# ;u.s:"ENVIRONMENTAL PROTECTION AGENCY AGENCY USE ONLY PREMANUFACTURE NOTICE 

# &EPA Date ofrecei t 

### FORNEW CHEMICAL SUBSTANCES ION 

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Part I GENERAL INFORMATION TEST DATA AND OTHER DATA You must provide the currently correct Chemical Abstracts (CA) Name ofthe new chemical substance, even ifyou claim the identity as confidential. You may authorize another person to submit chemical identity information for you, but your submission will not be complete and the review will not begin until EPA receives this information. A letter in support ofyour submission should reference your TS user fee identification number. You must submit an original and two copies ofthis notice including all test data. Ifyou claimed any information as confidential, a single sanitized copy must also be submitted. Part II HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE Ifthere are several manufacture, processing, or use operations to be described in Part II, sections A and B ofthis notice, reproduce the sections as needed. Part III LIST OF ATTACHMENTS Attach additional sheets ifthere is notenough space to answer a question fully. Label each continuation sheet with the corresponding section heading. In Part III, listthese attachments, any test data orother data and any optional information included in the notice. OPTIONAL INFORMATION You may include any information that you want EPA to consider in evaluating the new substance. On page 11 ofthis form, space has been provided for you to describe pollution prevention and recycling informationyou may have regarding the new substance. So-called "binding" boxes are included throughout this form for you to indicate your willingness to be bound to certain statements you make in this section, such as use, production volume, protective equipment
... This option is intended to reduce delays that routinely accompany the development ofconsent orders or SignificantNewUse Rules. Except in the case ofexemption applications (such as TMEA, LVE, LOREX) where certain information provided in such notification is binding on the submitter when the Agency approves the exemption application, checking a binding box in this notice does not by itselfprohibitthe submitter from later deviating from the information (except chemical identity) reported in the form. CONFIDENTIALITY CLAIMS You may claim any information in this notice as confidential. To assert a claim on the form, mark (X) the confidential box next to the information that you claim as confidential. To assert a claim in an attachment, circle or bracketthe information you claim as confidential. Ifyou claim information in the notices as confidential, you must also provide a sanitized version ofthe notice, (including attachments). For additional instructions on claiming information as confidential, read the Instructions Manual. DMark(x) ifany information in this notice is claimed as confidential.



### Page You are required to submit all test data in your possession or control and to provide a description ofall other dataknown to orreasonably ascertainable by you, ifthese data are related to the health and environmental effects on the manufacture, processing, distribution in commerce, use, or disposal ofthe new chemical substance. Standard literature citations may be submitted for data in the open scientific literature. Complete test data (written in English) not summaries ofdata. must be submitted if they do not appear in the open literature. You should clearly identify whether test data is on the substance or on an analog. Also, the chemical composition ofthe tested material should be characterized. Following are examples oftest data and other data. Datashould be submitted according to the requirements of§720.50 ofthe Premanufacture Notification Rule (40 CFR Part 720). Test Data (Check Below any included in this notice)

• Environmental fate data DYes •Other data DYes • Health effects data DYes Risk assessments • Environmental effects data DYes Structure/activity relationships • Physical/Chemical Properties*

### ~Yes Test data not in the possession or control ofthe submitter *A physical and chemical properties worksheet is located on the lastpage ofthis form. TYPE OF NOTICE (Check Only One)

### ~PMN (Premanufacture Notice) DINTERMEDIATE PMN (submitted in sequence with final productPMN) DsNUN (Significant NewUse Notice) DTMEA (Test MarketingExemption Application) DLVE (Low Volume Exemption)@40 CFR 723.50(c)(1) ' DLOREX (Low Release/Low Exposure Exemption)@ 40 CFR 723.50(c)(2) DL VE Modification DLOREX Modification IS THIS A CONSOLIDATED PMN? DYes # ofchemicals or polymers
__ (Prenotice Communication# required, enter# on page 3)



### 1Public reportili\g burden for this collection ofinformation is estimatedto average II0hours per response, including time for reviewing instructions, 

### ' searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection ofinformation. Send comments regarding the burden estimate or any other aspect ofthis collection ofinformation, including suggestions for reducing this burden, to Director, Collection Strategies Division (2822), U.S. Environmental Protection Agency, I200 PennsylvaniaAve., N.W., Washington, D.C. 20460; and to the Office of Management and Budget, Paperwork Reduction Act (2070-00I2), Washington, D.C. 20503. 

