United States Environmental Protection Agency

Washington, DC 20460

Section 4 Submission

This is an original submission:

✔

This is an amendment:

CERTIFICATION

I hereby certify to the best of my knowledge and belief that (1) all information entered on this form is

complete and accurate; and (2) any confidentiality claims are true and correct as to that information

for which they have been asserted. Any knowing and willful misinterpretation is subject to criminal

penalty pursuant to 18 USC 1001.

Signature: Official Title:

Lawyer

Contact Person:

W C. Norman

Email Address:

caffey.norman@squirepb.com

Date Signed:

02/09/2015

PART 1 Contact Information

Submission

Information

Submission Type:

ECA

Form Alias:

HAP Task Force

Federal Register Notice:

68 FR 33125

Chemical Name:

1,2-Ethylene Dichloride, (a/k/a

Ethylene Dichloride)

Date Submitted:

02/09/2015

Submitter

Information

Company Name:

HAP Task Force

Address:

PO Box 331

Millwood, VA, 22646

United States

Contact Person:

W C. Norman

Phone Number:

2024575270

Email Address:

caffey.norman@squirepb.com

Technical Contact

Information

CBI

Yes: 	No: 

✔

Company Name:

HAP Task Force

Address:

PO Box 331

Millwood, VA, 22646

United States

Contact Person:

Mr W C. Norman

Not for Submission
SEC4 Submission Page 2

Phone Number:

2024575270

Email Address:

caffey.norman@squirepb.com

PART 2 Study Plans & Conduct of Testing

Principal Test

Sponsor

CBI

Yes: 	No: 

✔

Contact Person:

Mr Peter E. Voytek

Address:

P.O. Box 331

1680 Bishop Meade Highway

Millwood, VA, 22646

United States

Phone Number:

5402773288

Email Address:

PVoytekRSI@aol.com

Sponsor

Organizations

CBI

Yes: 	No: 

✔

Contact Person:

Mr Peter E. Voytek

Address:

P.O. Box 331

1680 Bishop Meade Highway

Millwood, VA, 22646

United States

Phone Number:

5402773288

Email Address:

PVoytekRSI@aol.com

Testing Facilities Testing Facility:

WIL Research

Address:

1407 George Road

Ashland, OH, 44805

United States

Phone Number:

4192898700

CBI

Yes: 	No: 

✔

Contact Person:

Dr Pragati S. Coder

Address:

1407 George Road

Ashland, OH, 44805

United States

Contact Role:

ADMINISTRATIVE OFFICIAL

Phone Number:

4192898700

Email Address:

Pragati.Sawhney.Coder@wilresearch

.com

Study Professionals CBI

Yes: 	No: 

✔

Not for Submission
SEC4 Submission Page 3

Company Name:

WIL Research Laboratories

Address:

1407 George Road

Ashland, OH, 44805

United States

Contact Role:

STUDY DIRECTOR

Phone Number:

4192898700

Email Address:

melissa.beck@wilresearch.com

Experience:

Assistant Director, Neurosciences

PART 3 Additional Information

Additional

Information

File Name:

Dec HAP Testing Consent.pdf

Document Type:

Amendment to

the Study Plan

Attachment Date:

02/09/2015

File Name:

Oct HAP Testing Consent.pdf

Document Type:

Amendment to

the Study Plan

Attachment Date:

02/09/2015

Paperwork Reduction Act: The Government Paperwork Elimination Act (GPEA) (44 U.S.C. 3501) provides that, when practicable, Federal organizations use electronic forms, electronic filings, and

electronic signatures to conduct official business with the public. EPA's Cross-Media Electronic Reporting Regulation (CROMERR) (40 CFR part 3), published in the Federal Register on October 13,

2005 (70 FR 59848) (FRL-7977-1)(Ref. 2), provides that any requirement in title 40 of the Code of Federal Regulations (CFR) to submit a report directly to EPA can be satisfied with an electronic

submission that meets certain conditions once the Agency published a notice in the Federal Register announcing that EPA is prepared to receive certain documents in electronic form. For more

information about CROMERR, go to http://www.epa.gov/cromerr/.

Not for Submission