U.S. ENVIRONMENTAL PROTECTION AGENCY 

__~_r::DA PREMANUFACTURE 

_I:T""I-\ NOTICE 

Date ofReceipt: 

FOR NEW CHEMICAL SUBSTANCES 

Company Sanitized 

....,11 ... 1 un;;; llWlluer OJ pages 

in the Premanufacture N.otice 

• You must provide all information requested in this fonn to the extent that it is known to or reasonable ascertainable by you. Make reasonable estimates if you do 

not have actual data. 

• Before you complete this fonn, you should read the "Instructions Manual for Premanufacture Notification" (the Instructions Manual is available from the Toxic 

Substances Control Act (TSCA) Infannation Service by calling 202-554-1404, or faxing 202-554-5603). 

• Ifa user fee has been remitted for this notice (40 CFR 700.45), indicate in the boxes above the TS-user fee identification number you have generated. 

Remember, your user fee ID number must also appear on your corresponding fee remittance, which is sent to EPA, HQ Accounting Operations Branch (PM-266), 

P.O Box 360399M, Pittsburgh, PA 15251-6399, Attn .. TSCA User Fee. 

Part 1- GENERAL INFORMATION 

You must provide the currently correct Chemical Abstracts (CA) Name of the new 

chemical substance, even ifyou claim the identity as confidential. You may authorize 

another person to submit chemical identity information for you, but your submission 

will not be complete and the review will not begin until EPA receives this 

information. A letter in support ofyour submission should reference yow- TS user fee 

identification number. You must submit an original and two copies of this notice 

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 

If there are several manufacture, processing, or use operations to be described in Part 

II, section A and B ofthis notice, reproduce the sections as needed. 

Part III - LIST OF AITACHMENTS 

Attach additional sheets ifthere is not enough space to answer a question fully. 

Label each continuation sheet with the corresponding section heading. In Part 

Ill, list these attachments, any test data or other data and any optional 

information included in the notice. 

OPTIONAL INFORMATION 

You may include any information that you want EPA to consider in evaluating 

the new substance. On page II ofthis form. space has been provided for you to 

describe pollution prevention and recycling information you may have regarding the 

new substance. 

SQ-i:aJled "binding" boxes are included thrOUgllOut this form for you to indicate 

your willingness to be bound to certain statements you make in this public notice, 

such as use, production volume, protective equipment ... This option is intended to 

reduce delays that routinely accompany the development of consent orders or 

Significant New Use Rules. Except in the case ofexemption applications (such as 

TMEA, LVE, LOREX) where certain information provided in this notification is 

binding on the submitter when the Agency approves the exemption application, 

checking a binding box in this notice by itself prohibit the submitter from 

later deviating from the information (except chemical identity) reported in the form. 

CONFIDENTIALITY CLAIMS 

You may claim any information in this notice as confidential. To assert a claim 

on the form, mark (X) the confidential box: nex:! to the information that you claim as 

confidential. To assert a claim in an attachment, circle or bracket the information you 

claim as confidential. Ifvou claim informatipn in the notice as confidential. you must 

also provide a sanitized version of the notice (includjng 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 submit all test data in your possession or control and to provide a 

description of all other data known to or reasonable ascertainable to you, if these data 

are related to the health and environmental effects ofthe manufacture, processing, 

distribution in commerce, use, or disposal ofthe new chemical substance. Standard 

literature citations may be submitted for data in the open scientific literature. 

Complete test data (written in English) not summaries ofdata. must be submitted if 

they do not appear in the poen literature You should clearly identitY whether test data 

is on the substance or on an analog. Also, the chemical composition ofthe tested 

material should be characterized. Following are examples of test data and other data. 

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 DYes Other data DYes 

• Health Effects Data Dyes 	 Risk assessments 

• Environmental Effects Data Dyes 	 Structure/activity relationships 

• 	 Physical Chemical PropertiesO Yes Test data not in the possession 

or control ofthe submitter 

• 	 A physical and chemical properties worksheet is located on the last page ofthis 

form. 

TYPE OF NOTICE 

lK] PMN (Premanufaclure Notice) 	 ~ 

<'7:) 

<:.-::; 

D 	 c..u INTERMEDIATE PMN (submitted in sequence with final prod~MN) 

~~; 0::0 D SNUN (Significant New Use Notice) :g~; D t'0 -lf"7l TMEA (Test Marketing Exemption Application) 

D LVE (Low Volume Exemption)@40CFR 723.5O(c)(l) < .._.r'1 

C")W D LOREX (Low ReleaselLow Exposure Exemption) @ 723.50 (~) Ul D 	LVE Modification D LOREX Modification 

IS THIS A CONSOLIDATED PMN? 0 Yes

# of chemicals 3 

(PrerJOtice Communication # required, enter # on page 3) 

EPA FORM 7710-25 (Rev. 5-95) 	 Replaces previous editions of EPA Fonn 7710-25 

/ 

Public reporting burden for this collection of information 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 the burden estimate or any 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 of my knowledge and belief: 

1. 	 The company named in Part I. Section A, subsection 1 a of this notice form intends to manufacture or import for a commercial 

purpose, other than in small quantities solely for research and development, the substance identified in Part I, Section B. 

2. 	 All information provided in this notice is complete and truthful as ofthe date ofsubmission. 

3. 	 (am submitting with this notice all test data in my possession or control and a description of a1l other data known to or 

reasonably ascertainable by me as required by §720.50 ofthe Premanufacture Notification Rule. 

Addition,' Certification Statements: 

Ifyou are-MIbmitting-a f'MN, IntennediatePMN; Consol/datalPMN;l5tSNUN, check thcffolfow.ngllser ree ceitffiClition 

statement that applies: 

1&1 	 The Company named in Part I, Section A has remitted the fee 0($2500 specified in 40 CFR 700.45 (b), or 

o 	 The Company named in Part I, Section A has remitted the fee of $1 000 for an Intermediate PMN (defined @CPR 700.43) 

in accordance with 40 CPR 700.45 (b), or 

o 	 The Company named in Part I, Section A is a small business concern under 40 CF'R 700.43 and has remitted a fee 0($100 

in accordance with 40 CFR 700.45 (b). 

