# Part I: INTRODUCTION AND CBI INFORMATION

**CBI**

**Sector(s) If you chose "Other" as an end**  **use, please specify here. CBI**  **End-Use(s) 2. Indicate the**  **sector and end-use for which you are submitting this SNAP Information Notice. Select the appropriate box identifying the type of notice submitted (Select only one box):**  New alternative (substance, formulation or technology) not previously listed as acceptable, acceptable subject to use conditions or unacceptable under SNAP New end-use or application of substitute previously listed as acceptable, acceptable subject to use conditions or unacceptable under SNAP 

# Section B: Identification of Alternatives **1. Name of Alternative.** Note: Additional information about the proposed substitute must be provided in Part III, Section A **United States** 

## ENVIRONMENTAL PROTECTION AGENCY

**Washington, DC 20460** 

# SNA**P INFORMATION NOTICE When completed send CBI and public versions of this form and attachments electronically via CD or USB drive (preferred), or**  **print to:** Via US Postal Service: SNAP Document Control Officer

U.S. EPA Mail Code: 6205T 1200 Pennsylvania Ave, NW Washington DC 20460 Via Delivery Service: SNAP Document Control Officer

U.S. EPA Stratospheric Protection Division 4th Floor (MC 6205M) 1201 Constitution Ave., NW Washington, DC 20004 

# Part I: INTRODUCTION AND CBI INFORMATION **Section A: Introduction GENERAL INSTRUCTIONS**  This form may be used to submit information under the Significant New Alternatives Policy (SNAP) program for the review of alternatives to Class I and Class II ozone-depleting substances (ODSs) under section 612 of the Clean Air Act. Submitters are required to provide this information on new substitutes or new end-uses of existing substitutes to assist the Agency in assessing the acceptability of chemicals or processes that are considered alternatives in sectors that previously used ODSs. A separate notice must be filed for each alternative you are submitting. You may submit a single notice for multiple uses of the same alternative. If the alternative is a new chemical substance, you must submit a Premanufacturing Notice (PMN) to EPA's New Chemicals Program and the TSCA/SNAP Addendum form to SNAP. Please visit the SNAP website for instructions and frequently asked questions. Case Number: **AGENCY USE ONLY** OMB Control No.: 2060-0226 Expires: X/XX/2017 Date of Receipt:



# NOTE: Please [Bracket] the information you claim as confidential 1 of 2

# Part I: INTRODUCTION AND CBI INFORMATION

Part II: Contact Information Part III: General Information

Part VIII: Aerosols Part IX: Sterilants Part XI: Tobacco Expansion Part XIII: Attachments Part XIV: Certification Part XII: Additional Information Part X: Adhesives, Coatings & Inks Part VII: Fire Suppression



# Section C: Confidentiality Claims Anyone submitting data which are to be treated as Clean Air Act Confidential Business Information (CBI), must assert and substantiate a claim of confidentiality at the time of the initial submission. All information claimed as CBI will be treated in a manner consistent with 40 CFR Part 2, Subpart B. Failure to ass ert and substantiatea claim of confidentiality at the time of submission may result in disclosure of information by the Agency without further notice. To assert a claim on this form, [bracket] the information you claim as confidential and mark the confidential box in the column on the right-side of the corresponding row. If any information is claimed as confidential, you must substantiate those claims below and provide a “sanitized” version of this notice, including attachments, to EPA at the time of the initial submission. For any portion of a submission that you claim as confidential, the following information must be included in a Statement of Data Confidentiality Claims. • Identify specifically by page and line number(s) each portion of the document for which you claim confidentiality. • Give the reasons why the cited passage qualifies for confidential treatment. • If you assert that disclosure of this information would be likely to result in substantial harmful effects to you, describe those harmful effects and explain why they should be viewed as substantial. • Indicate the length of time - until a specific date or event, or permanently - for which the information should be treated as confidential. • Identify the measures you have taken to guard against undesired disclosure of this information. • Describe the extent to which the information has been disclosed, and what precautions have been taken in connection with these disclosures. • Enclose copies of any determinations of confidentiality previously made by EPA, other Federal agencies, or courts concerning this information. 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 evaluation of SNAP Information Notices. These Authorized Representatives may have access to any information received by the Stratospheric Protection Division within the EPA’s Office of the Atmospheric Programs. Access to such information is necessary to ensure that these companies can complete the work required by the contract. Such Authorized Representatives of the Administrator are subject to the provisions of 42 U.S.C. 7414(c) respecting confidential business information as implemented by 40 CFR 2.301(h).

**STATEMENT OF DATA CONFIDENTIALITY CLAIMS Please complete the following tabs of this submission form (click to go to each section):**  Sector Specific (please fill out the sector specific Part(s) for which you are applying): Part IV: Refrigeration and Air Conditioning Part V: Foam Blowing Part VI: Cleaning Solvents



# NOTE: Please [Bracket] the information you claim as confidential 2 of 2

## Part II: CONTACT INFORMATION

Name of Authorized Official Title CBI CBI Mailing Address Telephone Number CBI CBI

Name of Authorized Official Title CBI CBI Mailing Address Telephone Number CBI CBI Is this person granted full access to Confidential Business Information?

Name of Authorized Official Title CBI CBI Mailing Address Telephone Number CBI CBI Is this person granted full access to Confidential Business Information?

Name of Authorized Official Title CBI CBI Mailing Address Telephone Number CBI CBI Is this person granted full access to Confidential Business Information? Email Address

**CONFIDENTIALITY CLAIMS: All contacts listed on this page will be granted access to CBI, unless otherwise noted.** Email Address

**4. Joint Submitter (if applicable)**  : Identify the joint submitter, if any, who is authorized by the primary submitter to provide some of the information required in the notice. Company/Organization Email Address **2. Agent (if applicable):** Complete only if you authorize an agent to assist you in preparing this notice. The agent must also sign the certification. Company/Organization

Email Address

**3. Technical Contact (in U.S.):**If applicable, identify a person who can provide EPA with additional technical information on the substitute during the review period. If the authorized agent is also the technical contact, include that person's information in both locations. Company/Organization Company/Organization **United States** 

## ENVIRONMENTAL PROTECTION AGENCY

**Washington, DC 20460** 

# Part II: CONTACT INFORMATION **Section A: Submitter Contact Information 1. Person Submitting Notice (in U.S.):**  Enter information for the official who signs the certification in **Part XIV Certification** .



## NOTE: Please [Bracket] the information you claim as confidential 1 of 1

## Part III: GENERAL INFORMATION

(b) Percent Composition (by weight) (c) Chemical Abstracts Service (CAS) registry number (d) Molecular Formula CBI

CBI

**Patent Name Patent Number (if available)**  CBI
CBI

**(a) Impurity Chemical Name (b) Percent Composition (by weight)**  **(c) CAS registry number** CBI

**(a) Byproduct/Degradation Product**

**Chemical Name (b) Percent Composition (by weight)**  **(c) CAS registry number (d) When is product Formed?**  **(e) Amount (g) /Rate of Formation (g/s)**  CBI

CBI
CBI g/mol at 20°C °C at 1 atm. pressure °C at 1 atm. pressure at 20 °C ppm or % ppm or % °C °C
CBI (l) If you have performed chemical analysis and testing on the substitute to derive the properties, attach copies of all test reports and specify the protocol used. Supporting

documentation attached? (k) If you are extracting this information from a public reference source (e.g., CRC Handbook of Chemistry and Physics, Merck

Index), attach copies of the reference. Supporting documentation attached? (h) Bubble point (for blends) **2. Commercial/trade name(s) of alternative: 3. Generic name:**  If the name of the commercial/trade name of the proposed substitute is claimed Confidential Business Information, provide a generic name. The name should reveal the chemical identity or alternative process description to the maximum extent possible. (e) For alternative processes and technologies (e.g., Absorption Chillers, Stirling Cycle), describe the technology and provide a technical drawing and a diagram of the system as an attachment. Also provide the location and identity of any chemical constituents.

(g) Upper Flammability Limit (LFL) ( Using ASTM E681 ) (d) Boiling point (e) Specific gravity (Relative to water or air, specify ) (f) Lower Flammability Limit (LFL) ( Using ASTM E681 ) **5. Byproducts and Degradation Products:**Describe any byproducts or degradation products resulting from the manufacturer, processing, use or disposal of the chemical alternative or chemicals used in the new alternative. If there are unidentified byproducts/degradation products enter “unidentified.” Indicate when the byproduct/degradation product is formed (e.g. during manufacturing, during use, in contact with fire, etc.) and the amount or rate at which it is formed. **4. Impurities:** Identify any impurities that are reasonably anticipated to be present in the proposed substitute as manufactured for commercial purposes. If there are unidentified impurities, enter “unidentified” and estimate their total weight percentages. Do not include substances that are mixed with the proposed substitute after manufacture of the primary ingredients. **(d) Molecular Formula** (f) If you have applied for or hold a patent on the proposed substitute, provide the following: 

# Part III: GENERAL INFORMATION **1. Identify Proposed Substitute:** If a blend, provide the percent composition of each constituent by weight. **United States** 

### ENVIRONMENTAL PROTECTION AGENCY

**Washington, DC 20460**

(i) Flash point (j) Other (specify) 

## Section A - Alternative-Specific Information

**Topics Covered in Patent**

(a) Molecular weight (b) Physical state (c) Melting point **7. Physical and Chemical Properties:**Attach copies of all test reports and specify the protocol used. If submitting a blend substitute, physical and chemical properties are required for the blend. **6. Test Marketing:**Has a test marketing notification been sent to EPA?

