,,' 

r~ , r')_t :'!t<, 

'fA-tJl'n 1:;f?V 

Fom APPt'l:!ved. O.M.B. No. 2071).0)12. Apprcml Expins 10-31 

U. AGENCY USE ONLY S. ENVIRONMENTAL PROTECTION AGENCY 

ft EDI\ PREMANUFACTURE o rl'\ NOTICE 

FOR NEW CHEMICAL SUBSTANCES 

\\'I1l'1l DOCUMENT CONTROL OFFICER 

(Ilmplt'h'd OFFICE OF POLLtrrION PREVENTION Company Sanitized 

"l's,,1 thi, AND TOXIC SUBSTANCES, 7401 

!llrl11 III U.s. E.P.A. 401 M STREET, SW 

WASHINGTON D.C. 20460 

• .-1011 ucerl.aln.-1ole by yo•. MaI<c ._a.-ble eati••CII If)'oa 

Enler the tolal number of pages 


in the Premanufacture Notice 


·Yo..."at pl'OYldoe alliafomu.loa l'eq"ate;!1a \Jil' fo... 10 ,,,. ""1",,llh. It I, 0..-10 or _ 


not h ..... .\Ct.... dll&&. 


•Befon: YOIl complelel"l11 fOnD, )'OOI,hollld ,ud lIIe "IIuIn:dioa' MMII'" (Of Pran..nufact.... Noliflcatlo." (the InalrvCllo ..Ma:n"aI hi .vallable mill the Todc 5..1111.... _ Conlrol Act mCA) I.formatlon Service b)' allln,2111.S!S+-lt04, or lula, 2111-554-5603). 

·If .. _ ,.. h... b...a n.lIle;! few Ill'" "011,,, ("0 CFIl1OOAsl, iJI<Ilcale '" I.he bo_.abaft the Thserfee l4ea.tlfkatlo" ._ber),0. haYe ,lSIen\e4. 

R_e..... ),011' IIMr fft JD ....ber malt aIIo appe.u on }'Oar cOll'Hpo"d1n, fee ·teDIl.....cr. wllld!. .. ant 10: liPA. HQ Accoualla, Opaatlon,.....dI IPM·26 I, 

P.a. ~·Plt..b~h.. PI. 151511399, AItft. TSCA Ute. fee. 

p,art 1-CEJ:fERALINfORMA TION 

Yo......1P"IMde Ihe CUllfttl)' CDrrect Ch_k.aJ Al>llradt.(CA) N..... of the 

,,_,dI_lcaI,..bltlncr. _II,.. daialheld..Uty ... _fleI""U.1. yo" ....)' 

a",llIodze aaotllJ'porioa to , .. &.,11 dl_lcalldeaUfy lalonftillloil 1MYO", hI 

yovu.blld...loa will NIt lie complete aM u.. review wU\.ot lies'" ...IU 'EPA 

reotlv.. ljIIa.."'fil...alion. A Idler la ••,,....of you..1;......10. tho..leI 

rdefttltc 10llrTS ...... fceldlftllftcatloa ...ber. Yo.....,,,,b..11 "" ort,l"aI 

"',,' two cOpl. of Ihll.otlce IlId.ell"S alit_ dAi. 1f)'Oll dai.......,)' 

lalomatloa IICDftftdeat\aI, .. Ii"11e AIIlliud "'py ..... Uo bellllb..llted. 

Part ll- HUMAN El(I'OSURE AND ENVIRONMENTAL REUASE 

If Ihue ate sen.... 1II.1ll1l1factllrR, proca.lna.0' lite o""rallo.llo be elftalbe4 I. 


P.art II. sod/O.I A an4 BoftlllI MIla. reproel .. ", Ih. _10... at "ted.cI. 


Part m - UST OfATTACliMENTS 

Attach adclUIOft,,] ,heeta If Ihen I, aot oo.,lIap_to antWer a ql1..II011 full),. 


l.-bd aell CDnlla...IlOII th_wllh \Ji. CDI'IBPO"''''S Mdloll lIudlAl- I" Part 


nI.11at theM MtaclImcals, 1ft)' .... diU or otlt« dala Mel III)' optto.... 


lalomalloa "'dude;! la the aollce. ' 


omONAL INfORMATION 

Yo" • ..,. lIId..du:n1 1.Iora1i.... lIIaI )'0. WaM EPA to CDuld_l. eval.-ati'" 

lhe ,,_..........a Oa p .. ,e tt 0' I..........-....... p"",lde;! for YO." 

eI-.iH poIs..t\oa pl'll\'nlloa ..... *YeIl.SI...,.....yo. a¥/ h.......rell", 

Ihe n.w 'l1bttan~ .. 

So-ailed "bl"dl',- boxCli anladl1de;! Ih_,holll Ill'" fo... fO')'OlIlo "'eltc.ale 

yo.. r wiUlnJa_ 10 be ,,"acllo Clettal" .......10. lIIIake la lid. aotlao" Illeft 

at ...... prod.dln yol..-. prol4ldlve "'.1,....•... nil optloa" latellde;! to ftdva delays thai ro.. llaely _.put), lIIc develop.._1 of CD_I Orel_ 0. 

Sl,alfka:nl New U ..Jho1-. ltca.pt I. I...ClIN of ex_ptlo" a,pllcalioM lI.eII u 

TMEA, LYE" LOREX) wilen cuIaI. laJoraaUo. pnwlded Ia ,.dlllotifialio. 1.1 

bladl", OIl I", ••b..llte. w..... the A,etley .prov..lIIc .e..ptlo...ppllallon. 

checld., a blAdl", 110.0 I.IW. aoll",.tkIa..IIIIl1iy I ....., p...WIIoIIIII....II..iIlH 

&1Iallat••4ntatl", &1Ial... lllfilmatloa (_pt dI_k.aJ Idoe.. llIy) reported I" 

Ih. fonn. • 

CONfIOENTlALrrY ClAIMS 

Yo.. m:ll)' dala.y ",fomollo.l. 1"II.otlee at CD.fldmU .... To _It.. Clal. 

Oft Ihe to......uk 00 Ih. CD..ftdnllal ..... u:d 10 Ille laformatloa that YO. dai. 

