### F<xln Aoaove<!. O.M.E. )lc_ 2.070-00ll. ,._ 

### U..S. ENVIRONMENTAL PROTEcriON AGENCY 

## AGENCY USE 

# ONLY**~~--~s~~--.--~~~~~~~~~~----~** 

# II=DA PREil'LI\NUFACTURE NOTICE


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# 22 GENERAL INSTRUCTIONS 

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OPTIONAL INFORMATION**Y~** moa.'!' 

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# .... \S) .:) 7'! -·.J fA!•i**--.~-~** 

### ·-:-;

.'**~-"':** l

## I Public reporting burden for this collection ofinformation is**esimat~'li** 

### to average 110 houn 

### per response, indudlng time for reviewing**instructio~,** 

### searching existing data sources, gathering and maintaining

## th~ data needed, and completing and reviewing the collection 

### of information. Send 

# I

comments 

### regarding the burden estimate or 

### any other 

### aspect c:J 

### this collection of information, including

# su~tions for reducing this burden, 

# I

to Otiet, 

### Information Policy Branch, 

### PM-223, U.S. 

### Environmen131 Protection Agency, 401 M. St, S.W

... 

### Wll5Aington, D.C 20460; 

### and to the Office 

# ci Management and

### Bud~et.**P~ork** Reduction Act (2070-0012), 

### Washington, D.C 20503. 

### I 

# CERTIFICATION 

# I

I certify that to thebest of my knowledge and belie£:


### 1. The company named in 

### Part I, section 

### A, subsedion la of this notice form intends to manufacture or import for 

### a commercial purpose, other than in small-quantitE5 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 ofthe 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:
[f you are submitting a 

### PMN, Intermediate PMN, C:nsolidated PMN, or 

### SNUN, check the JOllowing userfee certification statement that applies: []) The Company named in Part 

### I, Section 

### A has remitted the fee of 

### S2.500 specified in 

### 40 CFR 700.45 (b), 

### or 

# 0 The Company named in Part 

## r, Section 

### A has remitted 

### the fee of 

### 51000 for an lntermediate 

### PMN (defined @ 4{) 

### CFR 

### 700.4J) in accordance with 4{) 

### CFR 700.45(b), or 

# n The Company !lamed in 

### Part!, Section 

### A is a 

### small b-usiness concern under 

### 40 CFR 700.43 and has remitted
a 

### fee of

### $100 in accordance with 

### 40 CFR 

### 700.-fi (b).
ff 

### you are submitting a low volume exemption 

### (LVE) 

### application in accordance with 

### 40 

### a:R 723.50 (c) (1) 

### or a 

### Low 

## ! release 

### and low exposure exemption (LoREX) application in accordance with 

### 40 CFR 723.50 (c) 

### (2), check the following certification statements: 

# 0 The manufacturer submitting this notice intendsto 

### manufacture or import the new chemical substance for commercial purposes, other than in small quantities solely for research and development, under the terms of

### 40 CFR 723.50. 

# 0 The manufacturer is familiar with the terms ofthis 

### section and will comply with those terms; and 

# 0 The new chemical substance for which the notice is 

### submitted meets all applicable exemption conditions. 

# 0 If this application is 

### for an 

### L VEin accordance 

### with 

### 40 CFR 723..50 (c)(l), 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 accuracy of the statements you make in this notice should 

### ntlectyour best prediction of 

### the anticipated fads 

### regarding the chemical

substance 

### desaibed herein. Any 

### koowing and willful misinterpmation is 

### subject to criminal 

### penalty plllSuant 1o 

### 18 USC 1001. 1 Confidential I 

### D.ate

Signature of agent- (if 

### applioble) Date

FORM EPA 7710-25 

### (Rev. 5-95) l"agc2

# Part I -GENERAL INFORMATION

Ia. Person Submitting Notice (in U.S.)

b. Agent (if applicable) 

### Q.ar:iant 

## I.S1 (lnEr:i.ca) 

# In::. Mailing address (number 

### and street)



# 2114 .Miers Rarl Otv, State, 

### ZIP Code 

# Elgm, s:**~5**
Name 

### of authorized 

### offic:i.al
Company
Mailing address (number and 

### street)

Gty, State, 

### ZIP Code 

# I Telephone 1

c. If you are submitting this notice as 

### part of a joint submi3sion, mark (X) this box.**---------------~** Joint Submitter (if applicable)



### 2. Technical Contact (in U.S.) Name of authorized official



### y
Mailing address (number 

### and street)


### Qty, State, 

### ZIP 

### Code

Name


### Company 

## Oariant I.S1 (lnEr:i.ca) 

# roc. Mailing address (number and street) 

# 2114 larry Jeffers 

# Rca:l Gty, State', 

### ZIP 

### Code 

## Elgin, 

# s: 29)45

3. 

### If you have had a prenotice communication (PO concerning this notice and EPA assigned a PC Number to the notice, enter the nUIIIber.



### 4. 

### If you previously submitted an exemption application for thechemical substance covered by this notice, enter the exemption number assigned 

### by EPA. 

### Ifyou previously submitted 

### a PMN 

### for this 

### substance enter the 

### PMN number assigned by 

### EPA (i.e. withdrawn or in**com~).** 

### --)loo
.... If you have submitted a 

### notice of 

### Bona fide intent to manufacture or 

### import for the 

### chemical substance covered by this notice. eater the notice number assigned by EPA 

## :;a...

I. 

# D Manufacture Only 

### Type of Notice- 

### MarJe (X) 

# D Binding Option Marlc(x) FORM EPA i710-25 (Rev. 5-95) 

### Page3 Position



### Telephone

Position



### Telephone 1 I

2. 