(a) Chemical Name (preferably IUPAC nomenclature)



## NOTE: Please [Bracket] the information you claim as confidential 1 of 3

## Part III: GENERAL INFORMATION

**(a) ODP relative to CFC-11** CBI

**Supporting documentation attached?**  CBI

**Proposed Substitute (If blend, include GWP of each**  **constituent) (a) 100-year GWP**  **(Relative to carbon dioxide) (c) Atmospheric Lifetime (ATL)**  CBI

Supporting Documentation Attached? CBI
**10. VOC Status Information:** CBI
CBI

CBI

**MIR (g O 3** 

### /g VOC) **kOH value Other** 

CBI CBI

Titles of the Clean Air Act (CAA) other than Title VI Clean Water Act (CWA) Safe Drinking Water Act (SDWA) Resource Conservation and Recovery Act (RCRA) Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) **Statute Statute Citation & Explanation of Requirements**  **(b) Provide any additional data on the ODP of the proposed substitute (e.g. chlorine or bromine loading potentials).**  **8. Ozone-depletion potential (ODP):**Provide the 100-year ODP of the proposed substitute relative to CFC-11. If the substitute is a blend, provide the ODPs of the individual constituents. Reference the source for each ODP.

(b) For blends, which components, if any, are exempt from the definition of VOC at 40 CFR 51.100(s)? (a) Is the substitute exempt from the definition of volatile organic compound (VOC) under CAA regulations (see 40 CFR 51.100(s)) addressing the development of State Implementation Plans (SIPs) to attain and maintain the national ambient air quality standards?

(d) For compounds that are not VOC exempt, provide information on the reactivity of the compound(s) in the atmosphere, such as the maximum incremental reactivity in grams of O 3

### per gram of VOC and/or the kOH value. **Proposed Substitute/Component**

Toxic Substances Control Act (TSCA) Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) **12. Environmental Regulations. 9. Global Warming Characteristics:**  Provide the alternative's global warming potential relative to carbon dioxide over a 100-year time horizon and atmospheric lifetime, if known. Reference the Fourth Assessment Report of the Intergovernmental Panel on Climate Change (IPCC AR4). Alternate sources may include the 2010 World Meteorological Organization (WMO) Scientific Assessment of Ozone Depletion or the peer-reviewed literature. If the substitute is a blend, provide the GWPs of the individual constituents and an estimate of the GWP of the blend at its nominal composition. **Information Sources**

(d) If the proposed substitute or any components of a blend is captured as a byproduct of another manufacturing or industrial process, indicate the source of the alternative.

(c) Provide information on any environmental regulatory statute (such as those listed below) applicable to the manufacture, use, and disposal of the proposed substitute. (a) Is the substitute, or a component of the substitute, a hazardous air pollutant? (b) Is the substitute, or a component of the substitute, a hazardous waste under RCRA regulations? **11. Cost of Proposed Substitute (chemical or blend):** Provide an estimated cost of the substitute in US$/kg, US$/lb, or other. (c) Has a request for VOC exemption been submitted? If so, provide details below (e.g., date of submission). **(c) Reference the source of this information and attach any supporting documentation.**  **Information Sources Proposed Substitute**  **( If blend, include ODP of each constituent**  **)**

CBI

CBI



## NOTE: Please [Bracket] the information you claim as confidential 2 of 3

## Part III: GENERAL INFORMATION

CBI

**Proposed Substitute (If blend, include all constituents), Impurity, and/or** 

**Byproduct (a) Permissible Exposure Limits**  **(PELs) (b) Occupational Exposure Limits**  **(OELs) (e.g., WEEL, TLV, STEL)**  **(c) Manufacturer’s Acceptable Exposure Limits (AELs)**  **Sources** CBI

CBI

**15. Safety Documents.**Please attach a copy of any documents that will be provided to any person who is reasonably likely to be exposed, such as: CBI **(d) If available, summarize the acute and chronic toxicity of the proposed substitute and of its constituent chemicals on any organism (e.g. human and/or other mammals, fish, wildlife, and plants). Attach all complete test reports that are reasonably**  **available to you. Supporting Documentation Attached?**  Occupational Safety and Health Administration (OSHA) (e.g., TLV-TWA, Personal Protective Equipment [29 CFR 1910.132]) **13. Health and Safety Regulations** : If applicable, describe how occupational, consumer, or general population exposure to the alternative is regulated under health and safety related statutory authorities. **Statutory Authority (a) How does regulation apply? Provide CFR citation.**  Emergency Planning and Community Right to Know Act (EPCRA or SARA Title III) State and local laws Other applicable environmental federal, state, and local laws not mentioned above

**Supporting Documentation Attached?** Department of Transportation (DOT) (e.g., Vapor UN1013, Class 2.2)

**Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission must be submitted with the bracketed information redacted or removed.**  Warning Labels Other (provide name) **Safety Document 14. Toxicity Limits.**  For the proposed substitute, impurities and/or byproducts, provide permissible exposure limits (PELs), occupational exposure limits (OELs), or acceptable exposure limits (AELs) set for use in the workplace, if available.

Material Safety Data Sheet (MSDS) Hazard Warning Statement Other (e.g., Food and Drug Administration Threshold of Regulation [TOR] Exemptions) State and local laws



## NOTE: Please [Bracket] the information you claim as confidential 3 of 3

### Part IV: REFRIGERATION AND AIR CONDITIONING-SPECIFIC INFORMATION

**End-Use Application**  **(a) Mark all that apply (b) New (N) equipment, retrofit (R)**  **equipment, or both (N,R)? (c) ODS and other substances**  **being replaced (d) Replacement ratio**  **(lb: lb)** CBI Centrifugal Positive Displacement Chillers (includes Reciprocating, Screw, Scroll, Rotary Compressors) Industrial Process Refrigeration (IPR) Industrial Process Air Conditioning Ice Skating Rinks Cold Storage Warehouses Refrigerated Trailers (Reefers) Refrigerated Shipping Containers Refrigeration Equipment within Motorized Vehicle (e.g., food delivery, ice cream truck, ship hold) Remote Rack System, Direct Remote Rack System, Indirect Stand-alone Units (self-contained equipment such as individual reach-in coolers, glass door merchandisers, fountain beverage dispenser, frozen beverage dispenser, etc.) Remote Condensing Units for Walk-in Coolers or Multiple Reach-in Coolers Vending Machines Built-in Water Fountain Stand-alone Water Coolers Self-contained Ice Machines Remote Ice Machines Household Refrigerator and Freezers Small Refrigerated Household Appliances (e.g., chilled kitchendrawers, wine coolers, and minifridges) Room Air Conditioners (such as window units, packaged terminal air conditioners (PTAC) and heatpumps (PTHP), and portable selfcontained air conditioners) Mini-Splits, Non-Ducted Multi-Splits, Non-Ducted Split-Systems, Ducted, Household (Central A/C) Split-Systems, Ducted, Light Commercial (Central A/C) Packaged Rooftop Units Water-Source Air Conditioning and Heat Pumps Chillers (Commercial Comfort AC)

Refrigerated Transport

Retail Food Refrigeration

Drinking Water Coolers Commercial Ice Machines
Household Refrigerators and Freezers **United States** 

### ENVIRONMENTAL PROTECTION AGENCY

**Washington, DC 20460** 

# Part IV: REFRIGERATION AND AIR CONDITIONING-SPECIFIC INFORMATION **Section A: Refrigeration and Air-Conditioning Use Profile 1. Specific End-Use**  : Identify each end-use and specific applications (if applicable) for which you are seeking review in new and/or retrofit equipment. Identify the ODS and other alternatives used in the end-use and/or application and the quantity of proposed substitute needed to replace it for each end-use and/or application (i.e., the replacement ratio).Note: If the proposed substitute can be used both as a retrofit and in new equipment, these uses should be treated as separate end-uses throughout this form. The applications listed below are not meant to be allinclusive and do not reflect regulatory requirements. The purpose of defining these applications is to inform the Agency's understanding of how the alternative being submitted to SNAP will be used.

