+-----------------------------------------------------+----------------+
| ![](media/image1.wmf){width="1.3in"                 | **[AGENCY USE  |
| height="0.30277777777777776in"}                     | ONLY]          |
|                                                     | {.underline}** |
| **United States**                                   |                |
|                                                     | OMB Control    |
| **ENVIRONMENTAL PROTECTION AGENCY**                 | No.: 2060-0226 |
|                                                     |                |
| **Washington, DC 20460**                            | Expires:       |
|                                                     | 06/30/2011     |
+-----------------------------------------------------+----------------+
| **TSCA/SNAP ADDENDUM**                              | Date of        |
|                                                     | Receipt:       |
| **for Significant New Alternatives**                |                |
+-----------------------------------------------------+----------------+
| When completed send this form via U.S. mail to: Or  | Date 90 Day    |
| via overnight delivery to:                          | Review Begins: |
|                                                     |                |
| SNAP Document Control Officer SNAP Document Control | Date Review    |
| Officer                                             | Completed:     |
|                                                     |                |
| Office of Air and Radiation, 6205 J U.S. EPA        | PMN Document   |
|                                                     | Control Number |
| U.S. EPA 1310 L St, NW                              |                |
|                                                     |                |
| 1200 Pennsylvania Ave, NW 10^th^ Floor (MC 6205J)   |                |
|                                                     |                |
| Washington, DC 20460 Washington, DC 20005           |                |
+-----------------------------------------------------+----------------+
| Enter the total number of pages in your SNAP        | SNAP Document  |
| information Notice:                                 | Control No.    |
+-----------------------------------------------------+----------------+
| **INTRODUCTION**                                    |                |
+-----------------------------------------------------+----------------+
| GENERAL INSTRUCTIONS                                |                |
|                                                     |                |
| This form may be used in conjunction with the       |                |
| Premanufacture Notice for new chemical substances   |                |
| (EPA Form 7710-25 (Rev. 1-19)) to submit chemicals  |                |
| for review under the Significant New Alternatives   |                |
| Policy program as alternatives to Class I and II    |                |
| ozone-depleting substances. In addition to the      |                |
| information provided in the Premanufacture Notice,  |                |
| the Agency is requesting submitters provide         |                |
| information on the following topics. This           |                |
| information will assist EPA in assessing the        |                |
| acceptability of the chemical as an alternative to  |                |
| ozone-depleting substances as required by Section   |                |
| 612 of the Clean Air Act. Please see the Guidance   |                |
| Manual for additional information on overlap        |                |
| between the SNAP and TSCA PMN programs and on       |                |
| completing this form.                               |                |
|                                                     |                |
| To facilitate Agency review of alternatives, both   |                |
| this form and the complete Premanufacture Notice    |                |
| form (including the physical and chemical           |                |
| properties worksheet) must be filled out as         |                |
| completely as possible. Please provide all          |                |
| information requested to the extent that it is      |                |
| known or reasonably ascertainable. Make reasonable  |                |
| estimates if actual data are unavailable.           |                |
|                                                     |                |
| All submissions must be provided in three complete  |                |
| copies. If information is to be claimed as          |                |
| confidential, all confidential information must be  |                |
| excised from one of the copies which will be placed |                |
| in the public file; the other two copies must       |                |
| include the confidential material. If no claims of  |                |
| confidentiality are made for the submission, all    |                |
| copies must be identical.                           |                |
|                                                     |                |
| Anyone submitting information must assert a claim   |                |
| of confidentiality at the time of submission for    |                |
| any data which is to be treated as Confidential     |                |
| Business Information (CBI). Substantiation of this  |                |
| claim must also be provided at this time. All       |                |
| information claimed as CBI will be treated in a     |                |
| manner consistent with 40 CFR Part 2, Subpart B.    |                |
| Failure to assert a claim of confidentiality at the |                |
| time of submission may result in disclosure of the  |                |
| information by the Agency without further notice.   |                |
|                                                     |                |
| Information submitted as CBI may be accessed by     |                |
| companies designated as Authorized Representatives  |                |
| of the United States Environmental Protection       |                |
| Agency (EPA) under an EPA contract for the purpose  |                |
| of assisting EPA in the development and             |                |
| implementation of national regulations for the      |                |
| protection of stratospheric ozone, including the    |                |
| development of the SNAP program. These Authorized   |                |
| Representatives may have access to any information  |                |
| received by the Stratospheric Protection Division   |                |
| within the EPA Office of Atmospheric Programs for   |                |
| use in reviewing the need for possible control of   |                |
| any substance, practice, process or activity that   |                |
| may reasonably be anticipated to affect             |                |
| stratospheric ozone. In general, this information   |                |
| will pertain to the feasibility, costs, and         |                |
| environmental and health impacts of using           |                |
| substitutes for Class I and Class II substances.    |                |
| Access to such information is necessary to ensure   |                |
| that these companies can complete the work required |                |
| by the contract.                                    |                |
|                                                     |                |
| Authorized Representatives of the Administrator are |                |
| subject to the provision of 42 U.S.C. 7414(c)       |                |
| regarding confidential business information as      |                |
| implemented by 40 CFR 2.301(h)                      |                |
+-----------------------------------------------------+----------------+

