# E"A

I

# ~IIIIJIIII)111111

# i'

uYY bl\;'> I

• You must provide all information requested in this form to the extent that it is known to or reasonably ascertainable by you. Make reasonable estimatesifyou do not have actual data. • Before you complete this form, you should read the "Instructions Manual for Premanufacture Notification" (the Instructions Manual isavailable from the Toxic SubstancesControl Act (TSCA) Information Service by calling 202-554-1404, or faxing 202-554-5603). • Ifa user fee has been remitted for thisnotice (40 CFR 700.45), indicate in the boxesabove the TS-user fee identification number you have generated. Remember, your user fee 

### lD number must also appear on your corresponding fee remittance. which issent to EPA, 

### HQ Accounting Operations Branch (PM·226), P.O. 

## U.S. ENVIRONMENTAL PROTECTION AGENCY 

# PREMANUFACTURE NOTICE 

# Jill II1111111111III!!III/I Jill}III,I111)111II/I

1v"**~'"** .... U.S. EPA,401 M STREET SW WASHINGTON DC 20460

360399M, Pittsburgh, PA 15251·6399, Attn. TSC'A User fee.
Part I - GENERAL INFORMATION You must provide the currently correct Chemical Abstracts (CA) Name ofthe new chemical substance. even ifyou claim the identity as confidential. You may authorize anotherperson to submit chemical identity inform3lion 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 yourTS user fee identification number. You must submit an original andtwo copies oflhis nalice including all test data. Ifyou claimed any information as confidential, a single sanitized copy must also be submitted.
Part 11- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE Ifthere are several manurncture. processing, or use operations to be described in Part II, sections A and Bofthis notice, reproduce the sections as needed.
Part III- LIST OF ATTACHMENTS Attach additional sheets ifthere is not enough space to answer a question fully. Label each continuation sheet with the corresponding section heading. In Part III, list these attachments, anytest data or other data and any optional information included in the notice.

OPTIONAL INFORMATION You may include any information that you want EPA toconsider in evaluating the new substance. On page II ofthis form, space has been provided for you to described pollution prevention and recycling inform3lion you 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 Significant New Use Rules. Except in the case ofexemption appliC3lions (such as TMEA, LVE, LOREX) where certain information provided in such notific3Iion is binding on the submitter when the Agency approves the exemption application, checking a binding box in this notice**do'~s** 

## ..IIQt by itselfprohibit the submitter from later devi3ling from the infonnation (except chemical identity) reported in the fonn.
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 tothe information that you claim as confidential. To assert a claim in an attachment, circle or bracketthe information you claim as confidential. Ifyou claim infonnation in the notices as con.fl!tential, you must '!l!;Ql!rovide a sanitized versionQfthe notice, (incJuding attachments). For additional instructions on claiming information as confidential, read the Instructions Manual.
Mark (x) ifany information in this notice is claimed as confidential. TEST DATA AND OTHER DATA You are required to suhmit all test data in your possession or control and to provide a description ofall otherdata known to or reasonably ascertainable by you, ifthese data are related to the health and environmental effects on the manufacture, processing, distribution in commerce, use, or disposal ofthe newchemical 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 ifthey do not appear in the open literature. You should dearly 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 otherdata. Data should 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 Health effectsdata Environmental effects data PhysicaVChemical Properties'

• A physical and chemical properties worksheet is located on the last page ofthis fonn. TYPE OF NOTICE (Check Only One)

## ~ PMN (PremanufactureNalice) 

# D INTERMEDIATE PMN (submitted in sequence with final PrPduct PMN) 

# D SNUN (Significant New Use Notice) TMEA (Test Marketing Exemption Application) 

# D LVE (Low Volume Exemption) (ll! 40 CFR 723.50(c)(I) 

# D LOREX (Low Release/Low Exposure Exemption) 

### (iiJ 40 CFR 72J.5O(c)(2) 

# D LVE Modification 

# D LOREX Modification IS THIS A CONSOLIDATED PMN') 

# D Yes # ofchemicals (Prenotice Communication # required, enter# onpage 3) 

## AGENCY USE ONLY

") 

# Company Sanitized

o Yes Other data 

### 18'1 Yes 

### 18'1 Yes Risk assessments 

# o Yes Structure/activityrelationships 

### 18'1 Yes Test data not in the possession or control ofihe submitter

### Public reporting burden for this collection ofinformation is estimated to average 110 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding theburden estimate orany other aspect ofthis collection ofinformation, including suggestions for reducing this burden, to Chief, Information Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M. St., S.W., Washington, D.C. 20460; and to the Office ofManagement and Budget, Paperwork Reduction Act (2070-0012), Washington, D.C. 20503. 

# CERTIFICATION I certify that to the best ofmyknowledge and belief 1. The companynamed in Part I, section A, subsection I a ofthis notice form intends to manufacture orimport 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 ofthe date ofsubmission. 3. I am submitting with this notice all test data in mypossession orcontrol and a description ofall other data known to or reasonably ascertainable byme as required by §720.50ofthe Premanufacture Notification Rule.
Additional Certification Statements: Ifyou are submitting a PMN, Intermediate PMN, Consolidated PMN, or SNUN, check the following userfee certification statement that applies: 

# I:8J The Companynamed in Part I, Section A has remitted the fee of$2500 specified in

## 40CFR700.45(b), or 

# D The Companynamed in Part I, Section A has remitted the fee 0[$1000 for an Intermediate PMN (defined @40 CFR 700.43) in accordance with 40 CFR 700.45(b), or 

# D The Companynamed in

## Part I Section A is a small businessconcern under 40 CFR700.43 andhasremitted a fee of$100 in 

## accordance with 40CFR700.45(b). Ifyou are submitting a low volume exemption (LVE) application in accordance with 40 CFR723.50(c)(I) or a Low release and low exposure exemption (LoRex) application in accordance with 40 CFR723.50(c)(2), check the following certification statements: 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 terms of40 CFR723.50. 