# D D - Fnv.i.rmn?ntal Affairs

Import Only Mark 

### CO ifnone



### Mark (X) 

### if none

Mark (X) if none

BindingOption Marlc(x) 

# ----=>• 

# m

3. 

# w Both

# Part I

- GENERAL INFORMATION

- Continued Section B _ CHEl\flCAL IDENTITY INFORMATION: You muat prov\de a cur!'f!ntly corr«t Olemical AbstnctS <CAl rwne ofthe substance based on the ninth Collectlve Index (9Cl) of CA**notnend~ture** rules**~d** conventlOIIS.I Mark(Xl the to any item you 

### cl.aim as confidential. 

### Complete either item 

### 1 (Clue 1or 

### 2 substances

### I or 

### 2 (Polymers) as 

### appropriate. Complete ail other 

### items. 

### If another 

### person 

### will submit chemical identity information for you (for 

### either item 

### 1or 2). mark (X) the box at the right. 

# 0
the name, 

### and address 

### ofthat in a continuation sheet. 

# >-
1. 

### Cl.assl or 

### 2 chemical substances (for definitions of class 

### 1 and class 2 substances, !leethe Instruction• Manual)

a. 

### Gass of substance- Mark (X) 

### 1 

# [X] Oasa I or 2 

# D OasiS 2

b. Oiemical name (Currently correct Chemical Abstrads (CA) Name**that~ cons~ent**  with TSCA Inventory listings for similar substances. For 

### Oass 1**substance~** a CA l.ndex Name must be proVided. For Oass 2**substance~** either a CA Index Name orCA Preferred Name 

### be provided, whichever i:J appropriatebased on CA 

### 9<J nomenclature rules and conventions.). 

# [ l

c. Please identify which method you 

### used to develop orobtain the specified chemical indentity information reported in this notice:

(check one). 

# rn Method 1 (CAS Inventory Expert Service- a copy of the Identification CMethod 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 Registry Number (if a number already exists for the substance)



# [ 

# l

e. For a clau 1 substance, prov1de a complete and correct chemical structure diagr3lll. For a claat 2 substance- (I) List the immediate precursor substances With their respective CAS Registry Numbers. (2) Describe the nature of the reaction or process. (3) Indicate the range of composition and the 

### typical COIIIposition (where appropriate). (4) Provide a correct representative or partial chemical strucrure diagram, as complete as can 

### be known, 

### ifone can be reasonably ascertained.



# L J

Mark (X) this box if you attach a continuation sheet. FORM EPA 7710-25 (Rev. 5-95) Page4 

## X

X
X

# J 

# I Part I -GENERAL INFORMATION- Continued 

# I 

# • Section B- CHEMICAL IDENTITY INFORMATION

- Continued 

# i

2. Polymers (For a definition of polymer, see the Instructions Manual.) 

# N/A Confidential 

### a. !ndicate the number-average weight of the lowest molecular weight composition 

### ol the polymer you intend to manufacture. I Indicate maximum weight**percet~t** of low molecular weight spedes (not including residual monomm, reactants, or solvents) below 

# I 500 and below I,000 absolute molecular weight 

### ci that composition. Describe the methoda of meallUI!ment or the 

### bMia for your estimatu: GPC 

# 0 

# Other0 :<Specify> 

## i i) lowest number average 

### molecular weight 

### ill maximum weight**~** below 

### 500 molecular 

### weight: 

## un maximum weight**~** below 1000 molecular Wl!ight 

# 0 Mark (X) this box 

### if you attach a continuation sheet. · . i



### b. You must make separate confidentiality claims for monomer or other reactant identity, composition information, and residual information. Mark (X) the "Confidential"box next to any item you 

### claim as confidential. 

# I (1)

- Provide the specific chemical name and CAS Registry Number 

### (if a number exists) 

### oieach monomer or other reactant used in the manufacture of the polymer. (2)

- Mark (X) this column 

### ifentry 

### in column (1) is ronfidentiaL (3)

- indicate the typical weight percent 

### ofeach monomer or other reacl:lnt in the polymer. (4)

- Mark (X) the identity column 

### ifyou 

### wanh monomer or other reactant uaed at two weight percent or less to be listed as part of the polymer description on the TSCA Chemical Subatance Inventory. (5)

- Mark (X) this column 

### if entries in columns 0) and (4) are confidential. (6)

- Indicate the maximum weight percent 

### oi each monomer or other reactant that may be present as a residual in the polymer as manufactured for commerdal purposes. I I (7)

- Mark (X) this column 

### if entry 

### in column (6) is confidentiaL 

## I Monomer or other reactant and 

### CAS Registry Number Conti- Typical Identity Conti- Maximum 

### Conti· denti.al composition Mark (X) denti.a! residual dental (1) (2) (3) (4) (5) (6) (A) 

# N/A % % 

# I

I % % I ! 

# "· I



# .. I I % 

# r. .I

I 

# "'· r. !

%**-"'"~** 

# l

r. r • 

# .D Mark (X) 

### this box 

### if you attach a continuation sheet.



### c. Please identify 

### which method you used to develop or obtain the speafied chemical identity information reported in this notice. (check one).



# D Method 1 (CAS Inventory Expert Service- a copy of the identification report 

# 0**M~od** 2 (other source) / obtained from CAS Inventory Expert Service must be submitted as 

# N A an attachment to this notice) d. The CUITently correct 

### Olemical**Abstract!~** (CA) name for the polymer that is consistent with TSCA Inventory listing1 for similar polymers. 