M coaftdcallaL To ...d a ckhia Ia ....UcII.C1It,. drde or bt.Kket lhe 

Inl_alloll YOII d"'lIIl1&coll8delllbL U JOP dam IpramallQI II !he DOIi« .., 

coIUdgl\al. yo...., allQ pmyJdu palt,,"1'$"'oa of IhuOU", !lDdudiDa 

iI1acbm'DIiI. f .... addllloil ... INtNdlou..dalllll'll.fonD..loa II 

co.ndeallal, read Ihe ).llncllo..Ma...... 

C8l Muk 00 If a1\)' IlIfonD..lotIl" \Jil••oIke II dal..ed u conlicleJlllaL 

TEST DATA AND ODfERDATA 

Yo. an nquln:d to ..II..lt ..U.... data '" )'Mr,--10.OlCD..trol 

...01 19 provide a dMalJido. of .aU other clata bowa .. 0. "_"ably 

_Jtalaable IIy ),0',If1"_41.... an waat... 10 t .... beallh UId 

eIlvlro......1aI cffedlo of the _.fact..... it_Ilia.dl..rtbatlo. 

ia (Dalll",,". Of dlapou.l of 1"',,_ dlemlal .........ce; $....darcl 

llIer.'ne dIMIo., .:11)' be ••II..llIed for dala lalhe ope1lIldea~Uk 

Ulct ......... QuDplde tat dati fwd",1 II EUI".hl lot .iJI!mad..Of d.tI.J. 

mllSt h, _,bmllted If Ihc:x do apt 1=_I. the""" IMmepm. Yo. ,hollJd 

clem)' Id_11ly wheth........ die .. I, ollile .....1tuCie eN' ......ualoa. AI.... 

thcc;llemk.aJ CD...,...lIloa of 111.1""" lllUedai nollld be dl.ullderized. 

foUowln, an ellUII,la of leat d"a ..... otlltr dall!. O .. la .hollld be ,.h .. I\tI!d .aCO>rclI.,10 th. """"Iat...... of sno.so of Ihe P"iaullfact.... NotlflcallOft :a.I,(40 Cl'lt Part 1lI)). 

Test D.... (Check 'Below .....)' ",d.cle;! In Ihla aotlce) 

• Envlroa..mlal 'olII. dlla o Yea • OIherd;a1.l 0 Yet \ 

• Hellllh effecta d.a 0 y.,. JItlak _..... t' 

• 1""11.......1.. 1 ,,"edt d.ata 0 Yea SI,.ct.nlactlvlly NlIIIonIlo


• Ph)'llcaliOl...k.aJP"'''''ItI....~ Yes THlula1101 1a'lIe,-..1 orCDlltrol of 1M.ubmllt« 

'11. ph:pk.aJ &ad dI_k.aJ p"'pertl.. _.a"", I.Ilocale4 OIl Ihel. p','" 

of Ihll form. . I 

TYI'E OF NOnCE 

\ ~ <t;.:;. 

o INTEllMEDIA TE PMN laubmllted In sequence wI\Ji f~ product 

PMN> c-) 

o $NUN (SlgnUIGUlI New UN: Nolloo) 

o TMEA cr.. Markdln, ElI_ptlo. Appllallo,,' en 

o LVE (low Vol....ltc_plio", • ~ Cl'lt 123.50 Cc)(1l-:'J , o LOREX (low Rek.-cIIAw Exposllft ue.I'Uoll' • 723:~c)(2). , 

o LVI ModUicalioll 0 LOREX ModlHat~i ' ,

C) 

IS THIS A CONSOLIQATTro PMNl 0 Y.. 

, of dI.Mlal. 


CP",,,,,Ik. Coalln ...lcal"'. , coeqlll..... , ~n\e. I OIl p"e " 


EPA FORM 771()'2S {Rev. 5-95) Replaces previous editions of EPA Form 771()'21 

J 

Public reportlrts burden fer thII collectiorl 0( Informalloo • estimated to average 110hours per response, iDdud1aS time fer revI.ewin& w"'..-M"",· 

searching existing data IOI.InleII, gatherinS and maintaining the data needed. .rut completingand rev:lewlng the colledl.oa 0(lnformaIloa. Seod 

COD\menb! reprcUng the burden estimate or any other aped of this coDectloa 0( InformaUon.lndudlng tuggesllQl\S for redudng this 'burda1. 

to Cldef.lnConnatioa Polley Bruc:h. PM-m. U.s. El\Yirorunel'ltal ProlectiOll Aseney.401 M. St., S.W_ Washington, D.C.l0460; and to the Office ( 

ManaRm\ent and Budget,. P Redudioa Act (2!J70.0012), Washington, D.C. 20503. 

CERTIFICATION 

I certify that to the best of my knowledge and belief: 

1. 	 The company named in Part I, section A, subsection la of this notice fonn intends to manufacture or import for a 


commercial purpose, other than in small quantities SOlely for research and development, the substance identified in 


Part I, Section B. 


2. 	 All information provided in this notice is complete and truthful as of the date of submission. 

3. 	 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 as required by §720.50 of the Premanufacture Notification Rule. 


Additional Certification Statements: 

Hyou are submitting a PMN, Intermediate PMN, Consolidated PMN, or SNUN, check the following user fee certification 

statement that applies: 

The Company named in Part I, Section Ahas remitted the fee of $2500 specified in 40 CFR 700.45 (b), or 

o The Company named in Part I, Section A has remitted the fee of $1000 for an Intermediate PMN (defined @ 40 a:R 700.4: ) in 

accordance with 40 CFR 7OO.45(b), or 

o The Company named in Part I, Section A is a small business concern under 40 CFR 700.43 and has remitted 


a fee of$100 in accordance with 40 CFR 700.45 (b). 


If you are submitting a low volume exemption (LVB) application in accordance with 40 CPR 723.50 (c) (1) or a Low 

release and low exposure exemption (LoREX) application in accordance with 40 CPR 723.50 (e) (2), check the following 

certification statements: 

o The manufacturer submitting this notice intends to manufacture or import the new chemical substance for 


commercial purposes, other than in small quantities solely for research and development, under the tenns 


of 40 CFR 723.50. 


o The manufacturer is familiar with the terms of this section and will comply with those termsj and 

o The new chemical substance for which the notice is submitted meets all applicable exemption conditions. 

o Ifthis application is for an LVB in accordance with 40 CFR 723.50 (e)(I), the manufacturer intends to commence 


manufacture of the exempted substance for commercial purposes within 1 year of the date of the expiration of the 


30 day review period. 