+-----------------------------------------------------------------------+
| **Part I - GENERAL INFORMATION**                                      |
+-----------------------------------------------------------------------+
| Section A - SUBMITTER IDENTIFICATION                                  |
+-----------------------------------------------------------------------+
| **1. (a) Person Submitting Notice (in U.S.)**                         |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Name of Authorized Official Title                                     |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Company/Organization                                                  |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Mailing Address Telephone & Fax Numbers                               |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Email Address                                                         |
+-----------------------------------------------------------------------+
| **(b) Agent (if applicable)**                                         |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Name of Authorized Official Title                                     |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Company/Organization                                                  |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Mailing Address Telephone & Fax Numbers                               |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Email Address                                                         |
+-----------------------------------------------------------------------+
| **(c) Joint Submitter (if applicable)**                               |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Name of Authorized Official Title                                     |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Company/Organization                                                  |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Mailing Address Telephone & Fax Numbers                               |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Email Address                                                         |
+-----------------------------------------------------------------------+
| **2. Technical Contact (in U.S.)**                                    |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Name of Authorized Official Title                                     |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Company/Organization                                                  |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Mailing Address Telephone & Fax Numbers                               |
|                                                                       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| Email Address                                                         |
+-----------------------------------------------------------------------+
| **3. If you have had a prior communication with EPA concerning this   |
| notice, note the date and type of communication (letter, phone, etc.) |
| and the EPA staff person's name:**                                    |
|                                                                       |
| Mark (X) if None \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                    |
+-----------------------------------------------------------------------+

Mark (X) this box if this page contains CBI \_\_\_\_\_\_\_\_\_\_

+-----------------------------------------------------------------------+
| **Part II - ALTERNATIVE-SPECIFIC INFORMATION**                        |
+-----------------------------------------------------------------------+
| 1\. Name of chemical (preferably IUPAC nomenclature) and molecular    |
| formula.                                                              |
+-----------------------------------------------------------------------+
| 2\. Generic name (if chemical name of substitute is declared          |
| Confidential Business Information)                                    |
+-----------------------------------------------------------------------+
| 3\. End-uses and ozone-depleting substances (ODSs) being replaced:    |
|                                                                       |
| \(a\) Describe each industrial sector and end-use that may be         |
| reasonably anticipated for the alternative.                           |
|                                                                       |
| \(b\) Identify the ODS and the quantity of substitute needed to       |
| replace it for each end-use (replacement ratio).                      |
+-----------------------------------------------------------------------+
| 4\. Ozone-depleting Potential (ODP):                                  |
|                                                                       |
| \(a\) Provide the alternative's 100-year ODP relative to CFC-11,      |
| known.                                                                |
|                                                                       |
| \(b\) Provide source of ODP or any additional data on the ODP of the  |
| alternative (e.g. atmospheric lifetime, chlorine or bromine loading   |
| potentials). Reference the source of this information and attach any  |
| supporting documentation.                                             |
+-----------------------------------------------------------------------+

Mark (X) this box if this page contains CBI \_\_\_\_\_\_\_\_\_\_

+-----------------------------------------------------------------------+
| **Part II - ALTERNATIVE-SPECIFIC INFORMATION (Continued)**            |
+-----------------------------------------------------------------------+
| 5\. Global-warming Characteristics                                    |
|                                                                       |
| \(a\) Provide the alternative's GWP relative to carbon dioxide over   |
| 100- and 500- year time horizon, if known.                            |
|                                                                       |
| \(b\) If known, provide the alternative's expected impact on energy   |
| efficiency relative to the ODS it is replacing (e.g. +/- X%). Also    |
| include results of any testing or modeling done (both theoretical and |
| actual testing).                                                      |
|                                                                       |
| \(c\) Provide source of GWP or any additional data on the GWP of the  |
| alternative, such as the atmospheric lifetime, infrared absorption    |
| spectrum, and infrared absorption capacity.                           |
+-----------------------------------------------------------------------+
| 6\. Flammability Concerns:                                            |
|                                                                       |
| \(a\) Provide the alternative's flash point, the upper and lower      |
| flammability limits (UFL & LFL) in percent by volume, the heat of     |
| combustion kJ/kg), maximum pressure (PSI), and maximum rate of        |
| pressure rise.                                                        |
|                                                                       |
| \(b\) Provide any additional information on flammability concerns.    |
| For example, if any abatement techniques are being used to minimize   |
| the risks associated with flammable substances or mixtures, detail    |
| those techniques below.                                               |
+-----------------------------------------------------------------------+
| 7\. Cost of Alternative:                                              |
|                                                                       |
| \(a\) Estimate the cost per pound for the alternative chemical. What  |
| information was used as the basis for this cost estimate?             |
|                                                                       |
| \(b\) Describe any new equipment and use profiles. If retrofitting of |
| existing equipment is required, detail changes in technologies needed |
| to use the alternative and address any materials compatibility        |
| issues. Provide information on any new materials, equipment lifetime, |
| changes in labor, and energy costs.                                   |
+-----------------------------------------------------------------------+