# N/A

e. ProVide a correct representative or partial chemical structure diagram, as complete as can be known, 

### If one can be reasonably ascertained. 

# I N/A



# 0 Mark(X) this box if you attach a continuiltion shel?t. FORM EPA i71 0..25 (Rev. 5-95) PageS 

# I I i I 

## I

### I I 

# Part I -GENERAL INFORMATION- Continued I

# ~ Section B - CHEviiCAL IDENTITY INFORMATION

- Continued I i
l. lmpurllle.



## \

(;l)- Identify e.oclo Imparity tbot**m~y** be rnaon.ably

.. ttdpalord to be prmeat In the chemlc.al aabotuce""**~auufactu,....j** for mmmerciol.l PUIJ><'M'L Provide the CAS Registry Namb« if**~milble.** If there= uidentlfled lmpariUH, •nter "unidentified." (b) -Estimate the mUiznum w•lghl "'-of udt Impurity. lfthtl!! -nldentifled lmpuritls, esUm.llle lhdr tot.U weight"'··



### Impurity and CAS Registry Number Maximum

## ~fi- (a)

## per~~t dential 

### ' I 

## Yater 

# 7732-18-5 0.2 

# r. I 

# J l_ 0.5 9'.

# ~ \ 

# J [ 0.2 % 

# lxl



# ] [ ] 0.2 'l'o 

# IX!

r 

# l [ 

# J 'l'o 

# P< ! I 

## 0.5 1--

## ~ 

# 1 [ 0.5 

# %1x \ lhkn::fflns**·~** 

# 0.5 o/, 

# IX i 

# 0 Mark (X) 

### this box 

### if you attach a continuation sheet. 

# I 4. Synonyms- Enter any chemical synonyms for the new chemical substance identified in subsection 1 or 2.

# ~~:~;. 

# (

- 

# ] XI

i 

# 0 Mark (X) this box 

### if you attach a continuation sheet. 5. T.r.ade identification- List trade names for the new chemical substance identified 

### in subsection 1 or 2 . 

# xj



# .. 

# J l 0 Mark (X) 

### this box 

### if you attach a continuation sheet.
6. Generic: chemical name 

### -if you claim chemical identity as confidential, you must proVide a generic chemical name for your substance that reveals the 

### specific chemicalidentity of the new chemical substance to the maximum extent possible. Refer to the T5CA Olemical Substance Inventory, 1985 Edition, Appendix Bfor guidance on developing generic names. 

## A1kyl substiruted 

# arrinJ-b:marri.


# D Mark (X) 

### this box 

### if you attach a continuation 

### sheet.
7. 

### Byproducta

- any byproducts resultingfrom themanufacture, processing. 