The ao:urac:y of the statemenls you make in this notice should reflect your best prediction of the anticipated facts regarding the chemical 

substance descnDed herein. Ally knowing and willful misinlerpretalion is subject 10 aiminal penalty pmsuant 10 18 USC 1001. "'-C-o-nfi-d-en-"l"'.I-1I 

U

Signature and title of Authorized Offidal (Original Signature Required) Date 

Signature of agent. (H appUcable) Date

FORM EPA mO-25 (Rev. 5-95) 	 Pagel 
Part I - GENERAL INFORMATION 

11. 	Person 

SubmiWng 

Notice 

(In US.) 

oty, State, ZIP Code 

b. Agent(if Name of authorized official 

applicable) 

Malllng address (number and street) 

Oty, State, ZIP Code 

Telephone 

c. If you are submitting this notice &$ part of I joint submIsslon. mark 00 this box. --------------_.. 

Joint Name of IUtharlzedoffldal Positioo 


Submitter 


(ifaWllcabW -C~~y-------------------------~-----------------------------

Ma1l1ng addreal (number and street) 

oty, State, ZIP Code 

Ttlephone 

2. TecluUca1 

Contact 

(In US.) 

Name Position 

Company 

Ma1l1ng addreM (number and street) 

Oty, State, ZIP Code 

Telephooe 	I 

I 

3. 	 If you have had I prenotlce communication (PC) CXlIlcemlng this notice 

and EPA assigned a PC Number to the notice, enter the number. Mark 00 

Ifnooe 

If you previously subl1'lltted an exemption applicatioo for the chemical 


substance covered by this notice, enter the exemptioo number assigned 


by EPA. If you previously lIUbmltted • PMN for this substance enter the 
 Mark 00 


PMN number assigned by EPA (i.e. withdrawn or l.ncomplete). 
 Hnone 

-~>.... If you have submitted. noth:e of Bona fide intent to manufacture or Mark 00 import for the chemical substance covered by this notice, enter the ifnooe -->~ Ox

notice number assigned by EPA. 	 ..... 

Manufacture Ivl Import Type of Notice - Mark 00 1. D Only 	 • Only 

D 3. 

2 DBoth D BlndingOption 

Mark (x) 

FORM EPA 71l()"2S (Rev. S-9S) 
II":'I 

Part I - GENERAL INFORMATION - Continued 

$ectlon~-CHEMICALIDENTlTYINFORMATION: ~=~C=~~~~l'IIleI 

Complete either item 1 (QUI 1 or 2aubltanee.) or 2 (Polymer.) a. appropriate. Complete aU other !tema. 

Ifanother penon will submit cbemlcal identity information for you (for either item 1 or 2), mark (X) the box at the ristlt. 0 

the and addresa a continuation 	 )Iloo1. eta.. 1 ex 2 dlernlcalaublltance. (for def!n1tions of clalIa 1 and class 2 substana!S, see the Inatructlon. Manu.1) 

a. <lass ofsubstance - Mark 00 1 0 Class 1 or 2 D <lass 2 

b. 	Cl\emlcal name (Currently oorrect Cl\ern1al Abstracts (00 Name that Ls consLstent with 1SCA Inventory listings for s1mllar substances. 

For Oass lllUbstana!S • CA Index Name must be provided. For a_2 substances either. CA Index Name or CA Preferred Name 

be provided. whichever is appropriate based on CA 9<l nomenclature rules and conventions.). 

Co Please Identify which method you used to develop or obtain the spedfled dlernica1 indentity Information reported In this notice: 

(c:heclc one). 

15<] Method 1 (CAS Inventory Expert Service - • copy of the Idenl:lfication I'XlMethod 2 (Other Source? 

1;;:'. /::'. report obtained from the CAS Inventory Expert Service must be :r;-.,fl.e.r-.u..-. ch.~,~ 

de,..,..J\1:..J submitted as an attadunent to lh1s 

d. Molecular formula and CAS RegI.stry Number (if • number already exists for the 1lUbs1ana!) 

CAS. 

e. For a claHl substance, provide. COOIplete and correct cbemlalstructure cllaJvam.. Fa: a clUl2 subatana!- (1) Ust the immediate 

precursorIII.Ibetances with theJr respective CAS Registry Numbera. (2) Describe the nature of the reactioa or procese. (3) Indicate the 

range ofCOOIposltion IJ1d the typlCIl COOIpoIltion (where appropriate). (') Pn.Md.e • correct representative or partial dlern1ca1 

structure diagram, U COOIplele as can beknown, ifone can be reasonably uc.ertaIned. 

Mark 00 this box if you attac:h a continuation sheet. 

RJRMEPA7l10-25 (Rev.S-9S) 	 Page 4 
Partl - GENERAL INFORMATION - Continued 

~ Section B - CHEMICAL IDENTITY INFORMAnON - ConUnued - 2. Polymell (For a definition of polymer, see the Instructions Manua1.) ~t~1 a. Indicate the number-average weight of the lowest molecular weight compa.rition of the polymer you inlend to manufacture. 

Indicate ma.ximum weight percent of low molecular weight spedes (not Induding residual monomers, readants, or solvents) below 

500 and below 1,000 absolute molecular weight of that composition. 

Delcri~ the method. of mn.urement or the bul. for your utimatu: GI'C 0 OtherD :(Specify) 

I) lowest number Iyr:rage lI\Olecul.v weight:: 

iii maximum weight '1ft below 500 DloIKuiar weight 

iill awdtnum wflghl '1ft below.1COO moIKuIar weiaht 

o Mark (X) this box if you attach a continuation sheet. 

b. You must make separate conlidentiality dai.ms for monomer or other reactant identity, composition Wormation. and residuallnEormation. 

Mark (X) the 'Confideatial" box next to any item you claim as conlidential. 

(1) - Provide the sped.ftc chemical name and CAS Registry Number (j.f a number exists) of each monomer or other reactant used in the 

manufacture of the· polymer. 