## CERTIFICATION I certifY thatto the best ofmyknowledge and belief: 

### 1. The company named in Part I, section A, subsection 1a ofthis notice form intends to manufacture or import for a commercial

purpose, otherthan in small quantities solely for research and development, the substance identified in Part I, Section B. 2. All informationprovided in this notice is complete andtruthful as ofthe date ofsubmission. 3. I am submitting with this notice all test data in my possession orcontrol and a description ofall other data known to orreasonably

ascertainable byme as required by §720.50 ofthe Premanufacture Notification Rule. Additional Certification Statements: 

# D Ifyou are submitting a PMN, Intermediate PMN, Consolidated PMN, or SNUN, check the following user fee certification statementthat applies: 

## cgj The Company named in Part I, Section A has remitted the fee of$2500 specified in 40 CFR700.45(b), or 

# D The Company named in Part I, Section A has remittedthe fee of$1000 for an Intermediate PMN (defined@ 40 CFR700.43) in accordance with40 CFR700.45(b), or 

# D The Company named in Part I Section A is a small business concern under 40 CFR700.43 and has remitted a fee of$100 in accordance with 40 CFR700.45(b). Ifyou are submitting a low volume exemption (LVE) application in accordance with 40 CFR723.50(c)(1) or a Low release and low exposure exemption (LoRex) application in accordance with 40 CFR723.50(c)(2), checkthe following certification statements: 

# D The manufacturer submitting this notice intends to manufacture or import the new chemical substance for commercial purposes, otherthan in small quantities solely for research and development, under the terms of40 CFR723.50. 

# D The manufacturer is familiar with the terms ofthis section and will comply with those terms; and 

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

# D Ifthis application is for an LVE in accordance with 40 CFR723.50(c)(l), the manufacturer intends to commence manufacture of the exempted substance for commercial purposes within 1year ofthe date ofthe expiration ofthe 30 day review period.

The accuracy ofthe statements you make in this notice should reflect your bestprediction ofthe anticipated facts regarding the chemical substance described herein. Any knowing and willful misinterpretation is subjectto criminal penalty pursuant to 18 USC 1001. 

### Signature and title ofAuthorized Official (Original Signature Required) Date
Signature ofagent (ifapplicable) Date

Page Confidential

X



### 2

### la.Person Submittin g Notice (in U.S.)

b. Agent (if applicabl 

### e)

Joint Name ofauthorized official Submitter (if Position applicable) t-c-=--om-pa_n_y
__________________ _._________________ _



### 2. Technical Contact (in 

### U.S.) Mailing address (number and street)

3. Ifyou have had a prenotice communication (PC) concerning this notice and EPA assigned a PC Numberto the notice, enterthe number. ---+1 

### 4. Ifyou previously submitted an exemption for the chemical substance coveredby this notice, enterthe exemption number assigned by EPA. Ifyoupreviously submitted a PMN for this substance enterthe PMN number assigned byEPA (i.e. withdrawn orincomplete). 5. Ifyouhave submitted a notice ofBona fide intent to manufacture or import for the chemical substance coveredbythis notice, enterthe notice number assigned by EPA.

6. Type ofNotice- Mark (X) 1. Manufacture Only 

# D Binding Option Mark

Page 

# -

-

- Import Only 

## D Binding Option Mark Mark (X) ifnone
Mark (X)

ifnone
Mark(X)

ifnone 

# ....

3. 0Both



### 3

### Section B- CHEMICAL IDENTITY INFORMATION: You mustprovide acurrently correct Chemical Abstracts (CA) name ofthe substance based on the ninth Collective Index (9CI) ofCA nomenclature rules and conventions. 