# use, or 

### disposal ofthe new chemical substance. Provide the CAS Registry Nuinber 

### if available. 

# I Byproduct CASRegistryNumb<!r 

# cJili- (l) (2)**de~l** 

# Nx:e



# I
' 

# D Mark (X) this box 

### if you attach a continuation sheet. FORM EPA 

### m0-25 (Rev. 5-95) Page 6 i


### ' I j

# Part I -GENERAL INFORMATION- Continued**~** 

## Section C- PRODUCTION, IMPORT, AND USE 

## INFORMATION:
Mark (X) 

### the "Confidential" box next to any item you daim as 

### confidentiaL 

### 1. Production volume- Estimate the maximum production volume during the 

### first 12 months ofproduction. Also estimate the j 

### maximum production volume for 

## any consecutive 12-month period during the first 

### three years ofproduction. Estimates**should~** 

### on 100% 

### new chemical substance basis. 

### Fara Low**Volu~** 

### Exempticm application, 

## ifyou**clwo~** 

### to 

### harJe 

## your notice rroieweJl 

### at a lower

### production volume than 10,000 

## lcg/yr, specify the 

### oolume and 

### t1111rk (x) in the binding box. If granted, 

## y011. rm 

### baund to this oolumc.. 

## I Maximum first 12-month production 

### (kg/yr) (100% 

### new chemical substance basis) 

# r l Maximum 12-month production 

### (kg/yr) (100% 

### new chemical substance basis) 

# l ] Confidential



## X Binding Option**~.Wj(** (X)

I 2. Use 

### Information

- You must make separate confidentiality claims 

### for the decription of the**e~tegory** 

### ofuse, 

### the percent 

### oi production volume : devoted to each category, the formulation 

### ol. the new substance, and 

### other 1.15e 

### information. Mark (X) 

### the "Confidential" Box next to any item yoUJ claim 

### as oonfidentiaL · a. (I) 

### -Describe each intended category of use 

### oi the new chemical substance by function 

### and application. (2)- 

### Mark 

### 00 this column if 

### entry in oolumn (1) is 

### confidential business information (CBO. (3)

- 

### lndlcate your willingness to have the information provided in column (1) 

### binding. (4)- 

### Estimate the percent oi 

### total production for the first three years devoted to each 

### cate&ory of use. (5)

- 

### Mark 

### 00 this column if

### entry in 

### oolumn (4) 

### is confidential business information (CBO. (6)- 

### Estimate the percent of the new substance as formulated in mixtures, suspensions, emulsions, solutions, or 

### gels as 

### manufactured for commercial purposes at sites under your control as50Ciated With each**e~tegory** 

### of use. (7)- 

### Mark 

### 00 this column if entry 

### in oolumn (6) is 

### confidential**busine~S** 

### information (CB!). (8)- 

### lndlcate %of product volume 

### expected for the listed "use" 

### -=tors. Mark more than one box if 

### appropriate. Mark 

## i (X) 

### to indlcate your willingness 

### to have the use 

### type provided in (8) 

### binding. 1 (9)- 

### Mark (X) 

### this column if

### entry(iesl in mlumn (8) is 

### (are) confidential busine55 

### information (CBO. l 

### Category of use (1) 

### (by function and application i.e. a dispersive dye for finishing polye!ter fib=) 

### CBI Bind

### ins ProducOption lion 'fe M.ark (•) 

### %of substance expected

### peruse 

# PJI <8> I CBI %in 

### CBI Form· ulabon (2) (3) (4) (5) (6) (7) !>ile- .Lon- 

### Indus- Com- 

### Binding limited sumer 

### bial mercia! 

### Option (9) 

## _Acet:a.l.clebyde 2cavenaoer for Plastic futtle 

# lCD 

# cr. cr. 

# lCO
o/o 

## cr.
% 

## cr.


# cr. cr. o/o %

% 

### %

% 

### o/o 

### •Ifyou 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 

### describe the chemical reactions 

### by which this substance

### loses its identity in the consumer product. 

# 0 Mark (X) 

### this 

### box 

### if you attach a continuation sheet. 

### b. Generic use 

### description U 

### you 

### daim any category of use 

### description 

### in subsection 

### 2a as 

### confidential, enter a generic desaiption of that category. 

### Read the Inltnlctions Manual for examples of 

### generic use descriptions.



# D Mark ()() 

### this box if 

### you attach a continuation sheet. 

# I

3. 

### Hazard Information- lndude in 

### the notice a 

### copy of reasonable facsimile of any hazard warning 

### statement, label, 

### material safety data**sh~t. Blnal~** 



### or o.thcr iniormalio? which Will be 

### provided to 

### any person who is reasonably likely to be 

### exposed to this substance regarding protective Op<l<it 

### 1., eqwpment or practices for the sate 

### handling. transport, use, 

### or disposal of the new substance. Ust 

### in part 

### Ill hazard information you include. Maritl<x> 

### ILJMark_{X) this box 

### if vou attach hazard information. 

# I FORM EPA 7710.25 

### (Rev. 5-95) Pagl' 7 1 '

# Part II

- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE**~Section** A- INDUSTRIAL SITES CONTROLLED 

## BY THE SUBMITrER Complete section A 

### for each type of 

### manuiactun, proceaaing, 

### orliH operation involving the new chemical RJblltance at industrial sites you conlrbl. Importers do not have to complete thi5 section for operations outside the U.S. ; however, you may !Kill have reporting requirements 

### ifthere are i further industrial 

### proceuing or

### use operations 

### after import. You muat describe these operations. 

### See instruction•**mU~uaL** 1. 

### Operation description
a. Identity- Enter the Name of the site at which the


## Clari.ant IS1 (lm:rica) 

## :f:n:.

City, County, State, 

### ZJP Code 

# s: 2cn45 will 

### occur.

If the same operation 

### will occur at more than one site, enter the number of !lile!. Identify the additional sites on a continuation sheet, and 

### if any of the sites have significantly different production rates or operations, include ail the information requated in this section for those



### Mark (X) 

### this box 

### if 

### b. TypeMark (X)

1. Batch attach a a>ntinuation sheet 

# [Z] Manufacturing



### 2. Continuous 

# D Processing

Hours/batch 

# 2A Hours/day 

# 0 Use

Batches 

### I 

### year 

# 22 Days/year



### d. Process 

### description 

# 0 Marit()() to indicate your willingneu to have your procesa description binding. I ot ailS I Con£ derltW

(1} 

### Diagram the 

### major unit operation steps and chemical conversions. Include interim storage and transport containers (spealy-e.g. 

### 5 gallon pails. 

### iSS 

### gallon drum, 

### rail car, tank truck, etc.). (2} ProVide the identity, the appro:Wnate weight (by kg/day or leg/batch on an 100% new chemical substance basis), and entry point of 

### all startingJ materials and feedstocks (including reactants, solvents, and catalysts, etc.), and of all products, recycle streams, and wastes. 

### Indude cleaning chemicals (notefrequency 

### ifnot 

### used daily or 

### per batch.). (3) Identify by number the points o{ release, including small or intermittant releases, to the environment of the new chemical substance.



# [X] Mark (X) this box if you attach a continuation sheet.
FORM EPA i710.25 (Rev. 5-95) PageS

# - rart II

- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE

- Continued i I



# - I 

## Jn 

## A- INDUSTRIAL SITES CONTROLLED BY 

## TirE SUBMITIER- Continued I 

### i •pational ElCp41811R

- You must make separate confidentiality claims for the de5crlption of worker activity, physical form of the newchemical : •lance, number of workers exposed, and duration of activity. Mark (X) the "Cor.fidcntial" box next to 