(2) - Mark ()O this column II entry in column (l) Is confidential. 

(3) -­ Indicate the typical weighl percenl of each monomC2" or other reactant in the polymer. . 

(4.) - Mark tlO the Identity column U yoa want a monomer or other I'tulant UN!d al two weight percent or leu 10 be li.tted :u part of the 

polymer det<:ription on the TSCA Chemical Sub.tanee Inventory. 

(5) - Mark ex) this column if enma in coIumn.t (3) and (4) are confidential. 

(6) - Indicate the madmum weight percent of each monomer or othet' reactant that may be preml as a residual in the polymer as 

manufactured lor commerdal purpow..s.. 

(7) - Mark ex) this column II entry In column (6) is confidential. 

Monomer or other reactant and CAS Reglsl:ry Number Conli- Typical ldetltity Conli­ Mald.rnwn 

(1) dmtlal 

(2) 

composition 

(3) 

Mark 

.(4) 

00 dential 

(5) 

residual 

(6) I~c: 

~ .,. 

.,. .,. 

.,. .,. 

.,. .,. 

.,. .,. 

-'It IF.. 

.,. .,. 

o Mark 00 this box If a\tach a continuation sheet. 

c. f'1_ Identify which method you \DIld to develop or obtain the .pedfled chemlc:al Identity information reported. in this notice. (chedc one). o Method 1 (CAS Invtmtory Smiice-. copy 01 the Identification report 0 Method 2 (other 1IOI.IrCt) 

obtained from Inventory Expert Service must be submitted as . 

an attachu\ent 10 IhlI notice) 

d. The CWTently correct OIem1c:al Abstracts (CA) name Eor the polymer that Is c:on5lstent with TSCA Inventory Ustings for slmUar polymers . 

.­

e. PrOvide a correct representative or pal1ial chemical structure diagram, a.t complete as can be known, if one can be reil!lOl1ably ascertained . 

. 

o Mark(X) this box II you attach a continuation sheet. '. , 

FORM EPA 7710-25 (Rev. 5-95) r.,e5 
Part I - GENERAL INFORMATION ­ Continued 

~ Section B - CHEMICAL IDEN'.I1'N INFORMATION - Continued 

;. lmpult" 

(a) - L:I_Ufy ""mpwdIJ duII_, be ---IJutldJNlled ... ,,_ ,...at Ia dut.....Ical.." __• _.factueol fot'GI••adal pIII'JIGe& 

Ptoride Ill_ CAS 'RqllllJ N••berlf available. U IIaem __klaUfle41mpwd....ala'"uId_tlflecl.­

(b) -&Ii...thelUldm••welpi" of ucla IaIpmlJ. Iflllere....ldmUfJed 1.~""llleit Iobl we,,1It ". 

Impurity and CAS Registry Number Maximum 

(I) percent ~:;l (1)) 

,. r;< 

II, 

,. 

II, 

II, 

" 

II, 

o Mark (X) this box if you attach • continuation sheet. I>(' 

4. Synonym_ - Enter any chemlcalsynonyms for: the new chemical substance ldentilled In subsection 1 or 2. : t:l 

-1'-k 

D Mark (X) this box ifYOI.lattach a continuation sheet. 

S. Trade identificatiGII - List trade names for: the new III1bsl1nce Identified In subsection 1 or 2. 

D Mark (X) this box if you attach a continuation liheel 

6. Generic chemical name - U you clalm chemlcal1denUty as c:onfI.dent1al. you mUll provide a generlc chemical name for your substance 

that revall the sped5c chemlcal.1dentlty of thenew cbemlcallUbstance to the maximum extent poalble. 

Refe'J' to the TSCA Qemical Substance Inventory, 1935 Edition, Appendix B for guidance on developing 

generic names. 

D ; b",-~; C­ ACI'.J t:5+e-r 

o Mark (X) this box if you attach a continuation sheet. 

7. Byproduct. any byproducts resulting from the manufacture, processing. UIie, or: disposal of the new chemical substance. Provlde the C. Registry.,_~ if available. ~ 

ByprodUd CAS Registry Number 

0) de;: (2) 

I>V 

r'-. 

o Mark (X) this box if you attach a continuation sheet. 

FORM BPA 7710-25 <Rev. S-9S) Page 6 
Part I - GENERAL INFORMATION - Continued 

Section C - PRODUCTION, IMPORT, AND USE INFORMATION: 

Mark 00 the "ConfldenUar box next to any ttl!Dl you dalm as confldential. 

L Production volume - Estimate the maximum production volume during the first 12 months of production. Also estimate the 

maximum production volume for any consecutive 12-month period during the first three years of production. Estimates should t: eon 

100~ new chemical substance basis. For 4l..ow Volume Exempfi07l ilJ1P'iazJ.ion, ifyou c~ to Iun¥ your notice re'I1iewtd 4t 4 lower produc ion 

volume tluzn 10,000 /cg/yr, specify the volume and mtII'k (x) in the binding box. Ifgrmlfesi, you fUll bound to this volume.. 

Maximum first 12-month production Ocg/yr) 

(100~ new chemical substance basis) 

Maximum 12-month production (kg/yr) 

(100% new chemical substance basiS) 

C0nfidential 

x 

2. Ule InformatiOCl ­ You must make separate c:onfidenliaUty clalml for the deaaiption of the category of U8e, the percent of produdion volume 

devoted to each category, the formulatioa of the newsubstance, and other use Information. Mark (X) the "Coofidential~ Box next to any ltl!Dl yOlJ 

claim as oonfidentlaL a. m- Describe each intended category of use of the new chemkalwbillan<2 by fundion and application. 

(2) - Mark 00 this column if enay in ooWmn (1) is oonfldential busln_ Information (CBI). 

(3) - fudicate your willingness to have the information provided in column 0) binding. 

(4) - Estimate the percent of total produd:lon f« the first three years devoted to each category of use. (5) - Mark 00 this column if enay in oolumn (4) Is confidential busln_information (CBI). 

(6) - EstImate the percent of the new"lance as formulated in mixtures. suspenslOlll, emulslOlll, IOlutioN, « ge1a 

as manufactured f« commercial purposes at sites under your COIItrol ueodated with each catepy of WIt. 