Ifyou are submitting a low vol.me exemptioD (LVE) application in accordance with 40 CPR 723.50 (c) ( 1 ) or a Low release and 

low exposure exemptiOD (LoREX) application in accordance with 40 CFR 723.50 (c) (2), check the following certification 

statements: 

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

purposes, other than in small quantities solely for research and development, under the terms of 40 CFR 723.50. 

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

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

o 	 If this application is for an LVE in accordance with 40 CPR 723.50 (c)(I), the manufacturer intends to commence 

manufacture of the exempted substance for commercial purposes within J year ofthe date of expiration ofthe 30 day 

review period. 

The,attUnq oftile IltaMaetlb)'GII.aU in lhla aotice .....ld ref'lKt year bet pl'"f!dldloll of tile alltXlpaled fadS reptilia, the eh_lm 


, ...._ dclc:rthd bmIIn. Any Imowinc alld willfltl.Waterprriatln. II subJed hi frilMPal penll» panuaat to 18 USC 11101. 
 Cootldential 

--------~ ....,.----.. -.. ---~

SilDature ofagent - (ihpplkable) Date 

FORM EPA 7110·25 (Rev. 5-95) 	 Page 2 

x 
Part I -- GENERAL INFORMATION 

Section A - SUBMITTER IDENTIFICATION 

la.Person ' 

Submitting 

Notice 

(in U.S.) 

b. Agent (if 

applicable) 

Name ofauthorized official 

Company 

Mailing address (number and street) 

City, State, ZIP Code 

Name of authorized official 

Company 

Mailing address (number and street) 

City, State, ZIP Code 

Position 

Telephone Area Code 

c. If you are submitting this notice as part of a joint submission, mark (X) this box. 

Joint 

Submitter (if 

applicable) 

2. Technical 

Contact 

(in U.S.) 

Name of authorized official 

Company 

Mailing address (number and street) 

City, State, ZIP Code 

Name 

Company 

Mailing address (number and street) 

City, State, ZIP Code 

3. If you have had a prenotice communication (PC) concerning this notice and 

EPA assigned a PC Number to this notice, enter the number. 

4. If you have submitted an exemption application for the chemical substance 

covered by this notice, enter the exemption number assigned by EPA. If you 

previously submitted a PMN for this substance, enter the PMN number 

assigned by EPA (i.e. withdrawn or incomplete). 

5. If you have submitted a notice of Bona fide inlent to manufacture or import 

for the chemical substance covered by this notice, enter the notice number 

assigned by EPA. 

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

o Binding Option Mark (X) 

Position 

Telephone 

Position 

Telephone 

2. 0 Import Only 

o Binding Option Mark (X) 

Page 3 

Number 

Mark (X) if none 

Mark (X) if none 

Mark (X) if none 

3. D Both 

0 

[X] 

[!] 

Confidential 

X 

X 
Part I - GENERAL INFORMATION - Continued 

Yon must provide a currently com:ct Chemical Abstracts (CA) name ofthe substance based Section B - CHEMICAL IDENTITY INFORMATION: 011 the ninth Collective (9CI) of CA nomenclature rules and conventions. 

Mark (X) the "Confidential" box next to any section you claim as confidential 

Complete either item 1 (Class 1 or 2 substances) or 2 (Polymers) as appropriate. Complete all other items, 

If another person will submit chemical identity infonnation for you (for either item I or 2) mark (X) the box at the right. 

IdentifY the name, company, and address of that person in a continuation sheet. 

o Confidential 

I, Class I or 2 chemical substances (for definitions of class I and class 2 substances, see the Instructions Manual) 

a, Class of substance - Mark (X) I,D Class I or 2, 0 Class 2 x 

b, Chemical name (Currently correct Chemical Abstracts (CA) Name that is consistent with TSCA Inventory listings for similar substances, For Class 

I substances a CA Index name must be provided, For Class 2 substances either a CA Index name or CA Preferred Name must be provided, 

whichever is appropriate based on CA 9CI nomenclature rules and conventions.) X 

c, 	 Please identifY which method you used to develop or obtain the specified chemical identity information reported in this notice: 

(check one) 

[] Method I (CAS Inventory Expert Service - a copy of the Identification D Method 2 (Other Source) 

report obtained from the CAS Inventory Expert Service must be 

submitted as an attachment to this notice) 

d. Molecular fonnula and CAS Registry Number (if a number already exists for the substance) 

X 

CAS # 

X 

e .For a class 1 substance, provide a complete and correct structural diagram, For a class 2 substance - (I) List the immediate precursor substances with 

their respective CAS Registry Numbers. (2) Describe the nature ofthe reaction or process. (3) Indicate the range of composition and the typical 

composition (where appropriate), (4) Provide a correct representative or partial structural diagram, as complete as can be known, if one can be reasonably 

ascertained, 

X 

Mark (X) this box if you attach a continuation sheet Refer to Continuation Sbeet Page 4(a)-1 

(Rev, 5-95) Page4(a) 
Continuation Sheet: Part I - General Information 

Section B - Chemical Identity Information 

Subsection B(1)(e) 

Page 4(a)-1 

s 

Part I - GENERAL INFORMATION - Continued 

You must provide a cummtly correct Chemical Abstracts (CA) name of the substarn:e based Section B - CHEMICAL IDENTITY INFORMATION: on the ninth Collective (9CI) ofCA nomenclature rules and conventions_ 

Mark (X) the "Confidential" box next to any section you claim as confidential 

Complete either item I (Class I or 2 substances) or 2 (Polymers) as appropriate. Complete all other items. 

ConfidIfanother person will submit chemical identity information for you (for either item I or 2) mark (X) the box at the right 	 D ential 

IdentifY the name, company, and address of that person in a continuation sheet. 

I. Class I or 2 chemical substances (for definitions of class I and class 2 substances, see the Instructions Manual) 

a. 	 Class ofsubstance - Mark (X) l. D Class I or 2. D Class 2 x 

b. 	 Chemical name (Currently correct Chemical Abstracts (CA) Name that is consistent with TSCA Inventory listings for similar substances. For Class 


I substances a CA Index name must be provided_ For Class 2 substances either a CA Index name or CA Preferred Name must be provided, 


whichever is appropriate based on CA 9CI nomenclature rules and conventions.) 
 X 

c. 	 Please identifY which method you used to develop or obtain the specified chemical identity information reported in this notice: 


(check one) 


[] Method I (CAS Inventory Expert Service - a copy of the Identification D Method 2 (Other Source) 

report obtained from the CAS Inventory Expert Service must be 

submitted as an attachment to this notice) 

d. 	 Molecular formula and CAS Registry Number (ifa number already exists for the substance) 

X 

CAS # 

X 

e .For a class I substance, provide a complete and correct structural diagram. For a class 2 substance - (I) List the immediate precursor substances with 

their respective CAS Registry Numbers. (2) Describe the nature ofthe reaction or process. (3) Indicate the range of composition and the typical 

composition (where appropriate). (4) Provide a correct representative or partial structural diagram, as complete as can be known, ifone can be reasonably X 

ascertained. 