### any item you 

### claim as confidential. '

- Desai be 

### the activities (e.g. bag dumping. tote filling. unloading 

### drums, sampling. cleaning. etc.) 

### in which workers 

### may be 

### exposed to the 

# I substance. .2)- Mark 

### 00 this column 

### iientry 

### in column (1) is confidential business information (CBD. 

## i (3)

- Desaibe 

### any protective**~uipment** and engineering controls used to protect workers. 

# I (4) and (6)- indicate you 

### willingnesato have the information provided 

### in column (3) or (5) binding. (5)

- Indicate the physical form(s) of

### the new chemical substance (e.g. solid: 

### crystal. granule. powder, or dust) and 

### '1. new chemical substance (il

### part of
a mixture) at the time of exposure. I (7)- Mark (X) 

### this column 

### if entry 

### in column (5) is confidential business inforatation <CBO. 

# ! (8)

- Estimate the maximum number 

### oiworkers involved.in 

### each activity for all sites combined. i I (9)- Mark (X) this column 

### ifentry in roh.!!ll.!l (8) is confidenfu.l b-.:siness information (CBI). 

# I (10) and (11)- Estimate themaxit:numduration ofthe activity for any worker in hours 

### per day and days 

### per year. (12)- Mark (X) this column 

### if entries in columns (10) and (11) are confidential 

### business information (CBI). \ Worker activity 

### CBI PnMedm**Equl~tl** Blndlns 

### f'hyllcatlorm''' Btadlns 

### CBI t of 

### CB! Maximum duration 

### fBI (e.g. bag dumping. filling drums) &paeaias Coatn>la Optloa (e.g.solid:powder) Optloa 

### Workers Muk(x) and"' new

### ~arkW 

### Expoeed M/day Days/yr 

# ll12) (1) 

## m {3}_ 

### ill**!lllbst;',g~** {@ m (B) 19) 

# nm (11) 

## S=e Attachrent 

## X 

# I I I 

# I I 

# 0 Mark (X) this box 

### if you attach a rontinuation sheet. 3. 

### Envh·onmentzlReleuc:**:~.nd** 

### Dispo;al- You must make separate confidentiality claims ior the release number 

### and the amount of the new chemital

substancereleased and otherrelease and 

### disposal information. Mark (X) the '"Confidential" box next to each item you claim as confidential. 

## i (1)

- Enter the number of each 

### re1- point identified 

### in the process description. 

### part IL section A. subsection ld(3). (2)

- Estimate the 

### amount of the new substance released (a) directly to the environment or (b) into control technology (in kg/day or kg/batch). (3)

- Mark (X) this column 

### ifen!riel in columns (1) and (2) are a:mfidential business information (CBI).

. . (4)

- Identify the media of release i.e. stadc air, fugitive air (optional.- Instruction Manual), surface water, on-site or off-site land or

### mcineratio~. f'O'IVV, or other (please specify) to which the new substance will 

# oo released from that release point. i (5)

- a.**Descri~** control technology, 

### if any, ,and control efficiency that 

### will be used to limit the release of the new substance to the environment. For releases 

### disposed of on land. characterize the 

### dispc&1l method and state whether it is approved for 

### disposal of RCRA hazardous waste.! 

### On a continuation sheet , for 

### each site desaibe any additional 

### disposal method! that 

### will be 

### U9l!!d and whether the waste is subject to secondary or tertiary on-site treatment. b. Estimate the amount released to the environment after control technology (in kg/day). : (6)

- Mark (X) this column 

### ifen!riel in columns (4) and (5) are ronfidential business information (CBI). 

### i (7)

- Identify the destinadon(s) ofreleases to water. Plea91! supply NPDES (National Pollutant 

### Discharge Elimination System) number! for 

### direQt dischargers or NPDES number8 

### ot the POIW (Publldy Owned Treatment Works). Mar.k (X) 

### if the POTW name or NPDES j is ccnfidentiall business information (CBD. 

# I
Release Amount ofnew substance 

### CBI Media of Contro( technology and efficiency (you may wish to optionally attach effidency data)

## I~BI**Num~** released release

# ~6)

(1) (2a)

## (~/dav**~~ad<** air 1 B1nc1111 8 

# kg/day (Sb) (3) (4) (Sa) I M.trk !xl I 

## a 

# 2.27 Air TIEIIIEl 

# Ox:i.dizer (99%) i 

# 0.023 

# I I I 

## b 

# 0.91 Air TIEIIIEl 

## Oxidizer 

# m I 

# o.cm I I I 

## !


# c 

# 0.10 Air 

## 1lEmal Ox:idizer 

# m I 

# O.COl 

# I I ' 

### I 

## d 

# 0.91 Air 

## 1lEmal Ox:idizer 

# m I 

# o.cm 

# I I I 

# 0.91 Air 

# TIEmEl Ox:idizer 

# m I 

# o.cm I e I I (7) Mark (X) the 

# 0 P01W provide name(s) below: 

### CBI 

# O Navigable 

# 0 Other · 

### 5peci1y provide 

### NPDES # 

### <!:BI destination(s) of 

## r-- waterway releases to water. 

# I I 

# W Mark 00 this box 

### if you attach a continuation she..t. 

## I FORM EPA 7710.25 (Rev. 5-95) Page9



## i

# I Part II

- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE- Continued**~** Section A- INDUSTRIAL SITES CONTROLLED llY TifE 