(7) ­ Mark 00 this oolumn if enay in column (6) III coo.fidential 'buslnesIs lnformaliaft (CBI). 

(8) -Indicate" of product volume expec:t.ed for the listed ...llftseeton. Mark D\OI'Ilhan oae box if appropriate. Mark 

00 10 indicate your wiIllngn_ to have the use type provided in (8) binding. 

(9) ­ Mark 00 this column if enay(les) in column (8) Is (are) confidential Information (CBI). 

(4) 

ea-....v of use 0) CBl ...., Procluo- CBI "in t""'DI 

-cr-J OptIoa tion" Form­ ......, (by fundion and appUcatlon i.e. a dlspersI.ve dye for Mark W ulation 

finishing poly.ster fibers) 

(2) (;3) (5) (6)

x ~ >< ~ X­ ~ ~ 

>< " >< " X­

" ~ 

>< ~X ~X 

~ ~ 

~ " 

" of substance expected. per use (8) 

-U you have identified a ·consumer" use, please provide on a continuation sheet a detailed description of the use(s) of this chemical 

substance in consumer products. In addition include estimates of the concentration of the new chemical substance as expected. in 

consumer products and descn'be the chemical reactions by which this substance loses itl identity in the consumer product. 

o Mark (X) this box if you attach a continuation sheet 

b. Generic 

use 

des<:rlption 

Uyou dalm any category of use description in subsection 2a as conf1dential, enter a generic desaiptlon of that 

category. Read the InllrUdion. Manual for examples of generic \I.Ile descriptions. 

o Mark 00 this box ifj'ou attach a continuation sheet. 

X 

>( 

)Z 

3. Huard Information - lndude in thellOtlce a copy of reasonable f'acsLmIle of any hazard warning statement, label, material safety data sheet., llII4l ~ 

or other Information whkh will be provided. to any persoa who III reasonably likely to be expoeed to thlll IUbstance regarding protective ~ . e:<Iulpment or practices for the safe handling, transport. use. or d.1sposal of tlie I'IeW substance. Usl in part III hazard iliformation you indude. 

l~Mark 00 this box UYOU attach hazard information. 

FORM EPA 771().25 (Rev. 5-95) Page 1 
Part 11 HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE 

Section A -INDUSTRIAL SITES CONTROLLED BY TIlE SUBMITTER 

Complete Relion A for: tach type of mUlufacture. proc ....in" 01' UIC operation Involving the new chemlcal.ubttance at Indultrial titu you 

Importer. do not have to complete this II!ction for operations outside the U.S.; however. you may still have repOl'lin& rellull'etmnt. U there ue 

further industri.al procHling or Ult operation. aftu import. You must describe these operations. See In.truclion.milllual. 

of the site at wh ich the wID occur.

Site addrest (number 

City, County. State, ZIP Code 

If the same optnIlion wID occur at more thUl one llite, enter the number at sites. IdmtUy \he 


additional sites on. continuation sheet, iIlId It any of the sites have Ilgnifica.ntly dUfuent ,.. 


mclducti()n rates or operations, include all the Information requested in this sedion for thOR 


Mark (X) this box II attach .. continuation sheet. 

b. 	Type­


Mark 00 o Manufacturing o Processing o Use 


Hours/day 

d. PrOCtSt d.esaiplion Muk 00 to indicate your wUlingnnl to han YOIII' proceu dncription binding.. 

(1) Diagram the major unit operation steps lUId cheDlica1 conversions. lndude Interim storage Uld transport contamen (spedfy-e.g. 5 gallon 


gallon drum, rail car, tank truck, etc.). 


(2) 	Provide the Identity. the approximate welsht (by kg/day or kg/batch on lIII100'11. new chemical su~tance basis), lUId enll")' point of all 


materials and feedstocb (induding reactants. solvents. and catalysts, etc.). and of aD products, recycle streams. and wastes. Indude cJeaning 


che1rlic:a1s (note frequency if not used daUy or per balch.). 


(3) Identi,fy by number the points of re\e.ue. lnduding small or in termitlant releases. to the environment 01 the new chemical substance. 

1. Batch 

2. 

o Mark (X) this box U you attach a continuation sheet. 

FORM EPA mo.2S (Rev. So9S) 
I 

l Part II - HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE - Continued 

~ Section A - INDUSTRIAL SITES CONTROLLED BY TIlE SUBMI1TER - Continued 

2. Occupational Expcwure - You enust Il'I.Ue IT:ate conHdentiality dalen, for the description of worker activity, pbysical form of the new d\eullcal I 

substance, number of workers exposed. and uration of activity. Mark 00 the 'Confidential" box next to any Item you clal.m IS confidential. 

(\) .. Desaibe the ac:livlties (e.g. bag dumping, tote filling, unloading drums, sampling, cleaning, etc.) in which worken may be exposed. to the 

substance. 

(2) .. Mark 00 this column il entry in column n) \, confidential business information (CBt). 

(3) .. Desaibe any protective equipment and engineering controls used to protect worken. 

(4) and (6) .. Indiale you wUllngness 10 have the Information provided in column (3) or (5) binding. ~ 

(5) - Indicate the pbysical formes) of the new chemlal substance (e.g. solid: crystal, granule, powder, or dust) and ,.. new chemical substance (i.f of 

a mixture) at the time of exposure. ,

, (7) .. Mark 00 this column if entry In column (5) is confidential business information (CBI). 

(8) .. Estimate the nwdmum number of worken involved in each activity for all sites coenblned. 

(9) .. Mark (X) this column If entry in column (8) is confidential business information (CBI). 

(10) and (11) .. Estimale the maximum duration of the activily for any worker in hours per day and days per year. 

(12) .. Mark 00 this column If entries in columns (10) and (11) are confidential business information (CBI). 

Worker activity CBI Protective E'I_lpaoe.tI Blndlll, rnYIIC:al fOrm\., ~I.dla, CBI lof CBI MaxlmJm! duration pst (e.g. bag dumping. fllling drums) fa,I..",,,,..., Co.bot. pptlo. (e.g.soUd:powder) 

~~w Wocken ~at..tx) and" I\CW EXpaNd HIs/clay Oay'/yr 

m m (3) (4) IIIlb.~ce ((,1 17\ (8) (9l (10) , on 12) 

0 Mark (X) this box If you attach a continuatiOn sheet. 

3. Envbonmmlal Keleate and Ditpoal- You must mllke separate confidentiality d.aI.ms for the release number and the amount of the new chemi :al 

substance released and other release and disposal information. Mark 00 the "Confidential" box next 10 each item you daim as conJidential. 