Residential and Light Commercial Air Conditioning and Heat Pumps



### NOTE: Please [Bracket] the information you claim as confidential 1 of 4

### Part IV: REFRIGERATION AND AIR CONDITIONING-SPECIFIC INFORMATION Ground-Source Air Conditioning and Heat Pumps Residential Dehumidifiers Light-duty Vehicles (e.g., passenger cars) Light-duty Trucks (e.g., minivans,full size pick-up trucks, and fullsize SUVs) Heavy-duty Vehicles (e.g., heavyduty pickup trucks and vans, andcommercial medium and heavyduty on-highway vehicles) Off-road Vehicles (e.g., farm and construction equipment) Buses and Passenger Rail Thermosiphon Recirculating Coolers Mechanical Heat Transfer Organic Rankine Cycle (ORC) Very Low Temperature Refrigeration Uranium Isotope Separation Processing Ice Cream Makers

CBI

**End-Use Application**  **(a) Technology changes, including material**  **compatibility issues when retrofitting**  **(b) Capital costs associated with**

**proposed substitute, alternative process, new equipment, and/or**  **new materials (c) Changes in labor and energy**  **costs (d) Ongoing operational**  **costs of equipment** CBI

**End-Use Application**  CBI

**End-Use Application**  **(a) Years until maximum market penetration**  **(c) Anticipated market share at market penetration (%)**  CBI

**End-Use Application**  CBI **4. Production**  : Provide estimated information on production of the proposed substitute or equipment using the proposed substitute by end-use and/or application.

**6. Energy Efficiency**: Provide the alternative’s impact on energy efficiency relative to the substance it is replacing in similar equipment. Attach documentation, if available. **Energy Efficiency (+/- X%) relative to substance(s) being replaced Supporting Documentation Attached?**  **(b) Maximum annual production at market penetration 5. Market Share**  : Estimate the timing for market penetration and percentage of the market that is anticipated to be captured by this proposed substitute. **(a) Year proposed substitute or technology will be available (or**

**note if currently available) (b) Anticipated first year annual production for end-use (kg)**  Motor Vehicle Air Conditioning

Non-mechanical Heat Transfer

Other (specify)
**2. Additional End-Use Description:**Please describe the specific uses for which you are applying. For example, what is the equipment layout and where is the refrigerant located? Is it a direct expansion unit and/or does it use a secondary loop? In what types of locations will the equipment be used (e.g., for refrigeration this could include supermarkets, convenience stores, and/or restaurants)? Is the equipment for low, medium, or high temperature refrigeration or air conditioning? Is air conditioning for the purpose of human comfort cooling or another application?
**3. Technology Changes and Costs** : Describe any new equipment technology changes and associated costs that will be necessary in order to use the proposed substitute. Provide information on materials compatibility (e.g., piping, refrigerant oil) and attach any available test results. Provide specific information on each different end-use and application and their associated costs, including design changes to equipment (e.g., component changes larger compressor, special safety features), changes in labor, and changes in energy costs, and ongoing operational costs.



### NOTE: Please [Bracket] the information you claim as confidential 2 of 4

### Part IV: REFRIGERATION AND AIR CONDITIONING-SPECIFIC INFORMATION

CBI

**End-Use Application**  **(a) Equipment Lifetime (years) (b) Typical charge size (kg)**  **(c) Maximum charge size (kg) (d) Equipment capacity**  **(kWh, tons)** CBI

**End-Use (e) Typical room size (m**  **3**

### ) **(f) Minimum room size (m 3** 

### ) **(g) Anticipated room air exchange rate (ACH)**  CBI

CBI

CBI atm kJ/mol °C atm CBI
CBI

CBI atm Joules **Supporting Documentation Attached?**  CBI

**Supporting Documentation Attached?**  CBI **3. Flammability Concerns and Mitigation**  : Provide any information on flammability concerns and mitigation measures. (a) Detail any abatement techniques that are used to minimize the risks associated with flammable substances or mixtures: (b) Additional information on flammability concerns and mitigation measures: (b) Maximum rate of pressure increase during combustion (Required only for refrigerants designated as ASHRAE flammability class 3 ) (c) Minimum ignition energy (MIE) **2. Flammability Assessments and Test Data.** (a) Fault Tree Analysis or Failure Mode and Effects Analysis (Required for each end-use) (b) Risk assessment for all end-uses, consumer and occupational (technician) exposure (c) Results of ASTM E681 Flammability Limits in Air (include temperature at which test was conducted in summary of results) (d) Fractionation during Leakage(Required only for blends with flammable components) **Required if flammable Summary of Results**  

### Section C: Flammability **1. Flammability-Related Physical and Chemical Properties.** Provide information on the physical and chemical properties relevant to evaluating the flammability of the proposed substitute in refrigeration and airconditioning end-uses. (a) Maximum pressure of combustion Published by ASHRAE SSPC 34. If so, provide the following information: **Substitute or Blend ASHRAE Designation**  **ASHRAE Classification** (d) Critical Pressure **2. ASHRAE Designation:** If applicable, indicate the status of submission to or publication by the ASHRAE Standing Standard Project Committee 34 (SSPC 34). Not submitted to ASHRAE SSPC 34. Submitted to ASHRAE SSPC 34, not yet published. If proposed designation and classification are available, provide below. Please also provide vapor pressure-temperature curve: **Attached?** (b) Heat of combustion (c) Critical temperature Other (i.e., International Electrochemical Commission (IEC), International Organization for Standardization (ISO)) 

### Section B: Refrigeration and Air Conditioning Physical and Chemical Properties **1. Physical and Chemical Properties** : Provide information on the physical and chemical properties relevant to evaluating the proposed substitute in refrigeration and air conditioning end-uses. (a) Vapor pressure @ 20 °C Underwriters Laboratories (UL) (e.g., UL 484, UL 250) Society of Automotive Engineers (SAE) International **Standard-Setting Organization (a) Standard Number and Title**  **(b) Status (e.g., under development, final)** American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE) (e.g., ASHRAE 15) **Application**

**9. End-Use Specific Standards:**List any standard-setting organizations (U.S. or ANSI/ISO) that have or will evaluate the proposed substitute and/or equipment in the proposed end-use(s) and identify the associated standard. **7. Refrigerant Oil** : Provide information on the chemical class of refrigerant oil you anticipate will be used (e.g., polyalkylene glycol, polyolester, mineral oil, etc.) and information on refrigerant/oil solubility.

**8. Application of Proposed Substitute** . Please provide information on the equipment lifetime, charge size, associated room size, and associated equipment size anticipated for the proposed substitute in the enduse(s) and application(s) for the proposed substitute. Note if personal monitoring data is provided in Section D: Exposure, you are not required to respond to questions (e) through (g) below.



### NOTE: Please [Bracket] the information you claim as confidential 3 of 4

### Part IV: REFRIGERATION AND AIR CONDITIONING-SPECIFIC INFORMATION

CBI

CBI

CBI **Typical Maximum**  **Typical Maximum**  hours/day hours/day ppm ppm day/year day/year % % hours/day hours/day ppm ppm day/year day/year % % hours/day hours/day ppm ppm day/year day/year % %

CBI

CBI

CBI

**Supporting Documentation Attached?**  CBI
**Supporting Documentation Attached?**  CBI
**Supporting Documentation Attached?**  CBI **6. Information on Recovery Practices: Section 608 of the Clean Air Act prohibits the intentional release (venting) of refrigerants, ozone-depleting and their substitutes, while maintaining, servicing, repairing, or disposing of air conditioning or refrigeration equipment. Please provide information below on how the substitute will be recovered.**  (a) How will the refrigerant be recovered? Please provide standards, reports, or analyses from ETL, UL, AHRI, or equivalent on refrigerant-specific servicing equipment or the feasibility of using existing refrigerant recovery/recycling equipment. (b) Please provide a description of recovery procedures (e.g., recover and recharge or recover and send to reclaimer).
(c) Indicate the anticipated recovery efficiency of the refrigerant (percent of charge). Is supporting documentation (e.g., personal monitoring data) attached? **5. Exposure during Use of Equipment** (a) Identify and explain the activity during which end-user exposure to the proposed substitute is expected to be the highest (e.g., operational leaks). **4. Provide information on training materials related to manufacture, installation and servicing, and disposal. If the proposed substitute is flammable, describe how these guidelines differ from training for non-flammable refrigerants.**  Are any training materials attached? (b) Installation and servicing (c) Disposal

CBI **Typical Maximum**  ppm ppm % %(b) Identify who is most likely to be exposed to the substitute at the enduse (e.g., consumers, workers)? (c) Estimate the typical and maximum annual leak rates from the equipment, in terms of (1) ppm and/or (2) percent of charge. **Scenario Typical Number of Pieces**  **Maximum Number of Pieces** (a) Manufacture and charging of equipment (b) Installation and servicing (e.g., connecting and disconnecting refrigerant lines) (c) Disposal (e.g., connecting and disconnecting refrigerant lines) **Is supporting documentation (e.g., personal monitoring data) attached? 3. Estimate typical and maximum number of pieces of equipment a worker would (a) manufacture and/or charge, (b) install and/or service, and (c) dispose per day.**  **2. Identify and explain the activities, duration of activities, and typical and maximum exposure concentrations in which worker exposure to the proposed substitute is expected to be the highest for each scenario in (a) through (c).** 

**Scenario Identify activities with typical**  **and maximum potential for exposure**  **Duration of Activity Exposure Concentration**  (a) Manufacture and charging of equipment (e.g., filling) (d) Identify engineering controls used to reduce or prevent releases to the environment (e.g., safety valves, gas scrubbers). (e) Identify the contact pathway (e.g., ingestion, inhalation, dermal). (f) Describe any protective equipment and engineering controls used to protect workers (e.g., goggles, gloves, chemical hoods). **1. Exposure Media and Release Information** (a) Identify the media(s) to which the proposed substitute is released (e.g., indoor air, outdoor air, water, land). (b) Indicate the physical form of chemicals at the time of handling/exposure (e.g., solid, liquid, gas). (c) If releases occur outdoors (e.g., outdoor air, water, land), provide information or estimates of the magnitude of release (ppm or percent of charge). 