## SUBMITrER- Cantinued
2. Occupational Expcware

- You must 

### maJce separate confidentiality <:biiM for the deaiption of 

### wori:.el' activity, ph}'9ical form 

### oi the new chemical :

substance,**num~** of workers 

### exposed. and duration of activity. 

### MarX 00 the "Confidential" 'oox net to an!

### item you claim as confidential. ; (1)

- 

### De5<nbe the 

### activities (e.g. 

### bag dumping.. tote 

### filling. u:uoading drum!, 

### sampling. cleamng. etc.) 

### in which woricers 

### may be exposed. to the 

### substance. 

### (2)- Mark 

### 00 this 

### column 

### ifentry in 

### column (1) 

### is confidential 

### business information 

### <CBn. (3)- 

### Describe 

## any protective

### equipment and 

### engineering rontrols 

### 'U3ed to 

### protect workers. (4) and (6)- 

### Indicate 

## you**willin~** to have the 

### information provided in column (3) ar (5) 

### bindlrlg. (5)

- lndica.te 

### the physical form(s) of the new chemical**subslan~** 

### (e.g. .30iid: crystal. granule, powder, or dust) and '- new chemical substance 

### (if

### part oi a mixture) at the 

### lime of 

### exposure. i (7)

- 

### Mark 00 this 

### column 

### iientty 

### in 

### colunm (5) is 

### conridential busine!ls information (CBI). (8}- Estimate 

### the maximum number' 

### ol

### worlcers involved 

### in each 

### activity for all 

### sites combined. (9) 

### -Mark 

### 00 this 

### column ifentry in column (8) is coofrdential busines information <CBD. (10) and (11)- Estimate themaximumdu.

..·ationoi the activity for**:~r~ywor.ker** in hours 

### per day and days 

### per 

### ye.. (12)

- 

### Mark 00 

### this 

### column if

### enll'ies in 

### coiWlUIS (1 0) and (11) are<Dtlldential business information (CBI). Worker activity CBI Protec:tln

### Eqai~ll**~tlldbls** l'hylllc.al tonnltl

### ~LDdfas CBI I of (e.g. bag dumping, filling drums) &paeen11!1 Coalnoia 

## Pf'liD- (e.g.soUd:powder) Optlaa Workaw

### ~ (xl and " new 

## Mutt <It Expo-ed f4)

### J&Jbe~~ce (6l 1'7\ (8) (1) CBl Maximum duration Hr:!/day 

### Da}'3/)T 19) (10) !111 

### 03! 

# I 1121



# 0 Mark (X) this box 

### if you attach a continuation sheet ; 3. Environmental 

### Releue 

### and**0~1-** Youmustmake 

### !eparate<U\lidentiality claims for the

### re!e=se number ar.d 

### the amount 

### oi the new chenutal

subst:mce 

### released and other**rei~** and 

### disposal information. 

### Mm: 00 the "Coniidential" box next to each

### item 

### ycu daim as confidential. \ (1)

- Enter the number of 

### each 

### l'l!i- pointidentified 

### in the 

### proces de!aiption. 

### pan II, section 

### A. .subsec:tioa 1 d(3). ' (2)

- Estimate the amOWlt of the 

### new substance releued (a) dlrediy to the environment ar (b) into control te:hnology (in kg/day or kg/batch). , (3}

- Mark 

### 00 this column 

### ifentries in columns (1) and (2) are amiidential businessinformation (CBI). i (4)

- 

### Identify the media of re!eMe i.e. 

### staclc air, fugitive air (optimaHee l.nstruction Manual), 

### surlxe water, on-site or off-site !and or incineratioa, POTW, or other (pi-speriiy) to which the newsub5tancewillbe released from thatreleaepoint.**~** (5}

- 

### a. Desaibe control technology, ifany, .and control

### efficiency that 

### will be 

### used. to limit the 

### release of 

### tbe new substance to the environment : For

### releases disposed ofon 

### land. characterize the 

### d.ispos;al method and state whethe!' 

### it is approved 

### i« disposal oi RCRA hazardous waste. I 

### On a 

### continuation sheet, for 

### each site describe any additional disposal methods that 

### will be 

### med and whether theWll5te is subject to i secondary or tertiary

### P~Hite treatment b. 

### Estimate the amaaat released to the environmentafter roatrol technology (in kg/day). I, (6)

- Mark 00 

### this column 

### ifentries 

### in columns (4) and (5) are 

### <Xl1111dential businessinformation 

# <Oin. (7)

- 

### Identify the destinadon(s) 

### oireleases to water. 

### Plea5e supply NPDES (N;ation;al PoUutant 

### Discharge Elhnination System) number! for 

## direlt di.schargen or NPDES numbers at the PO'l'\Y (PubUdy 

### Owned. Treatment Works). Mark 00 if the POlW name or NPDES 41 is conridentiall 

### busine!!S 

### information <CBD. 

# l Release 

### Number (1) Amount ofnew substance CBI !Media or 

### Cootroi tedmology and 

### efficiency (you may wish to opnonall

### y attad\ eifidency dala) .h:rl rl"lf>ll !Pd release .,_., (2a) , ·- ,Qb).

## ~-5-**~ddt...** 

# - ;Bllolln! 

# I .,;yy\.Jd.'j (3} (4) (Sa) 1 Matk!xl 

# Jw/Gy (Sb) t6) 

## f

(7) 

### Marx (X) the destinalion(s) of releases to 

### water. 

# 2.27**~lid** 

## Off-Site



# 0 POTW provide name{s) below: CB! 

# 0 Navigable 

### 1--- waterway 

# 0 Mark 

### 00 this box 

### if you attach a continuation sheet. FORM EPA 

### i7l0.25 (Rev. 5-95)

### ~e9 

## A 

# 2.27



# 0 Other · 

### Specify provide NPOES**;~~** 

## d:Br



# 10

# I Part II- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE- Continued**~** 

## Section B- INDUSTRIAL SITES CONTROLLED BY OTifERS Complete section 

### B for typical processingor use operations involving the new chemical substana! at sites you do not rontrol.lmporten do not hava to complete this section for operations outside the U.S.; 