(1) - ..........~""".......__""".........,....... ....._"...IL __ A. _~1dO> . j (2) - Estimate the amount of the neW substance relelUl!d (a) d.Irectly to the environment or (b) Into control technology (In leg/ day or leg/batch). 

(3) - Mark 00 this coI.umn If entries In columns (1) and (2) are oonfidentlal butineu information (01). 

(4) - Jdenlily the media of rel_le. stack air, fugitive air (optional.seeIn!ltruc:tlon Manual), surface water, on-sUe or off·Jile Land or Indneratl. 

POl'W, or other (please specify) to which the new substance will be released from that release point. 

(5) .. L Describe control tedu\ology, If any, ,and control efficiency thai Will be used to limit the release of the new substance to the environment. 

, For releases disposed of on land. characterize the disposal method and state whether It is approved for disposal of RellA huard.ous WISt•• 

On a eontinuation ab.t , for each lite desaibe any IddItionai disposaIenethoda,lhat will be used and wbett- the waste Is subject to , secondary or tertiaryolHite treatment. b. Estiznate the AD'Iounl rdeued to the environment after,'control technology (In leg/day). 

(6) - Mark 00 this coI.umn If entries In coI.umns (4) and (5) are confidential bwIinesa lNormalioll (CBI). ' 

(1) - ldenll.ly the destination(s) 01 releases 10 water. Please supply NPDFS <Nationlll PoDutant Oltcharge ElimInation System) numbers for d.ireo 

d.lscbargers or NPDES numbm 01 the POTW (Publidy Owned Treatment Works). Mark 00 If the P01W I\arne or NPDFS'II conJidential 

business lnlonnalion (CBI). . . . . 

Release Amount ~!::osubstance CBI Mec:Ii. ot Control technology and effidenc:y (you may wish to optionally attJch effidency dala) 

Number release ~ . 1 11M.... (1) (2a) (2b) .... illICIt air 

(3) (4) (Sa) : Mart. 101 (Sb) 6} 

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(1) Mailc (X) the o PCYIW providename(s) below: CBI o Navigable 0 Other • Specify provide NPDES. BI 

dcsti.nation(s) of - waterway 

releases to water. 

o Mark 00 this box If you attach a coatinualion sheet. '. 

FORM EPA m0-2S (Rev. 5-95) Page 9 

I 
Part II - HUMAN EXPOSURB AND ENVIRONMENTAL RBLEASB ­ Continued 

~ Section B - INDUSTlUAL SITES CONTROLLED BY O11iERS 

Complete IIedion Bfer typical proceIII.nJc: me ~tioNIinvolvlnl the IIIW chemk:al It sltet you do not a:mtroUmporten do DOt bav. to 

compJete this tedIorI fer operItIoDI ou the U . however, you mUll repcn any proceselns or use activities after Impart. See the InstrudiaM 

Manual O:mrpIek a sqo.,.,. S«tilm Bfor ':d type ofprocasfllg, or use opmrtiml fIlaJIvillg 1M rIIID dlrmic:al ~. Uthe same operation 1.1 peftOlll ~ 

at more than one site describe the typlca1 operation common to these slies. Identify additional sites on a continuation sheeL 

1. Operation Detcrlption - To daim information in this sectilX!lIS confidential. circle or bracket the spec:I.flc Information that you claim lIS cxmfidential 

(l) ­ Diagram the major unit operation Iteps and chem.lcal CX>l\vemons, Including interim atonge and transport conta1nen (specify. e.g. 5 gallon PI ils, 

55gallon drums, rail cars, tank tn1cb, etc). On the dJagram, identify by letter and briefly descrlbe each worlces- activity. (2) - Provide the identity. 

the approximate weight (by kg/day or kg/batch, IX! an 100,. new chemicallUbslmce balls), and entry point of an feedst.ocb (including reactanls 

solvenls and catalysis. etr) and. 01 an prodw:l:l,. teeyde streams. and Wllles.lnducle cleaning cheml.ca1a (note frequency If not \lied. dally or per 

batch). (3) -Identify by number the points 01 releue, induding small or intermittent releases, to the environment of the new chem.lca1I1Ubstance. 

(4) Please enter the' of sites (remember to identify the locations of these sites on a continuation sheet) : -

*' Oflltes 

D Mark 00 Ihls box if you attach a continuation sheet. 

2. Warker ExpotareIEnYIronlall.eleaM 

0) - From the diagram above, provide the letter for each worker activity. Complete 2-8 for each worker activity desc:rlbed. 

(2) - Estimate the number of workers exposed. for an.tea combined. 

(4) ­ Estimate the typical d.uration 01 exp:lIUI'e per worker In (I) hoUll per day and. (b) days per yar. 

(6) ­ Desc:rlbe physlcal form of ~ure and. ,. new c:bemlcaI. substance (If In mixture), and. any protec:tlw equipment and engineering controls us I!d.

to protect WOlken. 

(7) - Estimate the percent 01 the new IUbetance II formulated when pac:kased. or \lied. lIS a final product. 

(9) - Prom the proceII8 diagram above, enter !he number of each release point. Complete 9-13 for each release polntidenlified.. 

00) ­ Estimate the amount 01 the newsubstance releued (a) directly to theenvlnlnment or (b) into CQIItroi technology to the environment 

(In kg/day or kg/batch). 

02) - Desc:rlbe media ofrelease i.e. atack air, fugitive air (optlonal-eee1nlb:ud1oN Manual),mace water. on.cte or oH.cte land or Ind.ne:ralion. 

POIW, or oIher (specify) and control tedmology,lf any, that wm be used. to limit the releaJe 01 the new substance to the environment. 

04) ­ Identify byprod.UdII which may reeult from !he operatloa. 

(3), (5), (8), 01), 03) and. 05) ­Mark 00 Ihls column if any of the proceedlng entries III'e confidential buaInesIlnformatlon (CBl). 