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

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

# D Ifthis application is for an LYE in accordance with 40 CFR723.50(c)(I), the manufacturer intends to commence manufacture ofthe exempted substance for commercial purposes within I year ofthe date ofthe expiration ofthe 30 day review period.
The accuracy ofthestatements you make in this notice should renectyourbestprediction oftheanticipated facts regardillg the chemical substallce deseribed hereill. AllY Mowing and willful misinterpretation I. subject to criminal pellalty pursuantto 18 USC 1001. Signature and title ofAuthorized Official (Original Signature Required) Date COllfidential 

# x Signature ofagent
- (ifapplicable) Date

### la. Person Submitting Notice(in U.S.) Confidential 

# x

Mailingaddress (number and street)
ZIP Code

C. 

### Joint Submitter(if Name ofauthorized official applicable) Company Mailing address (number and street)

2. Technical Narne ofauthorized official Contact (in U.S.)

Mailing address (number and

4. Ifyou previously the chemical substance covered bythis notice, enter the exemption number assigned by EPA. Ifyou previously submitted a PMN for this substance enterthe PMN number assigned by EPA (i.e. withdrawn Or incomplete). 5. Bona intent to manufacture or for the chemical substance covered by this notice, enterthe notice number assigned by EPA. 

### I. Manumcture 6. 

### Type ofNotice

- Mark (X) 

### Only 

# o Binding Option Mark City, State, ZIP Code
b. 

### Agent (if 

### Name ofauthorized official applicable)

Mark (X) 

### ifnone Mark (X) 

### ifnone
Mark (X) 

### ifnone Company

ng address (number street)

Telephone

# Ifyouaresubmittlh·n~g~t~h~is~no~t~icZ.e~a;s;paoa.rt~~~~~~~~~~~O()tlri;bbo~X~.~:'.:':':':':':':':':':':':':':'~:':':':':':':':':':':':':':':':':':':':':':':':':':.:.:.:.:.~~-r"-

Telephone
Position

2. Import Only 3. 

# o Both 

# o Binding Option Mark


# .3

### Complete Ifanother person will submitchemical identity infonnation for you (for either Item I or2), mark (X) the box at the right. the andaddress ofthat in a continuation sheet. I. Class I or2 chemical substances (for definitions ofclass I and class2 substances, see the Instructions Manual) a. Class ofsubstance

- Mark (X) I 

# D**Cla.~s** I or 2 

# D Class 2 b. Chemical name (Currently correct Chemical Abstracts A) Name that is consistent A Inventory listings for For Class I substancesa CA Index Name must be 

### provided. ForClass 2 substances eithera CA Index Name orCA Preferred Name must be provided, which ever is appropriate based onCA 9CI nomenclature rules and conventions). 

# x 

# x

CAS#

e. For a class I substance, provide a complete and correct chemical structure diagram. Fora class 2 the precursor substances with their respective CAS Registry Numbers. (2) Describe the nature ofthereaction orprocess. (3) Indicate the range ofcomposition and the typical composition (whereappropriate). (4) Provide a correct representative or partial chemical structure dialmlm. as complete ascan beknown. ifonecan be reasonablv ascertained. 

# x


# x


# x

attach a continuation sheet.Confidential a. Indicate the numher-average weight ofthe lowest molecular weight composition ofthe polymer you intend to manufucture. Indicate maximum weight percent oflow molecular weight species (not includingresidual monomers, reactants, or solvents) below 500 and helow 1,000 absolute molecular weight ofthat composition. Descrihe the methods ofmeasurement or the basis for yourestimates: GPC 

# 0 Other 

# 0: (SpecifY) i) lowest number average molecularweight: ii) maximum weight % below 500 molecular weight: iii) maximum weight 

### 0/. below 1000 molecular weight:

b. You must separate monomer or other rcactant identity, composition information, andresidual information. Mark (X) "Confidential" box next to any item you claim**a~** confidential 

# x

(I) Providethe specific chemical name and CAS Registry Number (ifa numberexists) ofeach monomer orother reactant used in the manufacture of

e. the polymer. (2) Mark (X) this column ifentry in column(I) is confidential. (3) Indicate the typical weight percent ofeach monomer or otherreactant in the polymer. (4) Mark (X) theidentity column ifyou want a monomer or otherreactant used attwo weight percent orless to be listedas part ofthe polymer description on theTSCA Chemical Substance Inventory. (5)

- Mark (X) this column ifentries in columns(3)and (4) are confidential. (6) Indicate the maximum weight percent ofeach monomer or otherreactant that may be present as a residual in the polymer as manufuctured for commercial purposes. Mark this column if in column is confidential. Monomer or other reactant and CAS Registry Numher Confi- Typical Confi

# x 

# x x 

# x x 

# x

identity information reported in this notice (check one). Method I (CAS Inventory F.xpert Service - a copy ofthe identification report 

# 0 Method 2 (other source) obtained from CAS Inventory Expert Service must he submitted as asattachment tothisAbstracts (CA) name for the polymer that is consistent with Provide a correctrepresentative or partial structure diagram, as complete as can beknown, ifonecanbereasonably ascertained. 