Mark (X) this box ifyou attach a continuation sheet Refer to Continuation Sbeet Page 4(b)-1 

FORM EPA 771()"25 (Rev. 5-95) 	 Page4(b) 
Continuation Sheet: Part I - General Information 

Section B - Chemical Identity Information 

Subsection B(1)(e) 

Page4(b)-1 
Part I - GENERAL INFORMATION - Continued 

You must pr01lide a cummtly correct Cbemical Abstracts (CA) name oftbe subslance based Section B - CHEMICAL IDENTITY INFORMATION: on !be ninth Collective ('leI) of CA nomenclature rules and conventions. 

Mark (X) the "Confidential" box next to any section you claim as confidential 

Complete either item 1 (Class I or 2 substances) or 2 (Polymers) as appropriate. Complete all other items. 

ConfidIf another person will submit chemical identity information for you (for eitber item I or 2) mark (X) the box at the right. 	 o ential 

IdentitY the name, company, and address ofthat person in a continuation sheet. 

I. Class I or 2 chemical substances (for definitions of class I and class 2 substances, see the Instructions Manual) 

a. 	 Class ofsubstance - Mark (X) I. 0 Class I or 2. 0 Class 2 X 

b. 	 Chemical name (Currently correct Chemical Abstracts (CA) Name that is consistent with TSCA Inventory listings for similar substances. For Class 


I substances a CA Index name must be provided. For Class 2 substances either a CA Index name or CA Preferred Name must be provided, 


whichever is appropriate based on CA 9C1 nomenclature rules and conventions.) 
 X 

c. 	 Please identitY which method you used to develop or obtain the specified chemical identity information reported in this notice: 

(check one) 

Method I (CAS Inventory Expert Service - a copy ofthe Identification o Method 2 (Other Source) 

report obtained from the CAS Inventory Expert Service must be 

submitted as an attachment to this notice) 

d. Molecular formula and CAS Registry Number (if a number already exists for the substance) 

X 

CAS # 

X 

e .For a class I substance, provide a complete and correct structural diagram. For a class 2 substance - (I) List the immediate precursor substances with 

their respective CAS Registry Numbers. (2) Describe the nature ofthe reaction or process. (3) Indicate the range ofcomposition and the typical 

composition (where appropriate). (4) Provide a correct representative or partial structural diagram, as complete as can be known, if one can be reasonably 

ascertained. 

X 

Mark (X) this box ifyou attach a continuation sheet Refer to Continuation Sbeet Page 4(crt 

FORM EPA 7710-25 (Rev. 5-95) 	 Page 4(c) 
Continuation Sheet: Part I - General Information 

Section B - Chemical Identity Information 

Subsection B( 1 )(e) 

Page4(c)-J 
Part I - GENERAL INFORMATION - Continued 

Section B - CHEMICAL IDENTITY INFORMATION - Continued 

2. 'Polymers (For a definition of polymer, see the Instructions ManuaL) Confidential 

a. Indicate the number-average weight of the lowest molecular weight composition of the polymer you intend to manufacture. 

Indicate maximum weight percent oflow molecular weight species (not including residual monomers, reactants or solvents) below 500 and below 

1000 absolute molecular weight of that composition. 

Describe the methods ofmeasurement or the bases for your estimates: GPCD Other D (Specify)

i) lowest number average molecular weight: 

ii) maximum weight % below 500 molecular weight: 

iii) maximum weight % below 1000 molecular weight: N/A 

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

b. You must make separate confidentiality claims for monomer or other reactant identity, composition information and residual infurmation. 

Mark (X) the "Confidential" box next to any item you claim as confidential. 

(I) - Provide the specific chemical name and CAS Registry Number (if a number exists) of each monomer or other reactant used in the manufacture of the 

polymer. 

(2) - Mark (X) this column ifentry in column (I) is confidential. 

(3) -Indicate the typical weight percent of each monomer or other reactant in the polymer. 

(4) - Mark (X) the identity column ifyou want a monomer or other reactant used at two weight percent or less to be listed as part of the polymer description on 

the TSCA Chemical Substance Inventory. 

(5) - Mark (X) this column ifentries in columns (3) and (4) are confidential. 

(6) - Indicate the maximum weight percent of each monomer or other reactant that may be present as a residual in the polymer as manufactured for commercial 

purposes. 

(7) - Mark (X) this column if entry in column (6) is confidential. 

Monomer or other reactant and CAS Registry Number Confid- Typical Identity Confid- Maximum Confidential Composition Mark (X) ential residual ential 

(I) (2) (3) (4) (5) (6) (7) 

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

c. Please idenOwhich method you used to develop or obtain the specified chemical identity information reported in this notice: (check one) 

Method 1 (CAS Inventory Expert Service - a copy of the Identification D Method 2 (Other Source) 

report obtained from the CAS Inventory Expert Service must be 

submitted as an attachment to this notice) 

d. The currently correct Chemical Abstracts (CA) name for the polymer that is consistent with TSCA Inventory listings for similar polymers. 

e. Provide a correct representative or partial chemical structure diagram, as complete as can be known, if one can be reasonably ascertained. D 

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

FORM EPA 7710-25 (Rev. 5-95) Page 5(a)-(c) 

/() 
Part I - GENERAL INFORMATION - Continued 

Section B - CHEMICAL IDENTITY INFORMATION - Continued 

3. Impurities 

(a) ­ Identify each impurity that may be reasonably anticipated to be present in the chemical substance as manufactured for commercial purposes. 

Provide the CAS RegisII}' Number if available. If there are unidentified impurities, enter ·unidentified". 

(b) - Estimate the maximum weight % ofeach impurity. Ifthere are unidentified impurities, estimate their total weight %. 

Impurity and CAS RegisII}' Number 

(a) 

Maximum 

percent (b) 

Confidential 

None known % 

% 

% 

% 

% 

% 

% 

D 

4. 