### however, you must report 

### any processing 

### or use activities after import 

### See the Instructions I 

### ManuaL 

### Campllu 

# a sepa ndL sa:tion 

### 8 

## fur ada 

### type af

### pmassing, 

### ar use opm!lion 

### inrol"Ding 

### tr.: r.rw chDr.ical 

### substJuru:. 

### If the 

### same operation IS 

### performed at more than one site 

### describe the

### typical operation cmnmon to 

### these 

### sites. ldentify additional sites on a continuation sheet 

# i I 

### 1. Operation Desaiption -To claim information in 

### this section 

### as confidential, circle 

### or bracket the 

### specific information that you 

### claim 

### as coniidentiall (1)

- Diagram the major unit 

### operation steps and chemical conversions, includirlg 

### intmm storage and 

### transport**container.~** 

### (specify- e.g. 5 

### gallon pails, 55gallon 

### drums, 

### rail cars, 

### tank trucb, etc). 

### On the 

### diagram, identify by letter and briefly describe each worker activity. (2)- Provide the identity, 

## i the approximate weight (by kg/day orkg/batch, on an 

### HXJ'f. new chemical substaDc:e basis), and**e~~try** point of 

### all feedstocks (includingreactants.! solvents and 

### catalysts, etc) and of

### all products, recycle streams, and 

### wastes. Include cleaning chemicals (note frequency 

### if not 

### used daily or 

### per 

## i batch). (3)

- Identify by number 

### the points

### of

### release, including 

### small or intermittent

### releases, to 

### the environment of the new chemical substance. '! 1 (4) Please enter the If of sites ( rememba- to identifv 

### the locations of these sites on a continuation sheet): ,


# . . !**imm~** 

### , 

# ! i '



# 0 Mark (X) this box if you attach a continuation sheet. 2. Worker Expowre/Environmental Rein. (1)

- From t!le diagram above, provide the ietter ior each worker activity. Complete2-8 for each worker activity described. 

## i (2)- Estimate the number of workers 

### exposed for all stes combined.

. (4)- Estimate the typical duration of

### exposure per waker in (a) hours 

### per day and (b) days pEt 

### year. ) (6}- Describe physical form of exposure and % new chemical substance (if in mixture), and anyprotective equipment and engineering controls used to protect workers. ' (7)- Estimate the 

### percent of the new substance as formulated when paclc:aged or 

### 1.l:9ed as a 

### final product. 

## i (9)- From the 

### process diagram above, enter the number of each 

### release point Complete9-13 for 

### each release point identified. (1 0)- Estimate the 

### amount of the new substance 

### released (a) directly to the environment or (b) into control technology to the environment (In kg/day or kg/batch). (12)- Describe media of releasei.e. stack air, fugitive air {optional-5ee Instructions Manual), surface water, 

### on-site or off-site land or incineration, POTW, or other (specify) and control technology, 

### if any, that 

### will be used to limit the 

### relea!e of the new substance to the environment (14)- Identify byproducts which mayresult from the operation. (3), (5), (8), (11), (13) and (15)- Mark (X) 

### this column 

### if any o( the proceeding entries areconfidential business information 

### (CBO. Letter # of CBI Dl.uation Clll Protective Equip. 

### I '1'. in CBI Release Amount 

### of CBI 

### Media of Release f:BI

of Workers of Engineering Controls/ Form- Number New & Control Act- Exposed Exposure Physical Form and 'r. ulalion Substance Technology ivity new substance Released (7) I (11 (8) (9) (10a) I (lOb) I (]) (2) (3) (4a) I (4bl (5) (6) (12) 13) 

### I I I 

### I I I I 

### I 

### I I 

### I I 

### I I I I 

### I 

### I I 

### I I 

### I I 

### I 

### I (14)- Byproducts: 5) ' 

# 0 Mark (X) this box 

### if you attach a continuation she.!t. 

# I FORM EPA 

### m0-25 (Rev. 5-95) Page 10 

# !II
I 

# OPTIONAL POLLUTION PREVENTION INFORMATION I 

# I I 

### To claim information in this section as confidential circle 

### or bracket the specific information that you claim as confidential. !


# In 

# this section you may provide information not reported elsewhere in this 

# form regarding your 

# efforts to reduce or minimize potential 

# risks associated with activities surrounding manufacturing, processing, use and disposal of the P::MN substance. Please include new information pertinent to pollution prevention, including source reduction, recycling activities I 

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

### : 

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

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

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

# 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 I 

# this information to assess overall net reductions in 

# toxicity or environmental releases and exposures, not the shifting of risks to other environmental media or non-ffivironmental areas (e.g., occupational or consumer exposure). In 

# addition, information on the relative cost or performance characteristics of the P:MN substance to potential alternatives may be provided. I 

# 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.

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 performance, a decrease in 

### the cost of production and/or improved operation effidency of the new chemical substance in 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 hwnan health orthe environment.

: 

## i

I 

### i I 

## I 

# I

I 

## I

I 

# i
I I 

## I I 

# 0 Mark (X) this box if you attach a continuation sheet. I I FORM EPA 7710-25 (Rev. 5-95) Page 11

## r~I



# Part III -LIST OF A IT ACHMENTS

Attach continuation sheets for sections 

### oi the form and test data and other data (induding physical/chemical properties and structure/activity lnformation), and optional information after this page. Oearlyidentify the attachment 