# x

Mark (X) this box ifyou attach a continuation sheet.(a) Identify each impurity that may bereasonably anticipated to be present in thechemical substanceas manufuctured for commercial purpose. Providethe CAS Registry Number ifavailable. Ifthere areunidentified impurities, enter"unidentified." [fthereareunidentified estimatetheir total %. % ofeach
. Impurity and CAS Registry Number Maximum Confipercent dential 

# x

Confidential



# x 

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

### 5. substance identified in subsection 

### I or

### 2. 

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

### 6. chemical name - Ifyou claim chemical identify as confidential, you must name your substance that the specific chemical identity ofthe new chemical substance to the maximum extent possible. Refer to the TSCA Chemical Substance Inventory. 

### 1985 Edition, Appendix 

### B for guidance on developing generic names. 

## Polyalkenyl, N,N'-bistriazole 

# D 7. use, or disposal ofthe new chemical substance. Providethe CAS Registry CAS Number Confidential



# x Impurities

- Enter any chemical synonyms for the ncw chemical identified in subsection I or2.

# Part I - GENERAL INFORMATION

- Continued Section C - PRODUCTION, IMPORT, AND USE INFORMATION: Mark (X) the "Confidential"box next to any item you claim as confidential. 1. 

### Production volume- Estimate the maximum production volume during the first 12 months ofproduction. Also estimate the maximum production volume for any consecutive 12-month period during the first three years ofproduction. Estimates should be on 100"10 new chemical substance basis. Fora Low Volume Exemption application. ifyou choose to have your notice reviewed at a lowerproduction volume than 10,000 kg/yr, 

### specify the volume and mark (x) in the bindingbox. Ifgranted, you are bound to this volume Maximum first 12-monthproduction (kg/yr) Maximum 12-month production (kglyr) Confi- Binding 

### (100% new chemical substance basis) (100% new chemical substance basis) dential Option Mark (x) 

### X 2. 

### Use Information

- You must make separate confidentiality claims for the description ofthe category ofuse, the percent ofproduction volume devoted to each category, the tormulation of the new substance, and otheruse information. Mark (X)

### the "Confidential" Box next 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 column (1) is confidential business information (CBI). (3) 

### Indicate your willingness to have the information provided 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, orgels 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 ifentry(ies) in column (8) is (are) confidential business information (CBI). Category ofuse ( I ) CBI Binding Produc- CHI %in CHI % ofsubstance expected per use CHI Option tion % Fonn­ 

### (8) (by function and application i.e. a dispersive dye Marltlx) ulation Site- Con-· Indus- Com- Hinding for finishing polyester fibers) (2) (3) (4) 

### (5) (6) (7) limited sumer trial mercial Option (9) 

### X X X X



# • Ifyou have identified a "consumer"use, please provide ona 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 consumerproducts and describe the chemical reactions by which this substance loses its identity in theconsumer product. DMark (X) this box ifyou attach a continuation sheet. 

### (3) 

### Generic Ifyou claim any category ofuse description in subsection 2a as confidential, entera generic description ofthatcategory. Read the 

### use Instructions Manual for examples ofgeneric use descriptions. 

### Description 

## Lubricant Additive

D Mark (X) this box ifyou attach a continuation sheet. 3. Hazard Information

­ Include in the notice a copy ofreasonable fucsimile ofany hazard warning statement, label, material safety data sheet, orother Binding

information which will be provided to any person who is reasonably likely to be exposed to this substanceregarding protective equipment orpractices OpMn for the safe handing, transport, use, or disposal ofthe new substance. List in 

### part III hazard information you include. MarIt(x)

Mark (X) thisbox ifyou attach hazard information. (see Attached MSDS)

# II-HUMAN Section A INDUSTRIAL SITES CONTROLLEDBY THE SUBMITTER Mark (Xl the"Confidential" box next to any item you claim as confidential 

### Complete section A for type ure, processing, oruse operation involving Ihe 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 or use after You must describe these See instructions manual 1. 

### Confiofthe site at 

### which the will occur. dential 

# x Site address and street) City,


### Ifthe same operation occur at more one enter ofsites. additional sites on a continuation sheet, and ifany ofthe sites have significantly different production rates or operations. include all the information requested in this section for those sites as attachments.


# x Use


# x I. Batch Maximum kglbatch (100% new chemical 

### Hours/batch Batches/year substance) 

### 2. Continuous (3) 

### sheet. 

### Processing

d 

### Process description Mark (X) to indicate your willingness to have your process description binding. (I) Diagram the major unit operation steps and chemical conversions. Include interim storage and transport containers (specify- 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 a 100%new chemical substance basis), and entry point ofall starting materials and feedstocks (includingreactants. solvents, catalysts, etc.), and ofall products, recycle streams, and wastes. Include cleaning chemicals (note frequency ifnot used daily or per batch.

### J. (3) Identify by number the points ofrelease. including small or intermittent releases, to the environment ofthenew chemical substance.

)this box ifyou attach a continuation sheet.