LeUer 101 CSI Durallon CSI Proledl.ve Equlp. I 1:U~1- CBl Release Amount of CSI Media of Release ;::BI 

of WOfkerl of Engineering Controlsl Number New "'Control Act- Exposed Exposure Pbyak:al Form and. ,. ulatioo Substance Technology Ivlty new substance Released 

I 

004) : OOb} 0) (2) (3) (4a) I C4b) (5) (6) (7) (8) (9) 01 02) 13) 

10; I I 

'I-­ I y... l- I 

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® 

I I ( 'f... I l- f..-. I X 

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(14) - Byproducls: is) 

......... 

o Mark (X) Ihls box If you attach. CIOntinuation sheet. 

FORM EPA mO-2S (Rev. 5-95) PlgelO 
1 

OPTIONAL POLLUTION PREVENTION INFORMA nON 

To claim in£ormation in this section as confidential circle or bracket the specifk information that you claim as confidential. 

In this section you may provide information not reported elsewhere in this form regarding your 

! 

I 

efforts to reduce or minimize potential risks associated with activities surrounding 

manufacturing, processing, use and disposal of the PMN substance. Please include new \

information pertinent to pollution prevention, including source reduction, recycling activities 

and safer processes or products available due \ to the new chemical substance. Source reduction 

includes the reduction in the amount or toxicity of chemical wastes by technological I 

modification, I process and procedure modification, product reformulation, raw materials f 

substitution, and/or inventory control. Recycling refers to the reclamation of useful chemical t 

I 

components from wastes that would otherwise be treated or released as air emissions or water 

discharges, or land disposal. Descriptions of pollution prevention, source reduction and 

recycling should emphasize potential risk reduction subsequent to compliance with existing 

regulatory requirements and can be either quantitative or qualitative. The EPA is interested in 

this information to assess Qverall net reductions in toxicity or environmental releases and 

exposures, not the shifting of risks to other environmental media or non-environmental areas 

(e.g., occupational or consumer exposure). In addition, information on the relative cost or 

performance characteristics of the PMN substance to potential alternatives may be provided. 

All information provided in this section will be taken into consideration during the review 

of this substance. See the revised Instructions Manual that includes a Pollution Prevention 

manual for guidance and examples. I 

Describe the expected net benefits, such as (1) an overall reduction in risk to human health or the environment; (2) a reduction in 

the volume manufactured; (3) a reduction in the generation of waste materials through recycling, source reduction or other 

means; (4) a reduction in potential toxicity or human exposure and/or environmental release; (5) an increase in product I

performance, a decrease in the cost of production and/or improved operation efficiency of the new chemical substance in I 

comparison to existing chemical substances used in similar applications; or (6) the extent to which the new chemical substance 

may be a substitute for an existing substance that poses a greater overall risk to human health or the environment, 

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D Mark (X) this box if you attach a conlinuation sheet. " 

FORM EPA 7710-25 <Rev.s.95) Pap 11 

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I 

" Part III ­ LIST OF ATTACHMENTS 

Attach continuation sheets for ~lions of the form and test data and other data (including physical/ chemical propc!ftles and I 

I 

structure/activity Information), and optional information after this pa&e. Qearly Identify the attachment and the section o( the form to 

which it relates, if appropriate. Number consecutively the pa&es of the allachments. In the column below, enter the inclusive page 

I numbers of each attachment. 

Mark (X) the "Confidential" box next to any attachment name you claim as confidential. Read the In.wction. Manual for 

guidance on how to dalm any information in an attachment as confidential. You must include with the sanitized copy of the notice 

form a sanitized version of any attachment in which you claim information as confidential. 

Attachment name Attachment Cor fipage number(s) de~ \hi 

V"'1s .. ....tL-\ J.. CJ.,e""/::",,, fr~t,~ W""kttvt I 3 

ICf - 2L )< 

Mo..n.r;..... 1 5a..44v 'bA..~ 5~L<e..r z..3-l.b 

CA-S :z::.,""'''_J,"''h...Y £)(PU---r S"e........'c.e. R.."4>"...-r­ .... 7 

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t, 

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0 Marl<. (X) this box Uyou atlaCh I oonlinuation sheet. Eilter the attachment name and number. " i , i 

FORM EPA 7110-25 (Rev. S-9S) Pagt12 

\ 
PHYSICAL AND CHEMICAL PROPERTIES WORKSHIIET 

To UJi.II EPA', review of phr=ancl chemka1 prope:rtl.es data. please complete the followtnLworksheet for data you provide

ancllnciude It in the notice. denUfy the property measured, the page of the notice on wh1ch property appears, the value 

of the the wdbin which the property is (u neceasary), and whether or not the is dalmedu 

conllden :E!i!ca1 state of the neat IIUbstance should N provided. Th"'meuur~tIs be for the _t (1~ 

pure) chemk:al ceo Properties that are meuurecl for IIIlxtures or formulations be so noted (91. PMN IUbetancein _ ).You 

are not required to submit this worksheet; however, EPA stroogly recommends that you do 50, as it will almplify teVlew ancl e.t\II1lre 

that a:mfldenliallnformalion is properly protected. You should submit this worksheet as a supplement to your submlssion of test 

data. This worksheet is not a substitute for submission of test data. 

Property Page Value Me.uwoed Confi Mark (X)lf or dentia provided number iIIImaIoo 

(a) IQ (b) (c) Mark ( 

(Morl) (d) 

Physical state of neat substance _(s)_W_W )( 

Vaporpressure @Temperature "C Torr 

Density/relative density g/cm3 I 

Solubility 

@ "C I Temperature I 

Solvent R/L 

Solubility in water @Temperature "C "C 

Melling temperature "C 

Bolling/sublimation lmIperature @ torr preesure 

Spectra )( 

DIssodatlon oonstant 

Partlde size d1strlbutlon 

Octano1/water partition coeifident 

Henry's Law constant 

Volitalizatlon from water 

Volitall.zatlOCl from soil 

pH lit roncentratlon 

Flammability 'j. 

Explodabllity >< 

Adsorption/roe£fI.dent 

Other - Spedfy 

I~ 
If\\~ ,,\\()"R\\l' 

B\CL{\~ 

~C\Se.. )<1 - L~ 

I~ 

Technical Information 

MATERlAL SAFETY DATA SHEET 

(Research & Development) 

Note: Read and understand Material Safety Data Sheet before handling or disposing of product. 