### and 

### the section of the form to : 

### which it relates, if

### appropriate. Numba" conse...-utively the pages of 

### the attadunenl1 

### In the column below, enter the inclusive page numbers of each attachment. II 

### Mark (X) 

### the "Confidential" box next to any attachment name you 

### claim as confidential. Read the Inatructiona Manual for I 

### guidance on how to 

### claim 

### any information 

### in an attachment as ronfidentiaL You must include with the 

### sanitized copy of the notice i 

### form a 

### sanitized version of any attachment 

### in which you 

### claim information as confidentiaL 

# I
Attachment name Attaclunent 

## eo.ifipage number(s) 

### dmial 

# Material Safety Data Sheet (MSDS) · ' 

# 14-18 X 

# I

i 

## Block Flrn Diagran 

# 19 X I : 

## furnn. 

# :&rasure 20 X i I 

## Ch:mi.cal 

## Abstracts S2:rvice 

## 21 X

• 

# _C 

# lProcess OJervie;y 

## 22 X i
L_ ..J i I 

## Toxicological 

# Stulies Pacl<age 

## (See att.ac.lnEn.t, Table of O::nt:rnts) 

## X I I

I

I



### i I

i

1 I I I 

# ! I I 

## : !

I i 

### I

I 

### I

! 

## I I I 

## I 

# D Mark()() this box if 

### you attach a rontinualion sheet. Enter the attachment name and number. 

# i I 

### FORM EPA 7710.25 (Rev. 5-95) 

### Page 12


# 13I 

### i 

## I PHYSICAL AND OiE:MICAL PROPERTIES WORKSHEET I I I 

### To assist EPA's review ofphysical and chemical properties data, please complete the following worksheet for data 

### you provide and include it in the notice. Identify the property measured, the pageof 

### the notice on which 

### the property 

### appear5, the value 

# I of the property, 

### the units in 

### which the property ill measured 

### (as necessary), and 

### whether or not the property is claimed all 

### confidentiaL The physical state at 

### the neat substance should be 

### provided.**Th~** 

### measured properties should be 

### for the neat (1009', 

### pure) chemical 

### substan<E. Properties that are measured for mixrures or formulations should be 

### so noted (9', PMN substance in 

### _).You are not required to submit 

### this worksheet; however, EPA strongly recommends that you do so, all 

### it 

### will simplify review and ensure 

### I that roniidential information is properly protected. You should submit 

### this worksheet as a supplement to your submission of test 

# I data. 

### This worksheet 

### is not a substitute for submission of test data. Property Value Maau.C Confij. 

### Mar.k 00 if Page or 

### dential provided number Eot!..- (a) (b) (c) 

### Marie()() (MorEl 

### (d) I 

### I Physical state of neat substance 

## X 

## (s>--n>--W M
Vapor pressure ' 

### 'C I**@Tem~ture** 

### Torr I 

### Density/relative density 

### g/cm3 I I i 

### Solubility I 

### 'C I 

### @Temperature

Solvent 

### g/L 

## i 

# JJ.4 

# gJL H ! Soiubilitv in**wat~** 

### @Temperature 

# ac "C I 

# 1€6-171 M I 

### Meltin_Ktemperature 

# ac 

# i 655.9 ±:DOC M ! 

### Boiling/sublimation temperature @ 

### •orr pressure i



### Spectra i ! 

### Dissodation ronstant 

### i

I ' 

### Particle size distribution i



### Octanol/water partition coefficient 

## i ' Henry's Law constant 

## i I 

### '
Volitalization from water 

# I

Vo!italization from soil 

# I
pH @ooncentration 

# I FP 350.5 ± 54.2°C I 

### Flammability 

## M 

# I
I 

### Explodability 

# I
Adsorption 

### I coefficient 

# I

Other

- Specify 

# I
I 

## I I 

### ' I

# ~ I
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### HUMAN EXPOSURE TABLE

PRGC£SS: 

# ( ]

] Production approximately[ }ercampaign per year (Batch Size: 2772 kg;batch) Exposure tot \Vorker Exposure Protective Equipment and Physical #ofWorkers Hours/Day Days/Year Engineering Controls Form Exposed Estimate Sampling of solvent recetver Apron, full-faced resptrator, Liqutd I 

### 0.25 22 rubber gloves.

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### Chargingot 

# J Tyvek suit, full-faced Solid 2 0.50 

# .,,., respirator, rubber gloves.


## r 

# , Sampling o1 

# J Acid suit, full-faced respirator, Liquid l 

### 0.25 

### 22 recetver rubber gloves. 

## r 

# ., Sampling ot Jeactor Acid suit, full-faced respirator, Solid and l 

### 0.25 22 rubber gloves. liquid 

# ,. ., Samplingot }rystallizer Acid suit, full-faced resptrator, Solid and l 

### 0.25 22 rubber gloves. liquid 

# r 1 Sampling

## ~:6

# 1 jwet cake Acid suit, full-faced respirator, Solid l 

### 0.25 22 from centri uge rubber gloves. I"' 

## 1 UnloadingL jwet cake Acid suit, full-faced respirator, Solid l 

### 4.00 22 from centnruge rubber gloves. 

## r 

# ,**Chargin~** jvetcaketo Acid suit, full-faced respirator, Solid 2 0.50 22 dryer rubber gloves. 

# r.. 

# , Sampling ott Jfrom dryer Acid suit, full-faced respirator, Solid l 

### 0.25 

# .,,., rubber gloves. 

## .r: 

# , Unloading o1 Jromdryer Acid suit, full-faced respirator, Solid 2 l.OO 

### 22 rubber gloves. Sampling ofmother liquor in solvent Apron, full-faced respirator, Liquid I 

### 0.25 22 recovery pot rubber gloves. Sampling of stripped solvent/water Apron, full-faced respirator, Liquid I 

### 0.25 22 receiver rubber gloves. Sampling ofdistilled solvent receiver Apron, full-faced respirator, Liquid I 

### 0.25 22 rubber gloves.