### Section D: Exposure

**Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission must be submitted with the bracketed information redacted or removed.**  

### NOTE: Please [Bracket] the information you claim as confidential 4 of 4

### Part V: FOAM BLOWING-SPECIFIC INFORMATION

**End-Use (a) Mark all that apply**  CBI Rigid Polyurethane: Appliance Rigid Polyurethane: Spray Rigid Polyurethane: Commercial Refrigeration Rigid Polyurethane: Sandwich Panels Rigid Polyurethane: Slabstock and Other Rigid Polyurethane & Polyisocyanurate Laminated Boardstock Flexible Polyurethane Integral Skin Polyurethane Polystyrene: Extruded Sheet Polystyrene: Extruded Boardstock & Billet Polyolefin Phenolic Insulation Board & Bunstock Other (specify)
CBI

**End-Use (b) Capital costs associated with**  **proposed substitute, alternative process, new equipment, and/or**  **new materials (c) Changes in labor and energy costs**  **(d) Ongoing operational costs** CBI

**End-Use (a) Year proposed substitute or**  **technology will be available (or note if currently available)**  **(b) Anticipated first year annual production for end-use (kg)**  **(c) Years until maximum market penetration**  **(d) Maximum annual production at market penetration**  **(e) Anticipated market share at market penetration (%)**  CBI

**End-Use** CBI

**6. Application of Proposed Substitute** . Please provide information on the amount of blowing agent, associated room size, and anticipated room air exchange rate for the proposed substitute in the proposed end-use(s). Note: If personal monitoring data is provided in Section D: Exposure, you are not required to respond to questions (c) through (e) below. **5. Energy Efficiency**: Provide the alternative’s impact on energy efficiency relative to the substance it is replacing in similar products. Attach documentation, if available. **(a) Energy efficiency (+/- X%) relative to substance(s) being replaced (b) Source of Information**  **3. Technology Changes and Costs:**Describe any new equipment technology changes and associated costs that will be necessary in order to use the proposed substitute. **2. Additional End-Use Description:**Please describe the specific uses for which you are applying. For example, what type of material will be blown? What method or type of equipment is used for foam blowing? Who will be using the foam blowing agent/equipment? Will the foam blowing agent be used by consumers or restricted to commercial use? For spray foams, how many components are used? Will the alternative be used in high or low pressure spray foam?

**4. Production and Market Share** : Provide estimated information on production of the proposed substitute by end-use. If possible, estimate the percentage of the market held by the ODS being replaced that will be captured by this proposed substitute. **(a) Technology changes to use alternative United States**  

### ENVIRONMENTAL PROTECTION AGENCY

**Washington, DC 20460** 

## Part V: FOAM BLOWING-SPECIFIC INFORMATION **Section A: Foam Blowing Use Profile 1. Specific End-Use**  : Identify each end-use that may be reasonably anticipated for the alternative. Identify the ODS and other alternatives used in the end-use and/or application and the quantity of proposed substitute needed to replace it for each end-use and/or application (i.e., the replacement ratio). Note: If more than one end-use if listed, consider each end-use separately throughout application. **(b) ODS and other substances being replaced (c) Replacement ratio (lb: lb)** 



### NOTE: Please [Bracket] the information you claim as confidential 1 of 3

### Part V: FOAM BLOWING-SPECIFIC INFORMATION

**End-Use (a) Typical amount of blowing agent**  **(kg) (b) Maximum amount of blowing**  **agent (kg) (c) Typical room size**  **(m 3** **) (d) Minimum room size**  **(m 3** **) (e) Anticipated room air**  **exchange rate (ACH)** CBI

CBI atm W/m·K **Supporting Documentation Attached?**  CBI

CBI kJ/mol °C ppm or % CBI
CBI

**Scenario Identify activities with typical and**  **maximum potential for exposure** CBI (a) Manufacture ppm (b) End-Use (e.g., in products containing and processes using the proposed substitute) ppm (c) Disposal ppm CBI

CBI

**Typical Maximum**  **Typical Maximum** 

hours/day hours/day ppm ppm day/year day/year % % hours/day hours/day ppm ppm day/year day/year % % hours/day hours/day ppm ppm day/year day/year % %
(a) Is the proposed substitute is expected to be used in the spray foam end-use? CBI (b) If your answer to (a) is yes, please identify and explain potential worker exposure to the proposed substitute during application of the blowing agent (e.g., onsite, field). (c) Is consumer use of the spray foam (e.g., do-it-yourself spray foam cans) expected? If yes, please answer questions (e) and (f). (a) Manufacture and charging of equipment (e.g., preparation of foam formulations, injecting foam into appliances)

(c) Disposal of foam blowing agent **Is supporting documentation (e.g., personal monitoring data) attached? 3. Application of Spray Foam (If Applicable)**  **2. Identify and explain the activities, duration of activities, and typical and maximum exposure concentrations in which worker exposure to the proposed substitute is expected to be the highest for each scenario in (a), (b), and (c). If monitoring data is available, please provide it as an attachment.** 

**Scenario Identify activities with typical and**  **maximum potential for exposure Duration of Activity**  **Exposure Concentration**

(b) Manufacture of foam product/foam blowing CBI (f) Indicate the physical form of chemicals at the time of handling/exposure (e.g., solid, liquid, gas). (g) Identify the contact pathway (e.g., ingestion, inhalation, dermal). (h) Describe any protective equipment and engineering controls used to protect workers (e.g., goggles, gloves, chemical hoods). (d) Identify engineering controls used to reduce or prevent releases to the environment (e.g., safety valves, gas scrubbers). (e) If the proposed substitute is to be disposed of, indicate the method and location of disposal. 

### Section D: Exposure **1. Exposure Media and Release Information Identify the media(s) to which the proposed substitute is released**  **(e.g., indoor air, outdoor air, water, land) in each scenario below. Provide the estimated amount of each component in foam blowing agent**  **released to the environment (e.g., as a solid waste or wastewater effluent)**

**at the point of, or subsequent to, each scenario below.** (b) Additional Analyses (optional) **3. Flammability Concerns and Mitigation** : Provide any information on flammability concerns and mitigation measures. (a) Detail any abatement techniques that are used to minimize the risks associated with flammable substances or mixtures: (c) Additional information on flammability concerns and mitigation measures: (a) Results of ASTM E681 for Flammability Limits in Air (Required if substitute is flammable)

(b) For flammable foam blowing agents used in spray foam, provide a training program that addresses flammability concerns **Attached?** (b) Auto ignition temperature (c) For blowing agent blends containing flammable components, indicate the concentrations at which the blend is flammable **2. Flammability Assessments and Test Data. 2. Manufacture and Degradation Products.** Provide information on the catalyst used in the manufacture of foam blowing agent and the degradation products under different external conditions (e.g., temperature) during use to assess potential hazards of breakdown/degradation products of foam during use. Attach supporting documentation.
**Section C: Flammability 1. Flammability-Related Physical and Chemical Properties.**  Provide information on the physical and chemical properties relevant to evaluating the flammability of the proposed substitute in foam blowing end-uses. (a) Heat of combustion 

### Section B: Foam Blowing Agent Physical and Chemical Properties **1. Physical and Chemical Properties**: Provide information on the physical and chemical properties relevant to evaluating the proposed substitute in foam blowing end-uses. (a) Vapor pressure @ 20 °C (b) Thermal conductivity



### NOTE: Please [Bracket] the information you claim as confidential 2 of 3

### Part V: FOAM BLOWING-SPECIFIC INFORMATION

CBI
CBI

CBI **Typical Maximum** 
CBI



### Section E: Additional Information for Submission of Blends of Foam Blowing Agents Blends of different foam blowing agents may also require additional information, depending on the end-use. **1. For the following end-uses, a submission is required for blends of blowing agents, including blends with blowing agents that are already listed as acceptable:**  • Polyolefin • Polystyrene: Extruded Boardstock and Billet • Rigid Polyurethane and Polyisocyanurate Laminated Boardstock • Rigid Polyurethane: Spray Foam* • Phenolic Insulation Board and Bunstock *For spray foam, if any components of the blend are flammable, then an additional submission is required for the blend. **2. For the following end-uses, it is permissible to blend blowing agents that are already listed as acceptable without an additional submission for the blend:** • Rigid Polyurethane: Appliance • Rigid Polyurethane: Commercial Refrigeration • Rigid Polyurethane: Sandwich Panels • Rigid Polyurethane: Spray Foam* • Rigid Polyurethane: Slabstock and Other • Flexible Polyurethane • Integral Skin Polyurethane • Polystyrene: Extruded Sheet *For spray foam, if all components of the blend are acceptable and non-flammable, then it is permissible to blend those blowing agents without an additional submission for the blend. (d) Identify control measures used to reduce or prevent end-user exposures. (e) For each end-use, provide maximum annual emission rates for blowing agent leaks from foam application during the foam's lifetime (i.e., after manufacturing and before disposal) as a percentage of the original total amount of blowing agent used to produce the foam. Please also specify the anticipated number of years for which the blowing agent would be leaking from the foam (i.e., the emissive lifetime). For reference, please refer to EPA's standard annual emission rates listed in the Instructions. CBI (b) Identify who is anticipated to be exposed to the substitute at the end-use (e.g., consumers, workers)? (c) Provide (1) typical and (2) maximum exposure concentration estimates (ppm). If monitoring data is available, please provide it as an attachment. CBI **Supporting Documentation Attached?** ppm ppm