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

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

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

X 

5. Trade identification - List trade names for the new chemical substance identified in subsection I or 2. 

X 

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

6. 	 Generic chemical name - Ifyou claim chemical identity as confidential, you must provide a generic chemical name for your substance that reveals the specific 

chemical identity of the new chemical substance to the maximum extent possible. Refer to the TSCA Chemical Substances Inventory, 

1985 Edition, Appendix B for guidance on developing generic narnes. 

Salt of mixed fatty amidoamine5 and polyetbylenepolyamines 

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


7. Byproducts - Describe any byproducts resulting from the manufacture, processing, use, or disposal of the new chemical substance at sites yon control. Provide the 

CAS Registry Number if available. 

Byproduct 

(I) 

CAS Registry Number 

(2) 

Contidential 

None known 

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

FORM EPA 7710-25 (Rev. 5-95) 	 Page 6(a) 

/1 

Part I - GENERAL INFORMATION - Continued 

Section B - CHEMICAL IDENTITY INFORMATION - Continued 

3. Impurities 

(a) -	 IdentifY each impurity that may be reasonably anticipated to be present in the chemical substance as manufactured for commercial purposes. 

Provide the CAS Registry Number if available. Ifthere are unidentified impurities, enter ·unidentified". 

(b) - Estimate the maximum weight % of each impurity. If there are unidentified impurities, estimate their total weight %. 

Impurity and CAS Registry Number Maximum Confi­

(a) percent (b) dential 

None known % 

% 

% 

% 

% 

% 

% 

0 
 Mark (X) this box if you aUach a continuation sheet. 


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

0 

X 

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

5. Trade identification - List trade names for the new chemical substance identified in subsection I or 2. 

X 

0 Mark (X) this box ifyou 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 

chemical identity of the new chemical substance to the maximum extent possible. Refer to the TSCA Chemical Substances Inventory, 

1985 Edition, Appendix B for guidance on developing generic names. 

Salt ofa polyalkylenepolyamine derivative 

0 
 Mark (X) this box if you aUach a continuation sheet. 


7. 	 Byproducts - Describe any byproducts resulting from the manufacture, processing, use, or disposal ofthe new chemical substance at sites you control. Provide the 

CAS Registry Number ifavailable. 

Byproduct CAS Registry Number Confi­

(I) (2) dential 

None known 

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

FORM EPA 7710-25 (Rev. 5-95) 	 Page 6(b) 

/;J.. 

0 
Part I - GENERAL INFORMATION - Continued 

Section B - CHEMICAL IDENTITY INFORMATION - Continued 

3. Impurities 

(a) ­ I4entify each impurity that may be reasonably anticipated to be present in the chemical substance as manufactured for commercial purposes. 

Provide the CAS Registry Number if available. Ifthere are unidentified impurities, enter ·unidentified·. 

(b) - Estimate the maximum weight % of each impurity. If there are unidentified impurities, estimate their total weight %. 

Impurity and CAS Registry Number Maximum Confi­

(a) percent (b) dential 

None known % 

% 

% 

% 

% 

% 

% 

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

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

X 

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

5. Trade identification - List trade names for the new chemical substance identified in subsection I or 2. 

X 

0 Mark (X) this box jfyou 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 

chemical identity ofthe new chemical substance to the maximum extent possible. Refer to the TSCA Chemical Substances Inventory, 

1985 Edition, Appendix B for guidance on developing generic names. 

Salt of mixed fatty amidoamines 

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

7. Byproducts ­ Describe any byproducts resulting from the manufacture, processing, use, or disposal ofthe new chemical substance at sites you control. Provide the 

CAS Registry Number if available. 

Byproduct CAS Registry Number Confi­

(I) (2) dential 

None known 

0 Mark (X) this box ifyou attach a cOntinuation sheet. 

i 

i 

FORM EPA 7710·25 (Rev. 5-95) Page 6(c) 

/..] 

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. 

I. Production volume - Estimate the maximum production volume during the first 12 months of production. Also estimate the maximum production volume for any 

consecutive 12-month period during the first three years of production. Estimates should be on 100% new chemical substance basis. For a Low Volume Exemption 

application, ifyou choose to have your notice reviewed at a lower production volume than 10,000 kglyr, specify the volume and mark (x) in the binding box. if 

granted, you are bound to this volume. 

Maximum first 12-month production (kglyr) 

(100% new chemical substance basis) 

Maximum 12-month production (kglyr) 

(100% new chemical substance basis) 

Confidential Binding Option 

Mark (X) 

X 

2. Use Information - You must make separate confidentiality claims for the description ofthe category of use, the percent of production volume devoted to each 

category, the formulation of the new substance, and other use information. Mark (X) the "Confidential" box next to any item you claim as confidential. 

a. (I) Describe each intended category of use of the new chemical substance by function and application. 

(2) Mark (X) this column ifentry in column (I) is confidential business information (CBI). 

(3) Indicate your willingness to have the information provided in column (I) binding. 

(4) Estimate the percent oftotal production for the first three years devoted to each category of use. 

(5) Mark (X) this column if entry in column (4) is confidential business information (CBI). 

(6) Estimate the percent ofthe new substance as formulated in mixtures, suspensions, emulsions, solutions or gels as manufactured for commercial purposes at 

sites under your control associated with each category of use. 

(7) Mark (X) this column ifentry in column (6) is confidential business information (CBI). 

(8) Indicate % of product volume expected for the listed "use" sectors. Mark more than one box if appropriate. Mark (X) to indicate your willingness to have 

the information provided in (8) binding. 

(9) Mark (X) this column ifentry(ies) in column (8) is (are) confidential business information (CBI). 

Category of Use (I) 

(by function and application, i.e. a dispersive dye for finishing 

polyester fibers) 

CBI 

(2) 

Binding 

Option 

Mark (X) 

(3) 

Production% 

(4) 

CBI 

(5) 

%in 

Formulation 

(6) 

CBI 

(7) 

% of substance expected per use 

(8) 

CBI 

(9) 

Sitelimited 

'Consumer 

Industrial 

Commercial 

Binding 

Option 

X X X X 

• If you have identified a ·consumer" use, please provide on a continuation sheet a detailed description of the use(s) ofthis chemical substance in consumer 

products. In addition include estimates of the concentration ofthe new chemical substance as expected in consumer products and describe the chemical reactions by 

which this substance loses its identity in the consumer product. 