### the "Confidential" boxnext to item claim as confidential.

Class 1 or 2 chemical substances (for definitions ofclass 1and class 2 substances, see the Instructions Manual) a. Class ofsubstance

- Mark (X) 1

# IIClass 1 or 

# 211 Class

# 2
b. Chemical name (Currently correct Chemical Abstracts (CA) Name that is consistent with TSCA Inventory listings for

similar substances. For Class 1substances a CA Index Name must be provided. For Class 2 substances either a CA Index Name orCA Preferred Name must be provided, whichever is appropriate based on CA 9CI nomenclature rules and conventions
.

c. Please identify which methodyou used to develop or obtain the specified identity informationreported in this notice:

(check one)

## ~Method 1(CAS Inventory Expert Service- a copy ofthe Identification 

# D Method 2 (Other Source) report obtained from the CAS Inventory Expert Service must be submitted as an attachment to this notice) d. Molecular formula and CAS Number a number already exists for the substance) Confidential X

X



### CAS# X 

# -
e. For a class 1 substance, provide a complete and correct chemical structure diagram. For a class 2 substance- (1) 

### Listthe X

immediate precursor substances with their respective CAS Registry Numbers. (2) Describe the nature ofthe reaction or process. (3) Indicate the range ofcomposition and the typical composition (where appropriate). (4) Provide a correct chemical structure as can be known, ifone can be reasonably ascertained.

attach a continuation sheet. Page 

## 4

## .----JUL. 

# 2. 2008- 2:1OPMSed:ion B-CHEMICAL IDENTITY

### INFORMATION- Continued



### notice. (checkone) pOlymer, see

attach a continuationsheet 

### youusedto**aev1~IOP** 

### specified
• Method 1(CAS fnventory Expert 

### Service-a copy

### ofthe identificationreport obtainedfrom CAS Inventoxy Expert

### Service mtm:

### be submittedas an attachment to this the polymer

### that is



## TS-WN08Sl Page if

### one can be



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### Section B- CHEMICAL IDENTITY INFORMATION- Continued 3. Impurities (a)- Identify each impurity that may be reasonably anticipated to be present in the chemical substance as manufactured for commercial purposes. Provide the CAS Registry Number ifavailable. Ifthere are unidentified impurities enter "unidentified." (b)

- Estimate the maximum weight % ofeach impurity. Ifthere are unidentified impurities, estimate their total weight %. Impurity and CAS Registry Number 

### (a)

attach a continuation sheet. 

### 4. Synonyms- Enter any chemical synonyms for the new chemical substance identified in subsection 1 or2.

attach a continuation sheet.

attach a continuation sheet. Maximum percent

% % % % 

### %
Confidential



### 6. Generic chemical name- ifyou claim chemical identity as confidential, you mustprovide a generic chemical name for your substance thatreveals the specific chemical identity ofthe new chemical substance to the maximum extentpossible. Refer to the TSCA Chemical Substance Inventory, 1985 Edition, Appendix B for guidance on developing generic names. Alcohol propoxylate sulfate salt 

# D Mark (X) this box ifyou attach a continuation sheet. 

### 7. Byproducts- Describe any byproducts resulting from the manufacture, processing, use or disposal ofthe new chemical substance. Provide the CAS Number ifavailable. Byproduct Number Confidential

this box ifyou attach a continuation sheet. 

# Company Sanitized
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### Part I GENERAl INI1'0RMATION**-Com.~.1ecl**

# ~ Section C- CHEMICAL IDENTITY INFORMATION- Continued _Mark (X) the "Confidential" boxnextto any item you claim as .nf:rl,**ont:~** 

### 1. Production volume- Estimate the 

### maximum production volume duringthe first 12 months ofproduction. Also estimate the maximum production volume for any consecutive 12-monthperiod during the first three years ofproduction. Estimates shouldbe on 100% new chemical substance basis. 