**End-Use Annual Emission Rate**  **Emissive Lifetime of Foam (years)** (b) Provide information on training materials related to spray foam applications. If the proposed substitute is flammable, describe how these guidelines differ from training for non-flammable foam blowing agents. Are any training materials attached? **5. Exposure during Use** (a) Identify and explain the activity during use of blowing agent in which end-user exposure to the proposed substitute is expected to be the highest (e.g., rigid cell foams used in residential construction or insulation). Is supporting documentation (e.g., personal monitoring data) attached? **4. Training Materials** (a) Provide information on training materials related to manufacture, installation and servicing, and disposal. If the proposed substitute is flammable, describe how these guidelines differ from training for non-flammable foam blowing agents. Are any training materials attached? CBI **Typical Maximum**  ppm ppm (d) Please describe the application system for the consumer (e.g., size of system/container and amount of foam blowing agent in system/container). (e) Estimate the typical and maximum concentrations of consumer exposure (ppm). If monitoring data is available, please provide it as an attachment.

**Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission must be submitted with the bracketed information redacted or removed.** 



### NOTE: Please [Bracket] the information you claim as confidential 3 of 3

### Part VI: CLEANING SOLVENT-SPECIFIC INFORMATION

**End-Use (a) Mark all that apply**  **(c) Replacement Ratio (lb: lb)**  **(d) Open or closed process?** CBI Metal cleaning Electronics cleaning Precision cleaning
CBI

**End-Use (b) Capital costs associated with**  **proposed substitute, alternative process, new equipment, and/or**  **new materials (c) Changes in labor and**  **energy costs (d) Ongoing operational**  **costs** CBI

**End-Use (a) Year proposed substitute or**  **technology will be available (or note if currently available)**  **(b) Anticipated first year annual production for end-use (kg)**  **(c) Years until maximum market penetration**  **(d) Maximum annual production at market**  **penetration (e) Anticipated market**  **share at market penetration (%)**  CBI

CBI

CBI g/L

atm Pa·s specify units

CBI kJ/mol CBI (a) Heat of combustion **2. Flammability Concerns and Mitigation** : Provide any information on flammability concerns and mitigation measures. (a) Detail any abatement techniques that are used to minimize the risks associated with flammable substances or mixtures: (b) Additional information on flammability concerns and mitigation measures: 

### Section D: Exposure **1. Exposure Media and Release Information** (b) Odor Threshold (c) Dissociation Constant (d) Volatilization from soil

**1. Flammability-Related Physical and Chemical Properties.** Provide information on the physical and chemical properties relevant to evaluating the flammability of the proposed substitute in solvent cleaning enduses. (e) Volatilization from water (f) pH (g) Vapor pressure @ 20 °C (h) Viscosity (i) Henry's Law constant 

### Section C: Flammability **4. Production and Market Share** : Provide estimated information on production of the proposed substitute by end-use. If possible, estimate the percentage of the market held by the ODS being replaced that will be captured by this proposed substitute.

(a) Solubility 

### Section B: Cleaning Solvent-Specific Physical and Chemical Properties **1. Physical and Chemical Properties** : Provide information on the physical and chemical properties relevant to evaluating the proposed substitute in solvent cleaning end-uses. **United States** 

### ENVIRONMENTAL PROTECTION AGENCY

**Washington, DC 20460** 

# Part VI: CLEANING SOLVENT-SPECIFIC INFORMATION **Section A: Cleaning Solvent Use Profile 1. Specific End-Use**  : Identify each end-use for which you are seeking review. Identify the ODS and other alternatives used in the end-use or application and the quantity of proposed substitute needed to replace it for each end use (i.e., the replacement ratio). **(b) ODS and Other Substances Being Replaced**

**2. Additional End-Use Description:**Please describe the specific uses for which you are applying. For example, what type of work pieces will be cleaned? What type of equipment will be used to perform cleaning (e.g., open top vapor degreaser, vacuum sealed equipment, conveyorized equipment)? Where will the cleaning occur (e.g., commercial or industrial setting)? Please note that this end-use does not include manual cleaning or textile cleaning.

**5. Compatibility**: Provide information on and address any issues with materials compatibility of the proposed substitute with metals and plastic with regards to its use as a cleaning solvent (e.g., is the solvent corrosive to some materials). **3. Technology Changes and Costs:** Describe any new equipment ortechnology changes and associated costs that will be necessary in order to use the proposed substitute. **(a) Technology Changes to Use Alternative**



### NOTE: Please [Bracket] the information you claim as confidential 1 of 2

### Part VI: CLEANING SOLVENT-SPECIFIC INFORMATION

CBI

CBI

**Typical Maximum**  **Typical Maximum** 

hours/day hours/day ppm ppm day/year day/year % % hours/day hours/day ppm ppm day/year day/year % %

CBI CBI (a) End-Use (e.g., during removal of cleaned work pieces from an open-top degreasing unit) (b) Disposal (e.g., removing spent solvent from degreaser) Is supporting documentation (e.g., personal monitoring data) attached? **3. Describe disposal practices of used solvent (e.g., solvent collected and sent to a wastewater treatment facility, solvent collected and incinerated, recycling). 4. Provide information on training materials related to use and disposal.**  **Are any training materials attached?** (c) Provide the anticipated room air exchange rate (as air changes per hour [ACH]) during use and disposal of the substitute. CBI (d) Identify engineering controls used to reduce or prevent releases to the environment (e.g., safety valves, gas scrubbers). (e) Identify the contact pathway (e.g., ingestion, inhalation, dermal). (f) Describe any protective equipment and engineering controls used to protect workers (e.g., goggles, gloves, chemical hoods). **2. Identify and explain the activities, duration of activities, and typical and maximum exposure concentrations in which worker exposure to the proposed substitute is expected to be the highest for each scenario in (a) through (b).** 

**Scenario Identify activities with typical and**  **maximum potential for exposure Duration of activity**  **Exposure Concentration** (a) Identify the media(s) to which the proposed substitute is released (e.g., indoor air, outdoor air, water, land). (b) Indicate the physical form of chemicals at the time of handling/exposure (e.g., solid, liquid, gas). (c) If releases occur outdoors (e.g., outdoor air, water, land), provide information or estimates of the magnitude of release (ppm).

**Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission must be submitted with the bracketed information redacted or removed.** 



### NOTE: Please [Bracket] the information you claim as confidential 2 of 2

### Part VII: FIRE SUPPRESSION AND EXPLOSION PROTECTION-SPECIFIC INFORMATION

**End-Use Application**  **(a) Mark all that apply (b) ODS and other substances**  **being replaced (c) Weight and volume**  **equivalence replacement ratio**

**(lb: lb)** Note: Calculate using method described in Instruction Manual CBI Normally Occupied Areas Normally Unoccupied Areas Streaming Applications CBI

**End-Use Application**  **(b) Capital costs associated with proposed substitute or**  **alternative process (c) Changes in labor**  **and energy costs (d) Ongoing** 

**operational costs** CBI

**End-Use Application**  **(a) Year proposed substitute or technology will be available (or note**  **if currently available) (b) Anticipated first year**  **annual production for end-use**

**(kg) (c) Years until maximum market**  **penetration (d) Maximum annual**  **production at market penetration**  **(e) Anticipated**

**market share at market penetration**  **(%)** CBI

**End-Use Application**  **(a) Typical charge size (kg) (b) Maximum charge size (kg)**  **(c) Typical room size (m 3** **) (d) Minimum room size**  **(m 3** **) (e) Anticipated room** 

**air exchange rate (ACH)**  CBI

CBI

CBI atm kJ/mol J/K Pa·s g/m 3 g/m 3
CBI (f) Extinguishing Concentration ( Total flooding agents; use either a cup burner in heptane or full scale testing ) (g) Design Concentration (Total flooding and gaseous agents; provide design concentration as defined by NFPA and actual (if it is likely to be higher) based on manufacturer recommendations) **2. Degradation Products.** Provide information on the degradation products of the alternative following discharge in a fire situation. Explain the conditions used in determining these products (e.g., flame temperature, time required to extinguish the fire, amount of O 2present, combustible material). (c) Vapor Heat Capacity (d) Viscosity (e) Particle Size Distribution (only applies to non-gaseous agents) 

### Section B: Fire Suppression Agent Physical and Chemical Properties **1. Physical and Chemical Properties** : Provide information on the physical and chemical properties relevant to evaluating the proposed substitute in fire suppression end-uses. (a) Vapor pressure @ 20 °C (b) Heat of vaporization Other (e.g., International Maritime Organization (IMO), Federal Aviation Administration/International Civil Aviation Organization (FAA/ICAO)) **2. Additional End-Use Description:**Please describe the specific uses for which you are applying. For example, what is the method of distribution (e.g., localized, sprinkler system, handheld, gaseous)? Is it a clean agent? Is the agent aerosolized? Where will the fire suppression system be installed (e.g., marine, aviation, data center)? Where will handheld extinguishers be intended for use (e.g., residential, commercial, aviation)?