SECflON 3 HAZARDS IDENTIFICATION 

EMERGENCYOVERYmW 

Appeannce: Transparent liquid 

Odor: No odor 

Warning Statement: Caution! 

If swallowed, this product may cause abdominal discomfort. If contact with 

skin and eyes, this product may cause moderate irritation. 

Precautionary Measures: Wash thoroughly after handling. Keep away from heat. 

Acute: 

Eyes: May cause moderate irritation. 

Skin: May cause moderate irritation. 

Inhalation: Usually vapor is not generated at high concentrations from this product. But 

vapor or mist in unusually high concentrations from spraying, heating this 

product, or as from exposure in poorly ventilation, may cause physical 

discomfort such as headache. eyes and skin initation, and nausea. 

Ingestion: If more than several mouthfuls are swallowed, abdominal discomfort, 

nausea. and diarrhea may occur. 

Sensitization Properties: Unknown 

Chronic Properties: No information is available. 

Other Remarks: None 

ALL CI[~CL.LJ.LI.Nr-Qf3MATIQN 

IS CONFIDENTIAL 

1 
SECflON 4 FIRST AID MEASURES 

Eyes: 


Skin: 


Inhalation: 


Ingestion: 


Sensitization Property: 


Wash eyes with fresh water for at least 15 minutes. Get medical attention if 

eye irritation persists. 

Wash skin thoroughly with soap and water for at least 15 minutes. Launder 

contaminated clothing. Get medical attention if skin irritation develops or 

persists. 

If irritation, headache, or nausea occurs, remove to fresh air. Get medical 

attention if breathing becomes difficult or symptoms persists. 

If swallowed, give a large amount of water to drink and call a doctor 

immediately. Consult medical personnel before inducing vomiting. 


Unknown 


SECflON 5 FIRE FIGHTING MEASURES 

Flash point (Typical), "C 186(COC) 

Autoignition tempt., "C N.D.A 

Flammability limits Not Determined. 

Extinguishing media: CO2, dry chemical foam (Do not use water.) 

SECflON 6 ACCIDENTAL RELEASE MEASURES 

Procedures in Case of Accidental Release, Breakage or Leakage: 

Stop the source of the leak or release. Oean up releases as soon as possible. Contain liquid to prevent 

further contamination of soil, surface water or groundwater. Clean up small spills using appropriate 

techniques such as sorbent materials or pumping. Where feasible and appropriate, remove contaminated 

soil. Follow prescribed procedures for reporting and responding to larger releases. 

SECflON 7 HANDUNG AND STORAGE 

Do not weld, heat or drill container. Replace cap or bung. Emptied container still contains hazardous 

material which may ignite with explosive violence if heated sufficiently. 

Minimum feasible handling temperatures should be maintained. Periods of exposure to high temperatures 

should be minimized. Water contamination should be avoided. 

CAUTION: Do not use pressure to empty drum or drum may rupture with explosive force. 

SECflON 8 EXPOSURE CONTROLS/PERSONAL PROTECflON 

Eye Protection: Chemical type goggles or face shield optional. 

Skin Protection: Avoid prolonged or frequently repeated skin contact by wearing impervious 

protective clothing including gloves. 

Respiratory Protection: Wear a breathing mask. 

Ventilation: No special ventilation is usually necessary. However, if operating conditions 

create high air borne concentrations of this material, special ventilation may 

be needed. 

Other Clothing and Equipment: No special clothing or equipment is usually necessary, Work practices, 

hygienic practices: No information is available. 

Other Handling and Storage Requirements: N.D.A 

Protective Measures During Maintenance of Contaminated Equipment: N.D.A 

N.D.A: 	 No Data Available N.A: Not Applicable 

< Less Than > . Greater Than 

2 
SECTION 11 TOXICOLOGICAL INFORMATION 


Acute Oral: N.DA: Believed to be greater thaD 5 glkg (rat) 

Practically DOD-toxic 

Dermal: N.DA: Practically non-toxic 

SECTION 12 ECOLOGICAL INFORMATION 


Biodegradation: N.D.A 

Environmental Fate: This material is not expected to present any environmental problems other 

than those associated with oil spills. 

SECTION 13 DISPOSAL CONSIDERATIONS 


Waste Disposal Method 

Place contaminated materials in disposable containers and dispose of in a manner consistent with 

applicable regulations. Contact local environmental or health authorities for approved disposal of this 

material. 

SECTION 14 TRANSPORT INFORMATION 


The description shown may not apply to all shipping situations. 

DOT Proper Shipping Name: 

IMDG Proper Shipping Name: 

lCAO Proper Shipping Name: 

TDG Proper Shipping Name: 

NFPA Proper Name: 

N.D.A.: No Data Available 

< Less Than 

3 

Not applicable. 


Not applicable. 


Not applicable. 


Not applicable. 


Class 1. 


N.A.: Not Applicable 

> : Greater Than 

ALL QIB.CbEO.lNFORtvtA.IION 

lS CONEIQENT1Al.. 

2:;­
SECOON 15 REGUlATION INFORMATION 

None 

SEC110N16 OTHER INFORMATION 


None 

References 

1. Handbook of Toxic and Hazardous Chemicals and Carcinogens (2nd ed.) 

2. Registry of Toxic Effects of Chemical Substances (NlOSH, 1983) 

Material safety data sheets are provided as reference information on the safe handling of hazardous or 

harmful materials to companies using such materials. When referring to this data sheet, companies should 

remember that they must take responsibility for implementing the proper measures for their own particular 

situations. This data sheet is not a guarantee of safety. 
em Inventory Expert Service 


A division of the American Chemical Society Phone: 800·631·1884. 614·447·3600 (ext. 2308) 

F-ax: 614-447-3747 

E-mail: answers@cas.org 

Please print the above CA Index Name on the appropriate page of your PMN • 

D .' 

If this box is checked, CAS has made correction(s) marked in red to 

your IBS order. Please make the same correction(s) to yonr PHN before 

submitting it to the BPA. 

2540 O\entanl)' P.lYer Road P.O. Box 331) CoIumbu" Ohio ...3210-0334 

'J-7