# Part 11-- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE

-- Continued Section A ­ INDUSTRIAL SITES CONTROLLEDBY THE SUBMITTER

- Continued 2. Occupational Exposure

­ You must make separate confidentiality claims for the description ofworkeractivity. physical form ofthe new chemical substance, number ofworks exposed, andduration ofactivity. Mark (X) the "Confidential"box next to any item you claim 

### as confidential. (1) -- Describe the activities (i.e. bagdumping, tote filling. unloading drums, sampling, cleaning, etc.) in which workers may be exposedto the substance. (2)-- Mark (X)this column ifentry in column (I) is confidential business information (CBI). (3)-- Describe any protective equipment andengineering 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 suhstance (e,g., solid: crystal, granule, powder, or dust) and % new chemical substance(ifpart ofa mixture) atthe timeofexposure, (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 comhined (9) -- Mark (X) this column ifentry in column (8) is confidential business information (CBI), (IO) and (II) Estimatethe maximum duration ofthe activity for any worker in hours per day and days 

### per year. (12)

-- Mark (X) this column ifentries in columns (IO) and (II ) are confidential business information (CBI). Worker activity CBI Protective Equipment! Binding Physical forms(s) Binding CBI # of CBI Maximu duration CBI m (i.e" bag dumping. filling drums) EngineeringControls Option and % new Option Worker HrsJday Dayslyr Mru:I«x) substance Mru:I«x) S (I) (2) (3) (4) (5) 

### (6) (7) Expose (9) (10) ( II) (12) d 

### (8) 

## X X X X X X X X X


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

### 3, Environmental Release and Oisposal

-- You must make separate confidentiality claims for the release numberand the amount ofthenew chemical substance released and other release and disposal information. Mark (X)the"Confidential" box next to each item you claim as confidential. (I)

-­ Enter the number ofeachrelease point identified in the process description. 

### part II, section A, subsection 1d(3). (2) -- Estimate the amount ofthe new substance released (a) directly to the environment or (b) into control technology (in kg/day orkg/batch). (3)

-- Mark (X) this column ifentries in columns (I) and (2) are confidential business information (CBI). 

## X X X

(4) -- Identify the media (stack air, fugitive air (optional-see Instruction Manual), surface water. on-siteoroff-site land or incineration, POTW, orother (specify» to which the new substance will be released from that release point. (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, characterizethe disposal method and state whether it is approved for disposal ofRCRAhazardous 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 or tertiary on-sitetreatment. b, Estimate the amountreleased tothe environment aftercontroltechnology (in kg/day). (6) -- Mark (X) this columnifentries in columns (4) and (5) are confidential business information (CBI). (7)

-- Identify thedestination(s) ofreleases to water. Please supply NPDES (National Pollutant Discharge Elimination System) numbers for direct discharges or NPDES numbers ofthe POTW (rblicllOwnedTreatment Works). Mark (X) ifthe POTW name orNPDES # is confidential business information (CBI), Release Amount ofnew substance Medta of Control technology and efficiency (you may wish to optionally attach efficiency data) CBI Number released release

(I) (2a) (2b) eg. 'lock**~r** Binding (3) (4) (Sa) Man (X) (5b) (6)

# ~~ __ __

# ~~ __ ______________

# ~~ ______

# ~X I

(7) Mark (X) the destination(s) of releases to water, 

## X



# U POTW provide name(s) below: 

## None ] Mark (X) this box ifyou attach a continuation sheet. CBI 

# 0 Navigable 

### --:-:--X waterway 

## X



# D Other

- Specify provide NPDES # CBI 

# x

# Part II-HUMAN ENVIRONMENTAL RELEASE Section A - INDUSTRIAL SITES CONTROLLED BY THE SUBMITTER Mark (X) the "Confidential" box next to any item you claim as confidential 

### Complete section A for each type ofmanufacture, processing, or use 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
. or use after You must describe these See instructions manual I. Confiofthe site at which the will occur. dential 

# x Site address (number and street) City, County, State, ZIP code 

### If

### the same operation will occur at more than one site, enterthe number ofsites. Identify the additional sites on a continuation sheet, and ifanyofthe sites have significantly different production rates or operations, include all the infonnation requested in this section for those sites as attachments.

(3) 

# x DProcessing Duse Hoursfbatch Batches/year 

# x Maximum kglbatch (100;, new chemical 

### Hoursfbatch Batches/year substance) 

# x d. Process description Mark (X) to indicate your willingness to have your process description binding. (I) Diagram the major unit operation steps and chemical conversions. Include interim storage and transport containers (specify- e.g. 5 gallon pails, 55 gallon drum, rail car, tank truck, etc.). (2) Provide the identity, the approximate weight (by kg/day or kglbatch on a 100% new chemical substance basis), and entry point ofall starting materials and feedstocks (including reactants, solvents, catalysts, etc.), and ofall products, recycle streams, and wastes. Include cleaning chemicals (note frequency ifnot used daily or per batch.). (3) Identify by number the points ofrelease, including small or intermittent releases, to the environment ofthe new chemical substance. I. Batch
2. Continuous

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

## 8A

# Part 11-- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE

-- Continued SectionA ­ INDUSTRIAL SITESCONTROLLEDBY THE SUBMITTER

- Continued 2. Occupational Exposure

­ You must make separate confidentiality claims for thedeseription ofworkeractivity, physical form ofthe new chemical substance, number ofworks exposed, and duration ofactivity. Mark (X) the "Confidential" box next to any item you claim as confidential. (I)

-- Describe the activities (i.e. bag dumping, tote filling, unloading drums, sampling, cleaning, ctc.) in which workers may be exposedto the substance. (2) Mark (X) this column ifentry in column (I) is confidential business information (CBI). 