**4. Production and Market Share:**Provide estimated information on production of the proposed substitute by end-use. If possible, estimate the percentage of the market held by the ODS being replaced that will be captured by this proposed substitute.

**5. Application of Proposed Substitute** . Please provide information on the charge size, associated room size, and anticipated room air exchange rate for the proposed substitute in the end-use(s) specified. Note: If personal monitoring data is provided in Section D: Exposure, you are not required to respond to questions (c) through (e) below.

**6. End-Use Specific Standards:**Identify any standards set by standard-setting organizations (U.S. or ANSI/ISO) or requirements set by other organizations (e.g., IMO, FAA/ICAO) that will evaluate the proposed substitute and/or equipment in the proposed end-use(s). **(a) Standard Number and Title (b) Status (e.g., under development, final)**  **United States** 

### ENVIRONMENTAL PROTECTION AGENCY

**Washington, DC 20460** 

## Part VII: FIRE SUPPRESSION AND EXPLOSION PROTECTION-SPECIFIC INFORMATION **Section A: Fire Suppression Use Profile 1. Specific End-Use:** Identify each end-use and application (if applicable) for which you are seeking review and provide the requested information. Note: If more than one end-use if listed, consider each end-use separately throughout application.

Underwriters Laboratories (UL) (e.g., UL 711) National Fire Protection Association (NFPA) (e.g., NFPA 2010) Other (e.g., International Organization for Standardization (ISO)) **Organization 3. Technology Changes and Costs:** Describe any new equipment and associated technology changes and costs that will be necessary in order to use the proposed substitute. **(a) Technology changes to use alternative and address material**

**compatibility issues when retrofitting (d) Purpose of space in which the extinguisher**  **will be used (e.g., engine room, machinery space, cargo** 

**room)** Total Flooding Agents



### NOTE: Please [Bracket] the information you claim as confidential 1 of 3

### Part VII: FIRE SUPPRESSION AND EXPLOSION PROTECTION-SPECIFIC INFORMATION

CBI

CBI

CBI

CBI

(c) Identify the discharge rate (g/s) of the fire extinguishing device. CBI

CBI

CBI

(e) Identify the contact pathway (e.g., ingestion, inhalation, dermal). CBI

**Typical Maximum**  **Typical Maximum**  hours/day hours/day ppm ppm day/year day/year % % hours/day hours/day ppm ppm day/year day/year % %

CBI

CBI **3. Provide information on training materials related to manufacture of the proposed substitute and/or fire suppression equipment and installation and servicing of fire suppression equipment.**  **Are any training materials attached?**
**4. Exposure during Use of Equipment** (a) Identify and explain the activity in which end-user exposure to the proposed substitute is expected to be the highest (e.g., discharge of fire suppression agent). CBI (a) Manufacture and charging of equipment (e.g., assembly of generators) (b) Installation and servicing (e.g., accidental discharge during servicing of fire suppression equipment) **Is supporting documentation (e.g., personal monitoring data) attached? 2. Identify and explain the activities, duration of activities, and typical and maximum exposure concentrations in which worker exposure to the proposed substitute and/or associated equipment is expected to be the**  **highest for each scenario in (a) and (b). Scenario**  **Identify activities with typical and maximum potential for exposure**  **Duration of Activity Exposure Concentration**  (d) Identify engineering controls used to reduce or prevent releases to the environment (e.g., safety valves, gas scrubbers). (g) Describe any protective measures taken to limit worker exposure (e.g., ventilation, detection system). 

### Section D: Exposure (a) Identify the media(s) to which the proposed substitute is released (e.g., indoor air, outdoor air, water, land). (b) Indicate the physical form of pre- and post-activation products at the time of handling/exposure (e.g., solid, liquid, gas). (c) If releases occur outdoors (e.g., outdoor air, water, land), provide information or estimates of the magnitude of release (ppm or percent of charge).
(f) Describe any protective equipment and engineering controls used to protect workers (e.g., goggles, gloves, chemical hoods). **1. Exposure Media and Release Information** (e) Identify the settling rate of the particles, the mass median aerodynamic diameter (MMAD) (μm) and concentration (mg/m3) of the effluent released from the nozzle. (f) Provide the composition of flooding agent before and after discharge, including the amounts and weight percentages of all effluent gases and particulates that may not be filtered. (g) Identify the maximum egress time for personnel from the space and several approaches to facilitate safe egress (e.g., training, installation guidelines). Ocular irritation studies (Draize test) Dermal irritation study (powdered aerosols ) **5. Powdered Aerosol Flooding Agents Used in Occupied Spaces** . Provide the following additional information regarding the use of powdered aerosol flooding agents in occupied spaces which requires special considerations of the physical properties and toxicity of the agent and visibility in the protected space. (a) Identify the likelihood that the fire extinguisher will accidentally discharge (reported as the number of accidental discharges in 1 million). (b) Identify the number of extinguishing devices (i.e., generators) installed in a room and the location of these devices within the space. (d) Identify the length of time it takes for the particles to become distributed throughout the space and the particle size distribution over time. **4. Not-in-kind Halon Alternatives (Powdered Aerosols or Foam).**Provide the following additional information for foam streaming agents or powdered aerosol flooding agent used in occupied spaces. **Additional Information Attached?**  Acute toxicity inhalation study with rats ( foam streaming agent ) Static Acute toxicity inhalation study with rats at design application density (powdered aerosol flooding agent ) **3. In-kind Halon Alternatives (Halocarbons).**Provide the following additional information for halocarbon steaming agents or flooding agents used in occupied spaces. **Additional Information Attached?**  Cardiac Sensitization Study Acute, sub-acute, and subchronic toxicity inhalation studies with rats in addition to those already listed in Section C, Number 1. **2. Genotoxicity Studies** : Provide genotoxicity studies (e.g., Ames assays, forward mutation assays, cytogenetic assays) to determine the potential for the agent to induce DNA damage. **Genotoxicity Study Name Attached?**  

### Section C: Fire Suppression Agent Toxicity and Hazard Information **1. Inhalation Toxicity Studies** : Provide an inhalation toxicity study at least 28 days long if a) workers are exposed to the chemicals during manufacture or b) 8-hr TWA exposure levels have not been determined by OSHA, NIOSH, ACGIH, or AIHA. For reference, please refer to the list of recommended toxicity tests for this sector in the Instructions. **Inhalation Toxicity Study Name Attached?** 



### NOTE: Please [Bracket] the information you claim as confidential 2 of 3

### Part VII: FIRE SUPPRESSION AND EXPLOSION PROTECTION-SPECIFIC INFORMATION

ppm or % (b) Identify who is anticipated to be exposed to the substitute at the end-use (e.g., consumers, workers)? (c) Provide (1) typical and (2) maximum exposure concentration estimates (ppm). If monitoring data is available, please provide it as an attachment. CBI **Typical**

**Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission must be submitted with the bracketed information redacted or removed.**  Is supporting documentation (e.g., personal monitoring data) attached? **Maximum** ppm or %



### NOTE: Please [Bracket] the information you claim as confidential 3 of 3

### Part VIII: AEROSOLS-SPECIFIC INFORMATION

**End-Use Application**  **(b) Mark all that apply (d) Replacement Ratio**  **(lb: lb)** CBI Consumer Technical Medical Consumer Technical Medical CBI

**End-Use Application**  **(a) Technology changes, including material compatibility issues**  **(b) Capital costs associated with proposed substitute, alternative**  **process, new equipment, and/or new materials**  **(c) Changes in labor and energy costs.**  **(d) Ongoing operational costs** CBI

**End-Use Application**  CBI

**End-Use Application**  **(a) Years until maximum market penetration**  **(c) Anticipated market share at market penetration (%)**  CBI

**End-Use Application**  **(a) Typical amount of substitute per can (g)**  **(b) Maximum amount of substitute per can (g)**  **(c) Typical total weight of aerosol can (g)**  **(d) Maximum total weight of aerosol can (g)**  CBI

CBI

CBI

CBI g/L Pa s atm **4. Production**  : Provide estimated information on production of the proposed substitute or equipment using the proposed substitute by end-use. **(a) Year proposed substitute or technology will be available (or note if currently available)**  **(b) Anticipated first year annual production for end-use (kg)**

**(c) ODS and other substances being replaced** Propellants

(c) Vapor pressure @ 20 °C (a) Solubility (b) Viscosity **5. Market Share** : If possible, estimate the percentage of the market that is anticipated to be captured by this proposed substitute. **(b) Maximum annual production at market penetration United States**  

### ENVIRONMENTAL PROTECTION AGENCY

**Washington, DC 20460** 

# Part VIII: AEROSOLS-SPECIFIC INFORMATION **Section A: Aerosol Use Profile 1. Specific End-Use**  : Identify each end-use and application that may be reasonably anticipated for the alternative. Identify the ODS and other alternatives used in the end-use or application and the quantity of proposed substitute needed to replace it for each end use (i.e., the replacement ratio).