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

b. Generic If you claim any category of use description in subsection 2a as confidential, enter a generic description of that category. Read the Instructions 

use Manual for examples ofgeneric use descriptions. 

description 

Processing aid 

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

3. Hll23fd Information -Include in the notice a copy ofreasonable facsimile of any hll23fd warning statement, label, material safety data sheet, or other 

information which will be provided to any person who is reasonably likely to be exposed to this substance regarding protective equipment or 

[]tices for the safe handling, transport, use, or disposal of the new substance. List in part mhll23fd information you include. 

Mark (X) this box ifyou attach hll23fd information. Refer to Continuation Sbeet Page 7(a)-t 

Binding Option 

Mark (X) 

FORM EPA 7710-25 (Rev. 5-95) Page 7(a) 
Continuation Sheet: Part I - General Information 

Section C - Production, Import and Use Information 

Subsection CO) - Production Volume 

Page 7(a)-] 

/S 

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 of production. Also estimate the maximum production volume for any 

consecutive 12-month period during the first three years of production. Estimates should be on 100% new chemical substance basis. Fora Law Volume Exemption 

application, ifyou choose to have your notice reviewed at a lower production volume than 10,000 kg/yr. specify the volume and mark (x) in the binding box. If 

granted. you are bound /0 this volume. 

Maximum first 12-month production (kglyr) Maximum 12-month production (kglyr) Confid- Binding Option 

(l00"A> new chemical substance basis) (100% new chemical s\lbstance basis) ential Mark (X) 

X 

2. Use Information - You must make separate confidentiality claims for the description ofthe category of use, the percent of production volume devoted to each 

category, the formulation of the new substance, and other use information. Mark (X) the "Confidential" box next to any item you claim as confidential. 

a. (I) Describe each intended category of use of the new chemical substance by function and application. 

(2) Mark (X) this column if entry in column (I) is confidential business information (CBI). 

(3) Indicate your willingness to have the information provided in column (I) binding. 

(4) Estimate the percent of total production for the first three years devoted 10 each category of use. 

(5) Mark (X) this column ifentry in column (4) is confidential business information (CBI). 

(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 associated with each category of use. 

(7) Mark (X) this column if entry in column (6) is confidential business information (CBI). 

(8) Indicate % of product volume expected for the listed "use" sectors. Mark more than one box if appropriate. Mark (X) to indicate your willingness to have 

the information provided in (8) binding. 

(9) Mark (X) this column ifentry(ies) in column (8) is (are) confidential business information (CBI). 

Category of Use (I) CBI Binding Produc- CBI %in CBI % of substance expected per use CBI 

(by function and application, i.e. a dispersive dye for finishing Option tion% Form­ (8) 

polyester fibers) Mark (X) ulation 

Site­ 'Con- Indus- Com- Binding 

(2) (3) (4) (5) (6) (7) limited sumer trial mercial Option (9) 

X X X X 

• If you have identified a "consumer" use, please provide on a continuation sheet a detailed description of the use(s) of this chemical substance in consumer 

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

which this substance loses its identity in the consumer product. 

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

b. Generic If you claim any category of use description in subsection 2a as confidential, enter a generic description of that category. Read the Instructions 

use Manual for examples of generic use descriptions. 

description i 

Processing aid I 

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

3. Hazard Information - Include in the notice a copy of reasonable facsimile of any hazard warning statement, label, material safety data sheet, or other Binding Option 

information which will be provided to any person who is reasonably likely to be exposed to this substance regarding protective equipment or Mark (X) 

l]tices for the safe handling, transport, use, or disposal of the new substance. List in part III hazard information you include. 

Mark (X) this box if you attach hazard information. Refer to Continuation Sheet Page 7(b)-1 

/~ 

FORM EPA 7110·25 (Rev. 5-95) Page 7(b) 
Continuation Sheet: Part I - General Information 

Section C - Production, Import and Use Information 

Subsection C(l) - Production Volume 

Page 7(b)-1 
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. 

I. Production volume - Estimate the maximum production volume during the first 12 months of production. Also estimate the maximum production volume for any 

consecutive 12-month period during the first three years of production. Estimates should be on 100% new chemical substance basis. For a Low Volume Exemption 

application, ifyOu choose to have your notice reviewed at a lower production volume than J0, 000 kglyr, specify the volume and mark (x) in the binding box. If 

granted, you are bound to this volume. 

Maximum first 12-month production (kglyr) Maximum 12-month production (kglyr) Confid- Binding Option 

(100% new chemical substance basis) (100% new chemical substance basis) ential Mark (X) 

X 

2. Use Information - You must make separate confidentiality claims for the description of the category of use, the percent of production volume devoted to each 

category, the formulation of the new substance, and other use information. Mark (X) the "Confidential" box next to any item you claim as confidential. 

a (I) Describe each intended category of use ofthe new chemical substance by function and application. 

(2) Mark (X) this column if entJy in column (I) is confidential business information (CBI). 

(3) Indicate your willingness to have the information provided in column (I) binding. 

(4) Estimate the percent oftotal production for the first three years devoted to each category ofuse. 

(5) Mark (X) this column ifentJy in column (4) is confidential business information (CBI). 

(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 associated with each category ofuse. 

(7) Mark (X) this column ifentry in column (6) is confidential business information (CBI). 

(8) Indicate % of product volume expected for the listed "use" sectors. Mark more than one box if appropriate. Mark (X) to indicate your willingness to have 

the information provided in (8) binding. 

(9) Mark (X) this column if entJy(ies) in column (8) is (are) confidential business information (CBI). 

Category of Use (I) CBI Binding Produc- CBI %in CBI % ofsubstance expected per use CBI 

(by function and application, i.e. a dispersive dye for finishing Option tion% Form­ (8) 

polyester fibers) Mark (X) ulation 

Site­ 'Con- Indus- Com- Binding 

(2) (3) (4) (5) (6) (7) limited sumer trial mercial Option (9) 

X X X X 

• If you have identified a "consumer" use, please provide on a continuation sheet a detailed description of the use(s) of this chemical substance in consumer 

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

which this substance loses its identity in the consumer product. 