Mark (X) this box if this page contains CBI \_\_\_\_\_\_\_\_\_\_

  ------------------------------------------- ------------ ---------- -----
  **Part IV - LIST OF ATTACHMENTS**                                   

  List below any attachments that complete                            
  the responses to the questions on this form                         
  or that provide additional information that                         
  may assist EPA's review of the alternative                          
  under Section 612 of the Clean Air Act.                             
  Also, provide citation for information                              
  already submitted to EPA as part of past                            
  regulatory and information activities, as                           
  well as for other information that could                            
  not be included with this submission. If                            
  you have attached continuation pages,                               
  describe the Part, Section and question                             
  number being continued. Attach additional                           
  pages if necessary.                                                 

  Attachment Name                             Question \#  Number of  CBI
                                                           Pages      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      
  ------------------------------------------- ------------ ---------- -----

Mark (X) this box if this page contains CBI \_\_\_\_\_\_\_\_\_\_

+-----------------------------------------------------------------------+
| **Part V - CERTIFICATION**                                            |
+-----------------------------------------------------------------------+
| I certify to the best of my knowledge and belief that:                |
|                                                                       |
| 1\. All information provided in this notice is complete and truthful  |
| as of the date of the submission.                                     |
|                                                                       |
| 2\. I am submitting with this notice all test data in my possession   |
| or control and a description of all other data known to or reasonably |
| ascertainable by me.                                                  |
|                                                                       |
| 3\. If this is a submission of a new alternative, the company name in |
| Part I, Question 1a of this notice:                                   |
|                                                                       |
| \(a\) intends to manufacture, formulate, import, market, or use a new |
| alternative to a Class I or Class II ozone-depleting substance which  |
| is identified in Part I, Section B, Question 2.                       |
|                                                                       |
| \(b\) seeks an acceptability determination on a new alternative(s) to |
| a Class I or Class II ozone-depleting substance, which is identified  |
| in Part I, Section B, Question 2.                                     |
|                                                                       |
| 4\. The accuracy of the statements made in this notice reflects my    |
| best prediction of the anticipated facts regarding the alternative    |
| described herein. Any knowing and willful misinterpretation is        |
| subject to criminal penalty pursuant to section 113(c) of the Clean   |
| Air Act and 18 U.S.C.§1001.                                           |
+-----------------------------------------------------------------------+
| **Signature and Title of Authorized Official (Original Signature      |
| Required): Date**                                                     |
+-----------------------------------------------------------------------+
| **Signature of Agent (Where Applicable): Date**                       |
+-----------------------------------------------------------------------+

+-----------------------------------------------------------------------+
| For persons filing a SNAP Information Notice, the reporting burden is |
| estimated to average 150 hours per year. For persons filing a         |
| TSCA/SNAP Addendum, the reporting burden is estimated to average 46   |
| hours her year. Burden means that total time, or financial resources  |
| expended by persons to generate, maintain, retain, or disclose or     |
| provide information to or for a Federal agency. This includes the     |
| time needed to review instruction; develop, acquire, install, and     |
| utilize technology and systems for the purposes of collecting,        |
| validating, and verifying information; adjust the existing ways to    |
| comply with any previously applicable instructions and requirements;  |
| train personnel to be able to respond to a collection of information; |
| search data sources; complete and review the collection of            |
| information; and transmit or otherwise disclose the information. An   |
| agency may not conduct or sponsor, and a person is not required to    |
| respond to, a collection of information unless it displays a          |
| currently valid OMB control number.                                   |
|                                                                       |
| Send comments on the Agency's need for this information, the accuracy |
| of the provided burden estimates, and any suggested methods for       |
| minimizing respondent burden, including through the use of automated  |
| collection techniques to the U.S. Environmental Protection Agency,    |
| Attn: Director, Collection Strategies Division, Office of Information |
| Collection, 1200 Pennsylvania Avenue, NW, Mail Code 2822T, Washington |
| DC, 20460. Please include the EPA Docket ID Number OAR-2004-0077 and  |
| OMB Control Number 2060-0226 in any correspondence. Do not send the   |
| completed form to this address.                                       |
+-----------------------------------------------------------------------+