension : ń

11. Misto:
Place: Praha

12. Datum:
Date: 16 November 2011

13. Podpis:
Signature:

14. Dokumentaci k tóto żódosti o homologaci nebo rozśiienl homologace lze obdżet na vyżódóni.
The documents filed with the application or extension of approval authority can be obtained
upon request.

E81t0R-006300 pages 4 I page2

 Piiloha 28 - Doplnók
Annex 28 - Addendum

1. Doplńujici informace tlkajici se typovó homologace typu komponenty CNG dle Piedpisu Ć. 1 10
Additional information concerning the type approval of a type of CNG components pursuant
to Regulation No. 110

1.1 Nódż(e) nebo tlakovó(ć) lóhev(e):

Container(s) or cylinder(s) : N/A

1.2 Ukazateltlaku:
Pressure indicator: N/A

1.3 Pietlakovfventil(odpouśtóciventil):
Pressure relief valve (discharge valve): ń
1.4 Automatickli(e)ventil(y):
Automatic valve(s): N/A

1.5 Piepadovf ventil:

Excess flow valve: ń
1.6 Plynotósnó skiiń:
Gasłight housing: N/A

1.7 Regulótor(y)tlaku:
Pressure regulator(s): *
1.8 Zpótnó(ó) klapka(y) nebo zpótnV(e) ventil(y):
Check valve(s) or non-return valve(s): N/A

1.9 Pietlakovózaiizeni(iniciovanóteplotou):
Pressure relief device (temperature triggered): N/A

1.10 Ruóniventil:
Manualvalve: ń
1.11 ohebnó vedeni paliva:
Flexible fuel lines: N/A

1.12 Plnicijednotka nebo plnici hrdlo:

Filling unit or receptacle: *o
1.13 Smóśovaćplyn / vzduch (vstiikovaće):
Gas / air mixer (injectors): N/A

1.'l4 NastavovaĆ prfitoku plynu:

Gas flow adjustor: ń
1.15 SmóŚovaĆ plyn / vzduch (karburótor):
Gas / air mixer (carburettor): N/A

E8 110R-006300 pages4/page3
1.16 Elektronicki iidici jednotka (palivo CNG):
Electronic control unit (CNG-fuelling): N/A

1.17 Tlakovf(ó) a teplotni snimać(e):

Pressure and temperature sensor(s):
1.17.1 Pracovni tlak(y):
1/

450 kPa
1/
Working pressure(s):

1.17.2 Materiól: Viz dokumentace virobce.

Material: See manufacturer's documentation.

1.'tB Filtr(y) CNG:

CNG filter(s): N/A

1.'t 9 Pietlakovó zaYizeni (iniciovanó tlakem):

Pressure relief device (pressure triggered): N/A

Urćete toleranci.
Specify the tolerance.

E8110R-006300 pages4lpage4