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

b. Generic If you claim any category of use description in subsection 2a as confidential, enter a generic description of that category. Read the Instructions 

use Manual for examples ofgeneric use descriptions. 

description 

Processing aid 

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

3. Hazard Information - Include in the notice a copy of reasonable facsimile of any hazard warning statement, label, material safety data sheet, or other Binding Option 

information which will be provided to any person who is reasonably likely to be exposed to this substance regarding protective equipment or Mark (X) 

l]tices for the safe handling, transport, use, or disposal of the new substance. List in part III hazard information you include. 

Mark (X) this box ifyou attach hazard information. Refer to Continuation Sbeet Page 7(c)-1 

FORM EPA 7710-25 (Rev. 5-95) Page 7(c) 
Continuation Sheet: Part I - General Information 

Section C - Production, Import and Use Information 

Subsection C(l) - Production Volume 

Page 7(c)-l 

I' 
Part II - HUMAN EXPOSURE AND 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 of manufacture, 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 ifthere are further industrial processing or use 

operations after import. You must describe these operations. See instructions manual. 

I. Operation Description 

a. Identity - Enter the identity ofthe site at which the operation will occur. 

Name 

Site address (number and street) 

City, County, State, ZIP Code 

If the same operation will occur at more than one site, enter the number ofsites. IdentitY the additional sites on a continuation 

sheet, and if any ofthe sites have significantly different production rates or operations, include all the information requested in 

this section for those sites as attachments. 

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

b. TypeMark (X) D Manufacturing D Processing 

c. Amount and Duration - Complete I or 2 as appropriate. 

I. Batch Maximum kglbatch (100% new chemicol Hourslbatch 

substance) 

2. Continuous Maximum kg/day (1(J()% new chemical Hours/day 

substance) 

d. Process Description D Mark (X) your willingness to have our process description binding. 

D 

Batches/year 

Days/year 

# ofsites 

Use 

Confidential 

x 

x 

x 

x 

(I) Diagram the major unit operation steps and chemical conversions. Include intcrim storage and transport containers (specitY - ego 5 gallon pails, 55 

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

(2) Provide the identity, the approximate weight (by kglday or kglbatch on a 100% new chemical substance basis), and entry point of all starting materials 

and feedstocks (including reactants, solvents, and catalysts, etc.), and of all products, recycle streams, and wastes. Include cleaning chemicals (note 

frequency if not used daily or per batch). 

(3) IdentitY by number the points ofrelease, including small or intermittent releases, to the environment ofthe new chemical substance. 

[] Mark (X) this box if you attach a continuation sheet. Refer to Continuation Sheets 8(a)-1 and 8(a)-2 

FORM EPA 7710-25 (Rev. 5-95) Page 8(a) 
Continuation Sheet: Part II - Human Exposure and Environmental Release 

Section A - Industrial Sites Controlled by the Submitter 

Subsection A(1) 

Page 8(a)-1 
Page 8(a}2 
Part II - HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE 

Section A - INDUSTRIAL SITES CONTROLLED BY THE SUBMITTER Mart (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 ifthere are further industrial processing or use 

operations after import. Yon must describe these operations. See instructions manual. 

I. Operation Description 

a Identity - Enter the identity ofthe site at which the operation will occur. 

Name 

Site address (number and street) 

City, Connty, State, ZIP Code 

If the same operation will occur at more than one site, enter the number of sites. IdentifY the additional sites on a continuation 

sheet, and if any of the sites have significantly different production rates or operations, include all the information requested in 

this section for those sites as attachments. 

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

b. TypeMark (X) D Manufacturing D Processing 

c. Amount and Duration - Complete I or 2 as appropriate. 

I. Batch Maximum kglbatch (100% new chemical Hourslbatch 

substance) 

2. Continuous Maximum kg/day (100% new c'-""'" Hours/day 

substance) 

d. Process Description D Mart (X) your willingness to have our process description binding. 

D 

Batches/year 

Days/year 

# ofsites 

Use 

Confidential 

x 

x 

x 

x 

(I) Diagram the ml\ior unit operation steps and chemical conversions. Include interim storage and transport containers (specifY - ego 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, and 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 of release, including small or intermittent releases, to the environment of the new chemical substance. 

Mart (X) this box ifyou attach a continuation sheet. Refer to Continuation Sbeets Pages 8(b)-l and 8(b)-2 

FORM EPA 7710-25 (Rev. 5-95) Page 
Continuation Sheet: Part II - Human Exposure and Environmental Release 

Section A - Industrial Sites Controlled by the Submitter 

Subsection A(1) 

Page 8(b)-l 
Page 8(b)-2 
Part II - HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE 

Mark (X) the "Confidential" box next to any item you claim as Section A - INDUSTRIAL SITES CONTROLLED BY THE SUBMITTER confidential. 

Complete Section A for each type of manufacture, 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 processing or use 

operations after import. You must describe these operations. See instructions manual. 

I. Operation Description Confida. Identity - Enter the identity of the site at which the operation will occur. ential 

Name 

x 

Site address (number and street) 

City, County, State, ZIP Code 

If the same operation will occur at more than one site, enter the number of sites. Identify the additional sites on a continuation # of sites 

sheet, and if any of the sites have significantly different production rates or operations, include all the information requested in 

this section for those sites as attachments. 

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

b. 	TypeMark (X) D Manufacturing D 	 Processing Use D 

x 

c. Amount and Duration - Complete I or 2 as appropriate. 

l. Batch Maximum kg/batch (100% new chemical Hourslbatch 	 Batches/year 

substance) 

x 

2. Continuous Maximum kg/day (100% new chemical Hours/day Days/year 

substance) 

d. Process Description D Mark (X) your willingness to have our process description binding. x 

(I) 	 Diagram the major unit operation steps and chemical conversions. Include interim storage and transport containers (specify - ego 5 gallon pails, 55 

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

(2) 	 Provide the identity, the approximate weight (by kg/day or kg/batch on a 100"10 new chemical substance basis), and entry point of all starting materials 

and feedstocks (including reactants, solvents, and catalysts, etc.), and of all products, recycle streams, and wastes. Include cleaning chemicals (note 

frequency if not used daily or per batch). 

(3) 	 Identify by number the points of release, including small or intermittent releases, to the environment of the new chemical substance. 