### (3) Describe any protective equipment andengineering controls used to protect workers. (4) and (6) --Indicateyour willingness to havethe information provided in column (3) or (5) binding. (5) --Indicate the physical form(s) ofthe new chemical substance (e.g., solid: crystal, granule. powder. ordust) 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). (10) and (II)

-- Estimate the maximum duration ofthe activity for any worker in hours per day and days per year. (12)

-- Mark (X) this column ifentries in columns (I0) and (II) are confidential business information CBI). Worker activity eBI Protective Equipment! Binding Physical fonns(s) Binding CSI #of eBI Maximu duration CSI m (i.e
.. bag dumping. filling drums) Engineering Controls Option and % new Option Worker Hrslday Dayslyr Mark (x) substance Mark (xl s (I) (2) 

### (3) (4) (5) (6) (7) Expose (9) (10) (II) (12) d (8) 

## X X X X X X X X



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

### 3. Environmental Release and Disposal You must make separate confidentiality claims for therelease number and the amount ofthe new chemical substance releasedandotherrelease and disposal information. Mark (X) the "Confidential" box next to each itemyou claimas confidential. (1) Enter the number ofeach release point identified in the process description, part II, section A. subsection 1<1(3). (2) Estimatethe amount ofthe new substancereleased (a) directly to the environment or(b) into control technology (in kg/day or kg/batch). (3) Mark (X) this column ifentries in columns (I) and(2) are confidential business information (CBI). (4)

-- Identify the media (stack air, fugitive air (optional-see Instruction Manual), surfuce water, on-site oroff-site land orincineration. POTW, or other (specify» to which the new substance will be released from that release point (5)

-- a. Describe control technology, ifany. andcontrol efficiency that will be used to limit therelease ofthe new substanceto the environment. For releases disposed ofon land, characterize the disposal method and state whether it is approved for disposal ofRCRA hazardous waste. On a continuation sheet, for each site describe any additional disposal methods that will be used and whetherthe waste is subject to secondary ortertiary on-sitetreatment. b. Estimate the amountreleasedtothe environment after control technology (in kg/day). (6)

-- Mark (X) this columnifentries in columns (4) and(5) areconfidential business information (CBI). 

### (7) Identify thedestination(s) ofreleases to water. Please supply NPOES (National Pollutant Diseharge Elimination System) numbers for direct discharges or NPDES numbers ofthe POTW (Publich OwnedTreatment Works). Mark (X) ifthePOTW name or NPDES # is confidential business information (CBI). Release Amount ofnew substance CBI Media of Control technology andefficiency (you may wish to optionally attach efficiency data) CBI Number released release

(I) (2a) (2b) eg. slack air Binding (3) (4) (5a) Mark (X) (5b) (6) 

## X X X X

(7) Mark (X) the 

# D POTW providename(s) below: CBI 

# D Navigable 

# D Other

- Specify provide NPOES # !CBI destination(s) of 

# 7 waterway 

## X releases to water. 

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


## 9A

# Part 11-- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE

-- Continued 

# I SectionB

-- INDUSTRIAL SITES CONTROLLEDBYOTHERS

Complete section B for typical processing oruse operations involving thenew chemical substance at sites you do not control. Importers do not haveto complete this section for operations outside the U.S.; however, you must report any processing or use activities after import. Sce the Instructions Manual. Complete a separate section B for each type of processing, oruse operation involvingthenew chemicalsubstance. Ifthe same operation is perfonned at morethan one site describe the typical operation commonto these sites. IdentifY additional sites ona continuation sheet I, 

### Operation Description -. To claim infonnation in this seetion as confidential, circle Ofbracket the specific infonnation 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 gallonpails, 55 gallon drums, rail cars, tank trucks, etc). Onthe diagram, identifY by letterand briefly describe each worker activity. (2)

-- Provide the identity, theapproximate weight (by kg/day orkg/batch, on an 100·;' new chemical substance basis), and entry point ofall feedstocks (includingreactants, solvents andcatalysts, etc) and all products, recycle streams, and wastes. Include cleaningchemicals (note frequency ifnot used daily or per batch). (3) IdentifY by numberthe points ofrelease, including small orintennittent releases, to theenvironment ofthe new chemical substance. (4) Please enter the # ofsites (remember to identifY thelocations of these sites on a continuation sheet):


### # ofsites



# D Mark (X) this box ifyou attach a continuation sheet. 2. Worker ExposureiEnvironmental Release (I) From the diagram above, provide the letter for each worker activity. Complete2-8 for each workeractivity 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 per year. (6)

-- Describe physical fonn ofexposure and 

### % new chemical substance (ifin mixture), and any protective equipment and engineering controls, ifany, used to protect workers. (7)

-- Estimatethe percent ofthe new substance as fonnulated when packaged or used as a final product. (9)

-- From the process diagram above, enter the number ofeach release point. Complete 9-13 for each release point identified (10)

-- Estimate the amount ofthe new substance released(a) directly totheenvironment or(b) into control technology to the environment(in kg/day or kglbatch). (12)

-- Describe media ofrelease i,e, stack air, fugitive air(optional-see Instructions Manual), surface water, on-site oroff-site land orincineration, POTW, orother (specifY) and control technology, ifany, that will 

### be usedto limit the release ofthe new substanceto the environment. (14) IdentifY byproducts which may result from the operation,

(3), (5), (8), II). (13) and (15)

-- Mark (X) this column ifany ofthe proceeding entries are confidential business infonnation (CBI). Letter # of CSI Duration CBI Protective Equip. I %in CBI Release Amount of CBI Media ofRelease CBI

of Workers of EngineeringControls! Fonn- Number New & Control Act· Exposed Exposure Physical Fonn and 

### % ulation Substance Technology ivity new substance Released (I) (2) (3) (4a) (4b) (5) (6) (7) (8) (9) (lOa) (lOb) (II) (12) (13) 