### For a low volumeExemption application, 

### if you choose to haveyour notice reviewedata lowerproduction volume than 10,000 kglyr, specifYthe volume andmark (x) in the box. if 

### .s• ......<-.1, 

### you are boundto this volume. Maximum first 12-month production (kg/yr) Maximum 12-monthproduction (kg/yr) Conti- Binding Option (100% new chemical substance basis) (1 00% new chemical substance basis) dential Mark(x) 

# --**~** 

# [ 2. Use Information

- Youmust make separate confidentiality claims for the description ofthe category ofuse, the percent ofproduction volume devoted to each category, the formulation ofthe new substance, and other use information. Mark (X) the "Confidential" Boxnext to any item you claim as confidential. a. (1)- Describe each intended category ofuse ofthe new chemical substance by function and application.

(2)- Mark (X) this column ifentry in column (1) is confidential business information (CBI). (3)- Indicate your willingness to have the informationprovided in column (1) binding. (4)- Estimate the percent oftotal production for the first three years devoted to each category ofuse. (5)- Mark (X) this column ifentry in column (4) is confidential business information (CBI) (6)- Estimate the percent ofthe new substance as formulated in mixtures, suspensions, emulsions, solutions, or gels as manufactured for commercial purposes at sites under your control associated with each category ofuse. (7)- Mark (X) this column ifentry in column (6) is confidential business information (CBI) (8)- Indicate % ofproduct volume expected for the listed "use" sectors. Mark more than one box ifappropriate. Mark (X) to indicate your willingness to have the use type provided in (8) binding. (9)- Mark (X) this column**if~ntry(ie~** in column (8) is (are) confidential business information (CBI) Category ofuse (I) Binding Produc- %in %ofsubstance expected per use (by function and application i.e. a dispersive dye CBI Option CBI Form- CBI CBI for finishirur 

### IJV'J""'"'' fibers) Mark (x) tion% ulation (8) (I) (2) (3) (4) (5) (6) (7) Site- Con-* Indus- Com- (9) limited sumer trial mercia! Option**~** % 

### 18

.. % 

### 18**~** % % % % % % % % % % % % *Ifyouhave identified a "consumer" use, pleaseprovide on a continuation sheet a detailed description ofthe use(s) ofthis chemical substance in consumerproducts. In addition include estimates ofthe concentration ofthe new chemical substance as expected in consumer products and describe the chemical reactions by which this substance loses its identity in the consumer product. 

# D Mark (X) this box ifyou attach a continuation sheet. b. Generic Ifyou claim any category ofuse description in subsection 2a as confidential, enter a generic description ofthat category. use Read the Instructions Manual for examples ofgeneric use descriptions. description Enhanced oil recovery applications 

# D Mark (X) this box ifyou attach a continuation sheet. 3. Hazard Information- Include in the notice a copy ofreasonable facsimile ofany hazard warning statement, label, material safety Binding data sheet, or other information which will be provided to any person who is reasonably likely to be exposed to this substance Option regarding protective equipment orpractices for the safe handling, transport, use, or disposal ofthe new substance. List in part III Mark hazard informationyou include. (x) 

# D Mark (X) this box ifyou attach a continuation sheet. 

# Company Sanitized 

# D

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### Part II- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE • Mark (X) the "Confidential" box next 

### Section A- INDUSTRIAL SITES CONTROLLED BY THE SUBMITTER to any item you claim as confidential. Complete section A for eachtype ofmanufacture, processing, oruse operation involving the new chemical substance at industrial sites you control. Importers do not have to complete this section for operations outside the U.S.; however, you may still have reporting requirements if there are further industrial after You must describe these See Instructions manual. Confidential

Ifthe same operation will occur atmore than one site, enter the number ofsites. Identify the additional sites on a continuation sheet, and ifany ofthe sites have significantly differentproduction rates or operations, include all the information requested in this section for those sites as attachments.