Mark (X) this box ifyou attach a continuation sheet. Refer to CODtiDuatioD Sbeets Pages 8(c}-l aDd 8(c}-2 

FORM EPA 7710-25 (Rev. 5-95) Page 8(c) 

26 

Continuation Sheet: Part II - Human Exposure and Environmental Release 

Section A - Industrial Sites Controlled by the Submitter 

'Subsection A(1) 

Page 8(c)-1 

27 

Page 8(c)-2 

27 

Part II - HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE - Continued 

Section A - INDUSTRIAL SITES CONTROLLED BY THE SUBMITTER - Continued 

2. Occupational Exposure ­ You must make separate confidentiality claims for the description of worker activity, physical form of the new chemical 

substance, number of workers exposed, and duration of activity. Mark (X) the "Confidential" box next to any item you claim as confidential. 

(I) ­ Describe the activities in which workers may be exposed to the new chemical substance. 

(2) - Mark (X) this column ifentry in column (I) is confidential business information (CBI). 

(3) - Describe any protective equipment and engineering controls used to protect workers. 

(4) and (6) -- Indicate your willingness to have the information provided in column (3) or (5) binding. 

(5) - Indicate the physical form(s) ofthe new chemical substance (e.g. solid: crystal, granule, powder, or dust) and % new chemical substance (if part of 

a mixture) at the time of exposure. 

(7) - Mark (X) this column if entry in column (5) is confidential business information (CBI). 

(8) - Estimate the maximum number of workers involved in each activity. 

(9) - Mark (X) this column ifentry in column (8) is confidential business information (CBI). 

(10) and (II) -- Estimate the maximum duration of the activity for any worker in hours per day and days per year. 

(12) -- Mark (X) this column ifentries in column (10) and (II) are confidential business information (CBI). 

Worker Activity CBI Protective Equipment! Binding Physical form(s) Binding CBI # of CBI Maximum Duration CBI 

(eg., bag dumping, filling drums) Engineering Controls Option (eg. solid, powder) Option Workers 

Mark (X) and % new Mark (X) Exposed 

substance (8) Hrslday Dayslyr 

(I) (2) (3) (4) (5) (6) (7) (9) (10) (II) (12) 

Gloves & face shield, 

A. Quality control sampling long sleeve shirt X 1 X 

B. Filling product into tank Gloves & face shield, 

trucks long sleeve shirt X 1 X 

~ Mark (X) this box ifyou attach a continuation sheet. Refer to Continuation Sheet Page 9(a)-1 

3. Environmental Release and Disposal- You must make separate confidentiality claims for the release number and the amount of the new 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 of each release point identified in the process description, part II, section A, subsection I d (3). 

(2) ­ Estimate the amount of the new substance released (a) directly to the environment or (b) into control technology (in kg/day or kglbatch). 

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

(4) -Identify the media i.e. stack air, fugitive air (optional-see Instruction Manual), surface water, on-site or off-site land or incineration, 

POTW, or other (please 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 of the new substance to the environment. 

For releases disposed ofon land, characterize the disposal method and state whether it is approved for disposal of RCRA hazardous waste. 

On a continuation sheet, for each site describe any additional disposal methods that will be used and whether the waste is subject 

to secondary or tertiary on-site treatment. b. Estimate the amount released to the environment after control technology (in kg/day). 

(6) - Mark (X) this column if entries in columns (4) and (5) are confidential business information (CBI). 

(7) - Identify the destination(s) of releases to water. Please supply NPDES (National Pollutant Discharge Elimination System) #s for direct 

dischargers or NPDES numbers of the POTW (Publicly Owned Treatment Works). Mark (X) ifthe POTW name or NPDES # is confidential 

business information (CBI). 

Release Amount of new substance CBI ~edia of Release Control technology and efficiency (you may wish to optionally attach efficiency data) CBI 

Number (eg., stade air) 

(2a) (2b) (4) I (5a) I Binding (5b) (I) (3) I (6) 

I 

I 

I 

l 

I 

I 

I 

I 

(7) Mark (X) the D POTW provide name(s) below: CBI D Navigable D Other - Specify 

Provide NPDES # CBI 

destination(s) of f--­

releases to water. Waterway 

~ Mark (X) this box ifyou attach a continuation sheet. Refer to Continuation Sbeet Page 9(a)-1 

FORM EPA 7710-25 (Rev. 5-95) Page 9(a) 
Continuation Sheet: Part II - Human Exposure and Environmental Release 

Section A - Industrial Sites Controlled by the Submitter 

Subsection A(2) - Occupational Exposure 

Page 9(a)-1 

3() 

Part II - HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE - Continued 

Section A - INDUSTRJAL SITES CONTROLLED BY THE SUBMITTER - Continued 

2. Occupational Exposure - You must make separate confidentiality claims for the description of worker activity, physical fonn of the new chemical 

substance, number of workers exposed, and duration of activity. Mark (X) the "Confidential" box next to any item you claim as confidential. 

(I) ­ Describe the activities in which workers may be exposed to the new chemical substance. 

(2) -- Mark (X) this column if entry in column (I) is confidential business infonnation (CBI). 

(3) ­ Describe any protective equipment and engineering controls used to protect workers. 

(4) and (6) -Indicate your willingness to have the infonnation provided in column (3) or (5) binding. 

(5) -Indicate the physical fonn(s) of the new chemical substance (e.g. solid: crystal, granule, powder, or dust) and % new chemical substance (if part of 

a mixture) at the time of exposure. 

(7) ­ Mark (X) this column ifentry in column (5) is confidential business infonnation (CBI). 

(8) -- Estimate the maximum number ofworkers involved in each activity. 

(9) -- Mark (X) this column if entry in column (8) is confidential business infonnation (CBI). 

(10) and (II) -- Estimate the maximum duration of the activity for any worker in hours per day and days per year. 

(12) -- Mark (X) this column if entries in column (10) and (II) are confidential business infonnation (CBI). 

Worker Activity CBI Protective Equipment! Binding Physical fonn(s) Binding CBI # of CBI Maximum Duration CBI 

(eg., bag dumping, filling drums) Engineering Controls Option (eg. solid, powder) Option Workers 

Mark (X) and % new Mark (X) Exposed 

substance (8) Hrslday Days/yr 

(I) (2) (3) (4) (5) (6) (7) (9) (10) (II) (12) 

Gloves & face shield, 

A. Quality control sampling long sleeve shirt X 1 X 

B. Filling product into tank Gloves & face shield, 

trucks long sleeve shirt X 1 X 

[] Mark (X) this box ifyou attach a continuation sheet. Refer to Continuation Sheets Pages 9(b)-1 and 9(b)-2 

l. Environmental Release and Disposal-- You must make separate confidentiality claims for the release number and the amount of the new chemical substance 

released and other release and disposal infonnation. Mark (X) the "Confidential" box next to each item you claim as confidential. 