## X X X X X X X X X X

14)

-- Byproducts: (15) 

## None



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

# OPTIONAL POLLUTION PREVENTION INFORMATION To claim information in this section as confidential circle orbracket 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 orminimize potential risks associated with activities surrounding manufacturing, processing, use and disposal ofthe PMN substance. Please include new information pertinent to pollution prevention, including source reduction, recycling activities and safer processes orproducts available due to the new chemical substance. Sourcereduction includes the reduction in the amount ortoxicity ofchemical wastes bytechnological modification, process and procedure modification, product reformulation, raw materials substitution, and/or inventory controL Recycling refers to the reclamation ofuseful chemical components from wastes that would otherwise betreated orreleased as air emissions orwater discharges, orland disposal. Descriptions ofpollution prevention, sourcereduction and recycling should emphasize potentialrisk reduction subsequent to compliance with existing regulatoryrequirements and canbe either quantitative orqualitative. The EPA is interested in the information to assess overall net reductions in toxicity or environmental releases and exposures, not the shifting ofrisks to other environmental media or non-environmental areas (e.g., occupational or consumer exposure). In addition, information onthe relative cost or performance characteristics ofthe PMN substance to potential alternatives may be provided. All information provided in this section will be taken into consideration during the review ofthis substance. See Instructions Manual and Pollution Prevention Guidance manualfor guidance and examples. Describe the expected net benefits, such as (I) an overall reduction in risk tohuman health or the environment; (2) a reduction in the volume manufactured; (3) a reduction in the generation ofwaste materials through recycling, sourcereduction or othermeans; (4) a reduction inpotential toxicity orhuman exposure and/or environmentalrelease; (5) an increase in product performance, a decrease in the cost ofproduction and/or improved operation efficiency ofthenewchemical substance in comparison to 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 riskto human health or the environment.



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



# I I

### I 

# 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 afterthis page. Clearly identify the attachment and the section ofthe form to which it relates, ifappropriate. Numberconsecutively the pages ofthe attachments. In the column below, enter the inclusivepage numbers ofeach attachment. Mark (X) the "Confidential" box next to any attachment nameyou claim as confidential. Read the Instructions Manual for guidance on how to claim any information in an attachment as confidential. You must include with the sanitized copy ofthe notice form a sanitized version ofany attachment in which you claim information as confidential. Attachment name Attachment page number(s} Confidential



## X X X I 

## X X X X 

## X X Material Safety Data Sheet 68-72



# D Mark (X) this box ifyouattach a continuation sheet. Enterthe attachment name and number.

### PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET To assist EPA'sreview ofphysical and chemical properties data, pleasecompletethe following worksheet for data you provide and include it in the notice. IdentifY the property measured, the page ofthe notice on which the property appears, the value ofthe property, the units in which the property is measured (as necessary), and whether ornot the property is claimedas confidential. Thephysical state ofthe neat substance should be provided These measured properties should be for the neat (100% pure) chemical substance. Properties that are measured for mixtures or formulations shouldbe so noted (% PMN substance in_). You are not required to submitthis worksheet; however, EPA strongly recommends thatyou do so, as it will simplifY review andensure that confidential information is properly protected. You should submit this worksheet as a supplement to your submission oftest data. This worksheet is not a substitute for submissionoftest data. Property Mat\; Page Value Measured 0 Confi­ (X)if number Estimate denrial provided Marl< (X) (a) (b) (c) (M 

### or E) (d) 

## X Physical state ofneat substance (s) (1) 

## (g) Vaporpressure @ Temperature 

# °C Torr Density/relative density g/cm3 Solubility @ Temperature 

# °C

Solvent giL X Solubilityin water @ Temperature 

# °C gIL Melting temperature 

# °C Boiling I sublimation temperature@) torr pressure 

# °C Spectra Dissociation constant Particle size distribution X Octanollwater partition coefficient Henry's Law constant Volitalization from water Volitalization from soil 

## j pH@ concentration I 

# I I Flammability Explodability Adsorption I coefficient X Other

- Specify



# Attachment Page 13

## Part I, Section B, 1e: Product 5A 

## Raw Materials and Representative Chemical Structure Diagram

Attachment Page 14

## Manufacturing Description Section A, Part D -INDUSTRIALSITES CONTROLLED BY THE SUBMmER



# Page 15

## Process Description Section A, Part D - INDUSTRIALSITES CONTROLLED BYTHE SUBMITTER



# Page 16

## Infrared Spectrum

Page 17

# ope

18-22

## CAS IES Report



## 23

## Acute Oral Toxicity

24-36

### Solubility in Water

37-55

## OctanoliWater Partition Coefficient



## 56--67

# ~Afton. Material Safety Data Sheet

CHEMICAL. 