1. 

### Batch
2. Continuous Use Batches/year



### d. Process description Mark (X) to indicate your willingness to have yourprocess description binding. (1) Diagram the majorunit operation steps and chemical conversions. Include interim storage and transport containers (specity-e.g. 5 gallon pails, 55 gallon drum, rail car, tank truck, etc.). (2) Provide the identity, the approximate weight (by kg/day orkg/batch on an 100% new chemical substance basis), and entry point ofall starting materials and feedstocks (including reactants, solvents, and catalysts, etc.), and ofall products, recycle streams, and wastes. Include cleaning chemicals (note frequency ifnot used daily orperbatch). Identify bynumber the points ofrelease, including small or intermittent releases, to the environment ofthenew chemical substance.

Page 

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# cgj Mark (X) this box ifyou attach a continuation sheet.

Page 

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### TS 

### # WN08Sl·SubmitterContinuation sheet for ld (process description):

Page 

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### Section A- INDUSTRIAL SITES CONTROLLED BY THE SUBMITTER-- Continued 2. Occupational Exposure- You must make separate confidentiality claims for the description ofworker activity, physical form ofthe new chemical substance, number ofworkers exposed, and duration ofactivity. Mark (X) the "Confidential"box nextto any item you claim as confidential. (1)- Describethe activities (e.g. bag dumping, tote filling, unloading drums, sampling, cleaning, etc.) in which workers may be exposed to the substance. (2)- Mark (X) this column ifentry in column (1) is confidential business information (CBI). (3)- Describe any protective equipment and engineering controls used to protect workers. (4)- and (6)- Indicate your willingness to have the information provided in column (3) or (5) binding. (5)- Indicate the physical form(s) ofthe new chemical substance (e.g. solid: crystal, granule, powder, or dust) and% new chemical substance (ifpart ofa mixture) at the time ofexposure. (7)- Mark (X) this column ifentry in column (5) is confidential business information (CBI). (8)- Estimate the maximum number ofworkers involved in each activity for all sites combined. (9)- Mark (X) this column ifentry in column (8) is confidential business information (CBI). ( 1

0) and (11) -Estimatethe maximum duration ofthe activity for any worker in hours perday and days per year.

- Mark this column ifentries in columns and are confidential business information CBI Protective Equipment/ Binding Physical form(s) Binding CBI #of Engineering Controls Option (e.g.solid:powder) Option Mark (x) and%new Mark (x) substance 

## D 

# D I


## D D**~** 

## I 

## D D D D D D D D D D D D D D D attach a continuation sheet. 

## I 

# •
I 

# •

Environmental Release and Disposal- You must make separate confidentiality claims for the release number and the amount ofthe new chemical substance released and other release and disposal information. Mark (X) the "Confidential" box next to each item you claim as confidential. (1)

- Enterthe number ofeach release point identified in the process description, part II, section A, subsection 1 d(3). (2)- Estimate the amount ofthe new substance released (a) directly to the environment or (b) into control technology (in kg/day or kg/batch). (3)- Mark (X) this column ifentries in columns (1) and (2) are confidential business information (CBI). (4)- Identify the media ofrelease i.e. stack air, fugitive air (optional-see Instruction Manual), surface water, on-site oroff-site land or incineration, POTW, or other (please specify) to which the new substance will be released from that release point. 

## D D D

(5)- a. Describe control technology, ifany, and control efficiency that will be used to limit the release ofthe new substance to the environment. For releases disposed ofon land, characterize the disposal method and state whether it is approved for disposal of RCRA hazardous waste. On a continuation sheet, for each site describe any additional disposal methods that will be used and whether the waste is subject to secondary ortertiary on-site treatment. b. Estimate the amountreleased to the environment after control technology (in kg/day). (6)- Mark (X) this column ifentries in columns (4) and (5) are confidential business information (CBI). (7)- Identify the destination(s) ofreleases to water. Please supplyNPDES (National Pollutant Discharge Elimination System) numbers for direct dischargers orNPDES numbers ofthe POTW (Publicly Owned Treatment Works). Mark (X) ifthe POTW name orNPDES 