**2. Additional End-Use Description:**Please describe the specific uses for which you are applying. For example, in what type of products will the substitute be used (e.g., personal care, automotive, electrical contact cleaner, degreaser, medical adhesive spray, MDI)? **3. Technology Changes and Costs** : Describe any new equipment technology changes and associated costs that will be necessary in order to use the proposed substitute. Solvents

**6. Application of Proposed Substitute**. Please provide information on the amount of the substitute to be used per can and associated aerosols can size anticipated for the proposed substitute in each proposed end-use.



### Section B: Aerosol-Specific Physical and Chemical Properties **1. Physical and Chemical Properties** : Provide information on the physical and chemical properties relevant to evaluating the proposed substitute in aerosol end-uses. **7. Consumer Use** : Please indicate whether the proposed substitute will be used for consumer use. If yes, describe the anticipated consumer applications.

**8. End-Use Specific Standards:**List any standard-setting organizations (U.S. or ANSI/ISO) that have or will evaluate the proposed substitute and/or equipment in the proposed end-use(s) and identify the associated standard. **Standard-Setting Organization (a) Standard Number and Title**  **(b) Status (e.g., under development, final)**

Please also provide vapor pressure-temperature curve ( for aerosol propellants ): Attached?



### NOTE: Please [Bracket] the information you claim as confidential 1 of 2

### Part VIII: AEROSOLS-SPECIFIC INFORMATION

specify units

CBI kJ/mol °C atm ppm or % CBI

CBI
CBI

**Typical Maximum**  **Typical Maximum** 

hours/day hours/day ppm ppm day/year day/year % % hours/day hours/day ppm ppm day/year day/year % % hours/day hours/day ppm ppm day/year day/year % %
CBI (b) Use of aerosol product

CBI grams/sec grams/sec ppm ppm % % CBI
CBI **5. For aerosol solvents (e.g., degreasers, flux removers), describe disposal practices of used solvent (e.g., solvent co llected and sent to incinerator** **, recycling). 6. Provide information on training materials related to manufacture and filling and disposal of aerosol cans. If the proposed substitute is flammable,**  **describe how these guidelines differ from training for non-flammable aerosols.** Are any training materials attached? (a) Manufacture and filling of aerosol cans (c) Disposal
(a) Estimate the typical and maximum delivery rate for the aerosol product, in terms of grams/second (b) Estimate the typical and maximum release rates in terms of (1) ppm and/or (2) percent of aerosol can. **4. Estimate typical and maximum (a) delivery rate and (b) release rate for the aerosol can. Scenario**  **Typical Maximum number of cans per day**  (c) Disposal (e.g., collection of spent aerosol solvent) Is supporting documentation (e.g., personal monitoring data) attached? **3. Estimate typical and maximum number of aerosol cans a worker would (a) manufacture and/or fill, (b) use, and (c) dispose per day. Scenario**  **Typical number of cans per day Maximum number of cans per day**  **2. Identify and explain the activities, duration of activities, and typical and maximum exposure concentrations in which worker exposure to the proposed substitute is expected to be the highest for each scenario in (a) through (c).**  **Scenario Identify activities with typical and**  **maximum potential for exposure Duration of Activity**  **Exposure Concentration** (a) Manufacture and filling of aerosol cans (e.g., filling cans) (b) Use of aerosol product (c) Critical Pressure

(d) Identify engineering controls used to reduce or prevent releases to the environment (e.g., safety valves, gas scrubbers). (e) Identify the contact pathway (e.g., ingestion, inhalation, dermal). (f) Describe any protective equipment and engineering controls used to protect workers (e.g., goggles, gloves, chemical hoods). 

### Section D: Exposure **1. Exposure Media and Release Information** (a) Identify the media(s) to which the proposed substitute is released (e.g., indoor air, outdoor air, water, land). (b) Indicate the physical form of chemicals at the time of handling/exposure (e.g., solid, liquid, gas). (c) If releases occur outdoors (e.g., outdoor air, water, land), provide information or estimates of the magnitude of release (ppm).

**Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission must be submitted with the bracketed information redacted or removed.**  CBI (d) Odor Threshold (h) pH (f) Volatilization from soil (g) Volatilization from water (e) Dissociation Constant

(d) Explosive Range (LEL/UEL) **2. Flammability Concerns and Mitigation** : Provide any information on flammability concerns and mitigation measures. (a) Detail any abatement techniques that are used to minimize the risks associated with flammable substances or mixtures: (i) Henry's Law constant 

### Section C: Flammability **1. Flammability-Related Physical and Chemical Properties.** Provide information on the physical and chemical properties relevant to evaluating the flammability of the proposed substitute in aerosol end-uses.

(b) Additional information on flammability concerns and mitigation measures: (a) Heat of combustion (b) Critical temperature



### NOTE: Please [Bracket] the information you claim as confidential 2 of 2

### Part IX: STERILANTS-SPECIFIC INFORMATION

**End-Use** CBI Sterilant CBI

**End-Use (b) Capital costs associated with**  **proposed substitute, alternative process, new equipment, and/or**  **new materials (c) Changes in labor and**  **energy costs (d) Ongoing operational costs**  CBI

**End-Use (a) Year proposed substitute or**  **technology will be available (or note if currently available)**  **(b) Anticipated first year annual production for end-use (kg)**  **(c) Years until maximum market penetration**  **(d) Maximum annual production at market**  **penetration (e) Anticipated market share**  **at market penetration (%)** CBI

**End-Use** CBI

CBI g/L

CBI atm kJ/mol ppm or % CBI

CBI

CBI (d) Identify engineering controls used to reduce or prevent releases to the environment (e.g., safety valves, gas scrubbers). (e) Identify the contact pathway (e.g., ingestion, inhalation, dermal). (f) Describe any protective equipment and engineering controls used to protect workers (e.g., goggles, gloves, chemical hoods). (b) Additional information on flammability concerns and mitigation measures: 

### Section D: Exposure **1. Exposure Media and Release Information** (a) Identify the media(s) to which the proposed substitute is released (e.g., indoor air, outdoor air, water, land). (b) Indicate the physical form of chemicals at the time of handling/exposure (e.g., solid, liquid, gas). (c) If releases occur outdoors (e.g., outdoor air, water, land), provide information or estimates of the magnitude of release (ppm or percent of charge). (c) Explosive range (LEL/UEL) **2. Flammability Concerns and Mitigation** : Provide any information on flammability concerns and mitigation measures. (a) Detail any abatement techniques that are used to minimize the risks associated with flammable substances or mixtures: (a) Solubility **5. Application of Proposed Substitute**. Please provide information on the application of the substitute in the proposed end-use(s). **3. Technology Changes and Costs** : Describe any new equipment and use profiles and associated costs that will be necessary in order to use the proposed substitute. **(a) Technology changes to use alternative**

**4. Production and Market Share** : Provide estimated information on production of the proposed substitute by end-use. If possible, estimate the percentage of the market held by the ODS being replaced that will be captured by this proposed substitute.

**(a) Provide information on the leak-tightness of the equipment (e.g., maximum and typical leak rate of equipment)**  **1. Specific End-Use** : Identify the ODS and other alternatives used in the end-use or application and the quantity of proposed substitute needed to replace it for each end use (i.e., the replacement ratio). **United States** 

### ENVIRONMENTAL PROTECTION AGENCY

**Washington, DC 20460** 

# Part IX: STERILANTS-SPECIFIC INFORMATION **Section A: Sterilants Use Profile**
**(a) ODS and other substances being replaced (b) Replacement Ratio (lb: lb)** 
**2. Additional End-Use Description:** Please describe the specific uses for which you are applying. For example, provide information on how the sterilant is applied (e.g., sterilization chambers)?



### Section B: Sterilant-Specific Physical and Chemical Properties **1. Physical and Chemical Properties** : Provide information on the physical and chemical properties relevant to evaluating the proposed substitute in sterilization. **(b) Anticipated room air exchange rate (ACH)**



### Section C: Flammability **1. Flammability-Related Physical and Chemical Properties.** Provide information on the physical and chemical properties relevant to evaluating the flammability of the proposed substitute when used in sterilization. (a) Vapor pressure @ 20 °C (b) Heat of combustion



### NOTE: Please [Bracket] the information you claim as confidential 1 of 2

### Part IX: STERILANTS-SPECIFIC INFORMATION

CBI

**Typical Maximum**  **Typical Maximum** 

hours/day hours/day ppm ppm day/year day/year % % hours/day hours/day ppm ppm day/year day/year % % hours/day hours/day ppm ppm day/year day/year % %

CBI (a) Provide information on training materials related to manufacture and disposal. If the proposed substitute is flammable, describe how these guidelines differ from training for non-flammable sterliants. Are any training materials attached? **3. Training Materials** (g) Describe disposal practices of used sterilant (e.g., sterilant collected and sent to a wastewater treatment facility, recycling). **2. Identify and explain the activities, duration of activities, and typical and maximum exposure concentrations in which worker exposure to the proposed substitute is expected to be the highest for each scenario in (a) through (c).**  **Scenario Identify activities with typical and**  **maximum potential for exposure Duration of Activity**  **Exposure Concentration** (a) Manufacture and charging of equipment (e.g., filling) (c) Disposal (e.g., of sterilant or associated equipment containing the sterilant) Is supporting documentation (e.g., personal monitoring data) attached?

**Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission must be submitted with the bracketed information redacted or removed.**  CBI
(b) Use of sterilant or associated equipment containing steriliant



### NOTE: Please [Bracket] the information you claim as confidential 2 of 2

### Part X: ADHESIVES, COATINGS, AND INKS-SPECIFIC INFORMATION

**End-Use** CBI Adhesives Coatings Inks CBI

**End-Use (b) Capital costs associated with**  **proposed substitute, alternative process, new equipment, and/or**  **new materials (c) Changes in labor and**  **energy costs. (d) Ongoing Operational costs**  CBI

**End-Use (a) Year proposed substitute or**  **technology will be available (or note if currently available)**  **(b) Anticipated first year annual production for end-use (kg)**  **(c) Years until maximum market penetration**  **(d) Maximum annual production at market**  **penetration (e) Anticipated market share**  **at market penetration (%)** CBI

**(a) Typical amount per dispenser (g or %)**  **(b) Maximum amount per dispenser (g or %)**  **(c) Typical total weight of dispenser (g)**  **(d) Maximum total weight of dispenser (g)**  CBI

CBI

CBI g/L

atm Pa·s specify units

CBI atm kJ/mol (a) Vapor pressure @ 20°C (b) Heat of combustion (h) Viscosity (i) Henry's Law constant 

### Section C: Flammability **1. Flammability-Related Physical and Chemical Properties.** Provide information on the physical and chemical properties relevant to evaluating the flammability of the proposed substitute in adhesives, coatings, and inks end-uses. (f) pH (g) Vapor pressure @ 20 °C (b) Odor Threshold (c) Dissociation Constant (d) Volatilization from soil (e) Volatilization from water **(a) ODS and Other Substances Being Replaced (b) Replacement Ratio (lb: lb)**  **United States** 

### ENVIRONMENTAL PROTECTION AGENCY

**Washington, DC 20460** 

# Part X: ADHESIVES, COATINGS, AND INKS-SPECIFIC INFORMATION **Section A: Adhesives, Coatings, and Inks Use Profile** 1.**Specific End-Use** : Identify each end-use that may be reasonably anticipated for the alternative. Identify the ODS and other alternatives used in the end-use or application and the quantity of proposed substitute needed to replace it for each end use (i.e., the replacement ratio).

**2. Additional End-Use Description:**Please describe the specific use for which you are applying. For example, in what type of products will the substitute be used for adhesives (e.g., laminate, hardwood flooring, flexible foam, tire patch, metal to rubber, marine); coatings (e.g., metal coatings, wood stains, aerospace coating), or inks (e.g., flexographic printing, ratogravure printing)? What is the application method (e.g., spray gun, aerosol can, dip tank)?

**4. Production and Market Share** : Provide estimated information on production of the proposed substitute by end-use. If possible, estimate the percentage of the market held by the ODS being replaced that will be captured by this proposed substitute.

**5. Application of Proposed Substitute**. Please provide information on the charge size and associated dispenser size (i.e., total weight of contents) anticipated for the proposed substitute in the proposed end-use(s). **End-Use 3. Technology Changes and Costs:** Describe any new equipment technology changes and associated costs that will be necessary in order to use the proposed substitute. **(a) Technology Changes to Use Alternative and Address Material**

**Compatibility Issues**



### Section B: Adhesives, Coatings, and Inks-Specific Physical and Chemical Properties **1. Physical and Chemical Properties** : Provide information on the physical and chemical properties relevant to evaluating the proposed substitute in adhesives, coatings, and inks end-uses. (a) Solubility **6. Consumer Use** : Please indicate whether the proposed substitute will be used for consumer use. If yes, describe the anticipated consumer applications.



### NOTE: Please [Bracket] the information you claim as confidential 1 of 2

### Part X: ADHESIVES, COATINGS, AND INKS-SPECIFIC INFORMATION
% or ppm CBI

CBI

CBI

CBI **Typical Maximum**  **Typical Maximum** 

hours/day hours/day ppm ppm day/year day/year % % hours/day hours/day ppm ppm day/year day/year % % hours/day hours/day ppm ppm day/year day/year % %

CBI

CBI grams/sec grams/sec ppm ppm % % CBI **5. Provide information on training materials related to manufacture/filling and disposal of adhesives, coatings, and inks.** Are any training materials attached? (a) Manufacture and filling (c) Disposal (a) Estimate the typical and maximum delivery rate for the dispenser product, in terms of grams/second **4. Estimate typical and maximum (a) delivery rate and (b) release rate for the adhesives, coatings, and inks dispenser. Scenario**  **Typical Maximum number of cans per day**  (b) Estimate the typical and maximum release rates in terms of (1) ppm and/or (2) percent of dispenser. (c) Disposal (e.g., disposing of spent dispensers) Is supporting documentation (e.g., personal monitoring data) attached? **3. Estimate typical and maximum number of adhesives, coatings, and inks dispensers a worker would (a) manufacture and/or fill, (b) use, and (c) dispose per day. Scenario**  **Typical number of products per day Maximum number of products per day**  (b) Use of adhesives, coatings, and inks product **2. Identify and explain the activities, duration of activities, and typical and maximum exposure concentrations in which exposure to the proposed substitute is expected to be the highest for each scenario in (a) through (c).**  **Scenario Identify activities with typical and**  **maximum potential for exposure Duration of Activity**  **Exposure Concentration** (a) Manufacture and filling of dispensers (e.g., filling dispensers) (d) Identify engineering controls used to reduce or prevent releases to the environment (e.g., safety valves, gas scrubbers). (e) Identify the contact pathway (e.g., ingestion, inhalation, dermal). (f) Describe any protective equipment and engineering controls used to protect workers (e.g., goggles, gloves, chemical hoods). **1. Exposure Media and Release Information** (a) Identify the media(s) to which the proposed substitute is released (e.g., indoor air, outdoor air, water, land). (b) Indicate the physical form of chemicals at the time of handling/exposure (e.g., solid, liquid, gas). (c) If releases occur outdoors (e.g., outdoor air, water, land), provide information or estimates of the magnitude of release (ppm or percent of dispenser). **2. Flammability Concerns and Mitigation** : Provide any information on flammability concerns and mitigation measures. (a) Detail any abatement techniques that are used to minimize the risks associated with flammable substances or mixtures: (b) Additional information on flammability concerns and mitigation measures: 

### Section D: Exposure (c) Explosive Range (LEL/UEL)

**Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission must be submitted with the bracketed information redacted or removed.**  (b) Use of adhesives, coatings, and inks product



### NOTE: Please [Bracket] the information you claim as confidential 2 of 2

## Part XI: TOBACCO EXPANSION-SPECIFIC INFORMATION
**United States** 

## ENVIRONMENTA**L PROTECTION A GENCY** 

**Washington, DC 20460** 

# Part XI: TOBACCO EXPANSION-SPECIFIC INFORMATION **No additional information is needed for this sector.**



## NOTE: Please [Bracket] the information you claim as confidential 1 of 1

# Part XII: ADDITIONAL INFORMATION

**Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission must be submitted with the bracketed information redacted or removed.**  **United States** 

## ENVIRONMENTA**L PROTECTION A GENCY** 

**Washington, DC 20460** 

# Part XII: ADDITIONAL INFORMATION **Please provide any additional information in this section.** 



# NOTE: Please [Bracket] the information you claim as confidential 1 of 1

# Part XIII: ATTACHMENTS

**# Attachment Name/Citation**  **Associated Section of Information Notice (Part/Section/Question)**  **Number of Pages CBI**  **United States** 

## ENVIRONMENTAL PROTECTION AGENCY

**Washington, DC 20460** 

# Part XIII: ATTACHMENTS Identify attachments below. Select (X) in the CBI box next to any attachment that contains information you claim as confidential. The public version of the submission form must include the attachment name/citation at a minimum. All claims of confidentiality must be substantiated in Part I.

**Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission must be submitted with the bracketed information redacted or removed.** 



# NOTE: Please [Bracket] the information you claim as confidential 1 of 1

## Part XIV: CERTIFICATION



# Part XIV: CERTIFICATION

**Signature of Authorized Official (Original Signature Required): Date**  **Print Name and Title of Authorized Official: Date**  **Signature of Agent (Where Applicable):**  **Date Print Name and Title of Authorized Official:**  **Date United States**  

## ENVIRONMENTA**L PROTECTION A GENCY** 

**Washington, DC 20460**
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 named 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.



## A printed copy of this signature page, with original signature, must be submitted with CD or paper submission.



## Note: Please [Bracket] the information you wish to claim as confidential 1 of 1