# HiTEC 7135 - For R&D 

# Use Only MSDS no. 

### H7135 

### HiTEC is a trademark owned byAfton ChemicalCorporation orone ofits subsidiaries. 

# f. Product and company identification Product usc Petrochemical industry: Lubricant component 

### Uate ofissuelRevisions 24June2009 

## In case ofemergency - Chemical 1-800-403-0044 

### (US & Canada) 1-804-648-7727 (International) 32-2-507-20-64 (Europe) 81-3-5210-4890 (Japan)


### ManufacturerI Supplier Afton Chemical Corporation Afton Chemical Limited 500 SpringSt. Euro-Tech Centre Richmond, VA 23219 London Road, Bracknell, Berkshire 1-804-788-5800 RGI22UW, England 44 1344-304141 msds@aftonchemical.com In Japan: In Australia: Afton Chemical Japan Corporation AftonChemical Asia Pacific Company Sumitomo Fudousan Sanbancho Bldg. 5F Level 9, 20 Berry Street 6-26 Sanbancho, Chiyoda-ku North Sydney, NSW 2060 Tokyo 102-0075 Japan Australia Emergency phone: 81-3-5210-4890 Telephone nwnber: 02-9923-1588 Business Hours: 9:00am

- 5:00pm 

# p. Hazards identification N

### oti

### ee to reader 

### Afton operates a world-wide systemfor hazard communication. Some hazards shown in Section 2 

### may apply to non-EUcountriesand may not result in ciassijiauionandlabeling in the Elf. Please seeSections3 

### and 15 for country specijic ciassijiClltion information, andSection 11

### for additionaldetails. Europe: The product is not classified as dangerous according to Directive 1999/45IEC and its amendments. 

### Australia: NON-HAZARDOUS SUBSTANCE. NON-DANGEROUS GOODS. 

### Primary hnards and critical effects NOTICE! 

### 1':I\\'ironmental hazards Not classified as dangerous for the environment according to EC criteria. 

### Hazardous Material Information System (U.S.A.)



# 3. Composition/information on ingredients
Note: see section 8 for occupational exposure I imits and section II for LC50lLD50 information 

### Sublltllllt't'/Preparatioll : Preparation Ingredient name 

### ('AS no. COliC. (% 

### wl\\') Ell 

### Classification 

## 1Y!!M.!li Regulated? Mineral 

### Oil Mixture. 30 - 60 Not classified. No.

### iTEC 7135 - For R&D Use Only In 

### Case of Emergency 1-800-403-0044 

### (US/Canada) 1-804-648-7727 (Int'l) 

### 32-2-507-Page: 215 20-64 (Eu) 

# 14. First aid measures Inhalation Ingl.'stioll Skin contact Eye contact If inhaled, remove to fresh air. If not breathing. give artificial respiration. If breathing is difficult, give oxygen. Get medical attention ifsymptoms appear. If affected person is fully conscious. give one glass of water to drink. Never give anything by mouth to an unconscious person. Get medical attention if symptoms appear. Wash with soap and water. Get medical attention if irritation develops. In case of contact. immediately flush eyes with plenty of waterfor at least 15 minutes. Get medical attention immediately. 

# 15. Fire-fighting measures Extinguishing media In case offire. use water spray (fog). foam, dry chemical orCO!. Fire-fighting procedures Fire-fighters should wear positive pressure self-contained breathing apparatus (SCBA) and full turnout gear. Hazardous decomposition products Decomposition products may include the following materials: carbon dioxide carbon monoxide Flash point Closed cup: 150·C (302°F) [Pensky-Martens.MinimumJ 

# 16. Accidental release measures Pl.'rsonal precautions Immediately contact emergency personnel. Keep unnecessary personnel away. Use suitable protective equipment (section 8). Follow all fire-fighting procedures (section 5). Environmental precautions If emergency personnel are unavailable, contain spilled material. For small spills, add absorbent (soil may be and dean-up methods used in the absence of other suitable materials) and use a non-sparking or explosion-proof means to transfer material to a sealable, appropriate container for disposal. For large spills, dike spilled material or otherwise contain material to ensure runoff does not reach a waterway. Place spilled material in an appropriate container for disposal. Avoid contact of spilled material with soil and prevent runoffentering surface waterways. Note: 

### see section 1 

### for emergency contact information and seetion 13 

### for waste disposal. 

# 17. Handling and storage Ihmdling : Wash thoroughly after handling. Stol'agc : Keep container tightly closed. Keep container in a cool, well-ventilated area. 

# 8. Exposure controls/personal protection

Engineering controls Personal protective equipment Respil"l\lory system Skin and body Ilands Eyes 

### Occupational exposure limits Ingredient name 1) Mineral Oil Provide exhaust ventilation or other engineering controls to keep the airborne concentrations of vapors below their respective threshold limit value. Use appropriate respiratory protection if

### there is the potential to exceed the exposure limit(s). Disposable outer gannents when there is the potential for contact with the material. Use chemical-resistant. impervious gloves. Safety glasses with side shields. Goggles with a face shield may be necessary depending on quantity of material and conditions of use. Of], 

### United States 

### OEI. Canada 

### OEl Europe 

### OEL Australia

ACGIH 

### (United (Canada). EH40 (UK) 

### (Europe. NOHSC 

### (Australia, States). 

### 2002). 2003). TWA: 5mg/m' TWA: 

### 5 mg/m' TWA: 5 mg/m' 

### 8 TWA: 5 mg/rn' 

### 8 STEL: 10 mg/m3 STEL: 10 mg/m' hourIs). houris). OSHA 

### (United States).

TWA: 5 mg/rn" 

# 19. Physical and chemical properties Physical stale and Appearance Liquid. [Viscous liquid.] Color Brown. [Dari<] I)cnsity 

### Not detennined. Specific**~ra\"ity** 

### 0.9236 @ 25°C Solubility Insoluble in the follOWing materials: cold water. 

# bCf

### iTEC 7135 - For R&D Use Only In Case ofEmergency 1-800-403-0044 (US/Canada) 1·804-648·7727 (Int'l) 32-2-507-Page: 3/S 20-64 (Eu) 633 cSt@ 100° C .\ulo-ignition tempel'atlln.' Not determined. I·lash point Closed cup: 150°C (302°F) [Pensky-Martens.Minimuml 

# \10. Stability and reactivity Stability The product is stable. Materials to avoid Strong oxidizing and reducing agents. Conditions to avoid High temperatures, sparks, and open flames. 