### # is confidential business information attach CBI (l) (2a) (2b) (3) (Sa) (5b) (6) 

## I 

# - -**~** 

# • 

# -**~** 

## D D D D D D Page 

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# I 

# l I D 

# I ' 

## D 

# J D ' ' (7)**~ark** (X) the 

### rg)porwprovide name(s) below: CBI 

### rgj Navigable 

# 0 Other-Specify Provide NPDES# CBI destinations of 

### - waterway

releases to 

### rg] 

# - rg]

water. 

# D Mark (X) this box ifyou attach a continuation sheet.

Page 

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### Part II- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE -- Continued Section B- INDUSTRIAL SITES CONTROLLED BY OTHERS Complete Section B for typical processing oruse operations involvingthe new chemical substance at sites you do not control. Importers do not have to complete this section for operations outside the U.S.; however, you must report any processing or use activities after import. See the Instructions Manual. Complete a separate section B for eachtype ofprocessing, oruse operation involving the new chemical substance. Ifthe same operation is performed at more than one site describe the typical operation commonto these sites. Identify additional sites on a continuation sheet. 1. 

### Operation Description- To claim information in this section as confidential, circle orbracket the specific information that you claim as confidential. (1)- Diagram the major unit operation steps and chemical conversions, including interim storage and transport containers (specify e.g. 5 gallon pails, 55 gallon drums, rail cars, tank trucks, etc). Onthe diagram, identify by letter andbriefly describe each worker activity. (2) -Providethe identity, the approximate weight (by kg/day orkg/batch, on an 100% new chemical substance basis), and entry point ofall feedstocks (including reactants, solvents, and catalysts, etc) and ofall products, recycle streams, and wastes. Include cleaning chemicals (note frequency ifnot used daily orperbatch). (3)- Identify by numberthe points ofrelease, including small or intermittent releases, to the environment ofthe new chemical substance. (4) Please enter the# ofsites (rememberto identify the locations ofthese sites on a continuation sheet): 

# - #OF SITES



# D Mark (X) this box ifyou attach a continuation sheet. 2. 

### Worker Exposure/Environmental Release (1)- From the diagram above, provide the letter for each worker activity. Complete 2-8 for each worker activity described. (2)

- Estimate the number ofworkers exposed for all sites combined. (4)- Estimate the typical duration ofexposure per worker in (a) hours per day and (b) days peryear. (6)- Describe the physical form ofexposure and% new chemical substance (ifin mixture), and any protective equipment and engineering controls usedto protect workers. (7)- Estimate the percent ofthe new substance as formulated when packaged orused as a final product. (9)- From the process diagram above, enterthe number ofeachrelease point. Complete 9-13 for each release point identified. (10)- Estimate the amount ofthe new substance released (a) directly to the environment or (b) into control technology to the environment (in kg/day orkg/batch). (12)- Describe media ofrelease i.e. stack air, fugitive air (optional-see Instructions Manual), surface water, on-site or off-site land or incineration, POTW, orother (specify) and control technology, ifany, that will be used to limit the release ofthe new substance to the environment. (14)- Identify byproducts which may result from the operation. (3), (5), (8), (11), (13) and (15)- Mark (X) this column ifany ofthe

Page (7) entries are confidential business information (CBI).