# Ill. Toxicological information
Routes ofentry Skin, Eyes, Ingestion, and Inhalation. Target organs None known. Acute l"ffccls Inhalation Inhalation of oil mist orvapors at elevated temperatures may cause respiratory irritation. Ingcstion Not determined. Skin contact Repeated or prolonged contact with the preparation may cause removal of natural fat from the skin, resulting in non-allergic contact dermatitiS and absorption through the skin. Elc contact Advent' effects Non-irritating tothe eyes. Not determined. 

### Product/ingredient name ACGIH tARC Not 

### classified or 

### listed by 

### IARC, NTP, 

### OSHA, EU and ACGIH. 

### EPA NIOSH NTP OSHA EU

Toxklty data



### Product/ingredient name Not 

### determined. 

### Result Species Dose Exposure

Other informatioll : Not available. 

# \12. Ecological information Environmental**hazard~** Not classified as dangerous for the environment according to EC criteria. Based on calculation. I':nvironmental fate This product contains components which may 

### be persistent in the environment. 

# 113. Disposal considerations Waste handling and : Waste must 

### be disposed of in accordance with federal, state and local environmental control regulations. disposal 

# 114. Transport information RcgulatOl,) liN number Proper shlpplnil lIame Class Packing group l.abel ,\ddltional informatioll information nOT 

# . Not 

# - 

# - - Class! Ikation regulated. 

### TIlG Not


### - 

# - - 

# - ClassiticatIon egulated. AI>RfRIJ) Class Not - 

### - 

# - egulated. IMIlG Class Not 

# - - 

# - - regulated. IATA-IlCR 

# . Not 

# - - 

# - (,hiSS regulated. 

# 70

### iTEC 7135 - For R&D 

### Use Only 

# I Not /­ regulated. In Case 

### of Emergency 1-800-4a3-0044 (US/Canada) 1-804-648-7727 (Int'l) 32-2-S07-Page: 415 20-64 (Eu) 

## 1­ Not available.
Notil"e to reader 

### The above transport information is provided to assist in the proper classification of this product and may not be suitable for all shipping conditions. 

# 115. Regulatory infonnation Ell regulations Risk phrases Safet)! phrases
liS rcl'(ulations

SARA 313 toxic chemical notification and release reportinl'( (w/w%) SARA 3111312 lIazardous Catel'(orizalion RQ (Reportable quantity) State

- Califol'Uia Prop. 

### 65 ("anadian rel/ulations W 111\11 S (Classification) International Inventor)! Statns

llnited States (TSCA) Canada Europe JapUlI (EN('S) Australia (NICNAS) Korea (EC!.) (:hinR (It:CSC) Philippines (PICCS) 

# 116. Other infonnation This product is not classified according to EU legislation. Not applicable.

No SARA 313 chemicals are present abovethe reporting threshold.
SARA 311/312 

### MSDS distribution - chemical inventory hazard identification: Immediate (acute) health hazard CERClA: Hazardous substances.: No products were found. No products were found.
Not controlled underWHMIS (Canada).

United States inventory (TSCA 8b): Not determined. Canada inventory: Not determined. Europe inventory: Not determined. Japan inventory (ENCS): Not determined. Australia inventory (AICS): Not determined. Korea inventory (KECI): Not determined. China inventory (IECSC): Not determined. Philippines inventory (PICCS): Not determined.



## PREPARATION INFORMATION Validated by IIS&E I)epartment (Tel: +18047885800) on 6/24/2009.



# ,... Uatc 

### 01' printing 6/2412009. Indicat('s infol'mationthat has chnnl'(ed from previously issued version. Notice to reader 

### This information and these recommendations are offeredingood faith andbelievedto be correctasof thedate hereof. Information and recommendationsare supplied upon the condition that the recipients will maketheir own decision asto sofety and suitabilityfor theirpurposes. No representations or warranties, either expressed or implied, of merchantability,fitnessfor aparticularpurpose, or of any other nature, are made with respect to theproduct or the information andrecommendations. Aftonmakesno representation as to completeness or accuracy. In no event will

### Afton beresponsiblefor damages of any nature whatsoever resultingfrom theuseorreliance upon theinformation andrecommendations. 

## ADDRESS CONTACTINFORMATION



# /1

### iTEC 7135 - For R&D Use Only In Case of

### Emergency 1-800-403-0044 (US/Canada) 1-804-648-7727 (Int'l) 32-2-507-Page: 5/5 20·64 (Eu) In the United States and Canada: Afton Chemical Corporation 500 Spring Street Richmond, Virginia USA 23219-2183 Telephone number: 804-788-5800 In Singapore: III Somerset Road #09-05 Singapore Power Building Singapore238164 Telephone number: 65-6732-0822 In Australia: Afton Chemical Asia Pacific Company Level 9, 20 Berry Street North Sydney, NSW 2060 Australia Telephone number: 02-9923-1588 Business Hours: 9:00am

- 5:00pm



### * * * END OF MSDS 

### * * * In Europe: AftonChemical Limited Euro-Tech Centre London Road, Bracknell, Berkshire RGI2 2UW, England 44-1344-304141 In Japan: Afton Chemical Japan Corporation Sumitomo Fudousan Sanbancho Bldg. 5F 6-26 Sanbancho, Chiyoda-ku Tokyo 102-0075 Japan Emergency phone: 8J -3-5210-4890