(8) (9) (lOa) (lOb) 

## D (11) 

## D Media ofRelease & Control Technology (12) CBI (13) 

## D

13

## - 

## 0 0 0 0 0 0 0 0 0 0 0 D D D 

# D (14)- Byproducts: (15) 

## D 

# D Mark 

### (X) this box ifyou attach a continuation sheet.

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### OPTIONAL POLLUTION PREVENTION INFORMATION To claim information 

### in this section as confidential circle orbracketthe specific informationthat you claim as confidential. 

### In this sectionyou mayprovide information notreported elsewhere inthis form regarding your efforts to reduce or minimize potential risks associated with activities surrounding manufacturing, processing, use and disposal ofthe PMN substance. Source reduction includes the reduction inthe amount ortoxicity ofchemical wastes by technological modification, process andprocedure modification, product reformulation, rawmaterials substitution, and/or inventory control. Recycling refers to the reclamation ofuseful chemical components from wastes that would otherwise be treated orreleased as air emissigns orwater discharges, or land disposal. Descriptions ofpollution prevention, source reduction and recycling should emphasize potential risk reduction subsequentto compliance with· existing regulatory requirements and canbe either quantitative or qualitative. The EPA is interested inthis informationto assess overall net reductions intoxicity or environmental releases and exposures, not the shifting of risks to other environmental media ornon-environmental areas (e.g., occupational orconsumer exposure). In addition, information onthe relative cost orperformance characteristics ofthe PMN substance to potential alternatives maybe provided. 

### All information provided in this section will be taken into consideration during the review ofthis substance. See the revised Instructions Manual that includes a Pollution Prevention manual for guidance and examples. Describe the expected net benefits, such as (1) an overall reduction in risk to human health orthe environment; (2) a reduction in the volume manufactured; (3) a reduction in the generation ofwaste materials through recycling, source reduction or other means; (4) a reduction in potential toxicity orhuman exposure and/or environmental release; (5) an increase in product performance, a decrease in the cost of production and/or improved operation efficiency ofthe new chemical substance in comparisonto existing chemical substances used in similar application; or (6) the extent to which the new chemical substance maybe a substitute for an existing substance that poses a greater overall risk to humanhealth orthe environment.



# D Mark (X) this box ifyou attach a continuation sheet. Page 

### 15' 

### Part 

### III- LIST OF ATTACHMENTS , 

### Attach continuation sheets for sections ofthe form and test data and other data (including physical/chemical properties and structure/activity information), and optional information after this page. Clearly identify the attachment andthe section ofthe form to which it relates, if appropriate. Number consecutively the pages ofthe attachments. Inthe column below, enterthe inclusive page numbers ofeach attachment. Mark (X) the "Confidential"boxnext to any attachment name you claim as confidential. Read the Instructions Manual for guidance onhow to claim any information in an attachment as confidential. You must include with the sanitized copy ofthe notice form a sanitized version of any attachment in which you claim information as confidential. Attachment Name Attachmentpage Confnumber(s) dential Material Safety Data Sheet Attachment 1

# ~ CAS Inventory Expert Services Report Attachment 2

# ~ 

# D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D Mark (X) this box ifyou attach a continuation sheet. Enter the attachment name and number.
Page 

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### PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET To assist EPA'sreview ofphysical and chemical properties data, please complete the following worksheet for data youprovide and include it in the notice. Identify the property measured, the page ofthe notice on whichthe property appears, the value ofthe property, the units 

### in which the property is measured (as necessary), and whether ornot the property is claimed as confidential. The physical state ofthe neat substance should be provided. These measuredproperties should be for the neat (100% pure) chemical substance. Properties that are measured for mixtures or formulations should be so noted (% 

### PMN substance in_). You are notrequired to submit this worksheet; however, EPA strongly recommends that you do so, as it will simplify review and ensure that confidential information is properly protected. You should submit this worksheet as a supplementto your submission oftest data. This worksheet is not a substitute for submission oftest data. Property
. Mark (X) 

### if provided Page number Value Measured or Estimate (MorE) 

### Confidential Mark (a) (b) (c) 

### (X)

state ofneat substance Vaporpressure 

### t Solubility

@Temperature
___________ 

### t Solvent

Dissociation constant Particle size distribution

Law constant Volitalization from water Volitalization from soil concentration

OtherPage 

### 17

# ATTACHMENT 1 Material Safety Data Sheet

# ATTACHMENT 2 CAS Inventory Expert Services Report