(I) -­ Enter the number of each release point identified in the process description, part II, section A, subsection I d (3). 

(2) ­ Estimate the amount of the new substance released (a) directly to the environment or (b) into control technology (in kg/day or kglbatch). 

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

(4) -IdentifY the media i.e. stack air, fugitive air (optional-see Instruction Manual), surface water, on-site or off-site land or incineration, 

POTW, or other (please 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 of the new substance to the environment. 

For releases disposed of on land, characterize the disposal method and state whether it is approved for disposal of RCRA hazardous waste. 

On a continuation sheet, for each site describe any additional disposal methods that will be used and whether the waste is subject 

to secondary ot tertiary on-site treatment. b. Estimate the amount released to the environment after control technology (in kg/day). 

(6) ­ Mark (X) this column if entries in columns (4) and (5) are confidential business infonnation (CBI). 

(7) -- IdentifY the destination(s) ofreleases to water. Please supply NPDES (National Pollutant Discharge Elimination System) #s for direct 

dischargers or NPDES numbers ofthe POTW (Publicly Owned Treatment Works). Mark (X) ifthe POTW name or NPDES # is confidential 

business infonnation (CBI). 

Release Amount ofnew substance CBI ~edia ofRelease Control technology and efficiency (you may wish to optionally attach efficiency data) CBI 

Number (eg., Slack air) 

(2a) (2b) (4) , (5a) I Binding (5b) (I) (3) I (6) 

I 

I 

I 

I 

I 

~ 

I 

~ 

","'"'NPDEsq (7) 

destination(

Mark (X) 

s) 

the 

of 

D POTW provide name(s) below: ~ 

CBI D Navigable D Other - SpecifY

releases to water. Waterway 

[] Mark (X) this box if you attach a continuation sheet. Refer to Continuation Sbeets Pages 9(b)-J and 9(b)-2 

FORM EPA 7710-25 (Rev. 5-95) Page 9(b) 

3/ 

Continuation Sheet: Part II - Human Exposure and Environmental Release 

Section A - Industrial Sites Controlled by the Submitter 

Subsection A(2) - Occupational Exposure 

Page 9(b)-1 

32 
Page 9(b)-2 

33 

Part II - HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE - Continued 

Section A - INDUSTRIAL SITES CONTROLLED BY THE SUBMITTER - Continued 

2. (ktupational Exposure - You must make separate confidentiality claims for the description of worker activity, physical form ofthe new chemical 

substance, number of workers exposed, and duration of activity. Mark (X) the ·Confidential" box next to any item you claim as confidential. 

(I) - Describe the activities in which workers may be exposed to the new chemical substance. 

(2) - Mark (X) this column if entry in column (I) is confidential business information (CBI). 

(3) -	 Describe any protective equipment and engineering controls used to protect workers. 

(4) and (6) -- Indicate your willingness to have the information provided in column (3) or (5) binding. 

(5) -Indicate the physical formes) ofthe new chemical substance (e.g. solid: crystal, granule, powder, or dust) and 0/. new chemical substance (if part of 

a mixture) at the time of exposure. 

(7) -	 Mark (X) this column ifentry in column (5) is confidential business information (CBI). 

(8) -	 Estimate the maximum number of workers involved in each activity. 

(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 jfentries in column (10) and (II) are confidential business information (CBJ). 

Worker Activity 

(eg., bag dumping, filling drums) 

(I) 

CBI 

(2) 

Protective Equipment! 

Engineering Controls 

(3) 

Binding 

Option 

Mark (X) 

(4) 

Physical formes) 

(eg. solid, powder) 

and % new 

substance 

(5) 

Binding 

Option 

Mark (X) 

(6) 

CBI 

(7) 

# of 

Workers 

Exposed 

(8) 

CBI 

(9) 

Maximum Duration 

Hrslday Days/yr 

(10) (II) 

CBJ 

(12) 

A. Quality control sampling 

Gloves & face shield, 

long sleeve shirt X 1 X 

Gloves & fate shield, 

trutks 

B. Filling product into tank 

long sleeve shirt X 1 

Mark (X) this box if you attach a continuation sheet. Refer to Continuation Sheets Pages 9(e)-1 and 9(e)-2 ~ 

3. 	 Environmental Release and Disposal - You must make separate confidentiality claims for the release number and the amount of the new 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 ofeach release point identified in the process description, part II, section A, subsection I d (3), 

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

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

(4) -- Identify the media i,e. stack air, fugitive air (optional-see Instruction Manual), surface water, on-site or off-site land or incineration, 

POTW, or other (please 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 of on land, characterize the disposal method and slate whether it is approved for disposal of RCRA hazardous waste. 

On a continuation sheet, for each site describe any additional disposal methods that will be used and whether the waste is subject 

to secondary or tertiary on-site treatment. b. Estimate the amount released to the environment after control technology (in kg/day). 

(6) -	 Mark (X) this column ifentries in columns (4) and (5) are confidential business information (CBJ). 

(7) -	 Identify the destination(s) ofreleases to water. Please supply NPDES (National Pollutant Discharge Elimination System) #s for direct 

dischargers or NPDES numbers of the POTW (Publicly Owned Treatment Works). Mark (X) if the POTW name or NPDES # is confidential 

business information (CBI). 

Release Amount of new substance CBI ~edia ofRelease Control technology and efficiency (you may wish to optionally attach efficiency data) CBI· 

Number (os. stack air) 

(4) I

(2a) (2b) (Sa) 	 I Binding (5b) (I) (3) ~ (6) i I 

I 

I 

I 

I 

~ 

I 

I 

(7) Mark (X) the D POTW provide narne(s) below: CBI Provide NPDES # CBI 

destination(s) of I--­D Navigable D Other - Specify 

Waterway releases to water. 

Mark (X) this box if you attach a continuation sheet. Refer to Continuation Sheets Pages 9(e)-1 and 9(e)-2 [] 

FORM EPA 7710-25 (Rev. 5-95) 	 Page 9(c) 

X 
Continuation Sheet: Part II - Human Exposure and Environmental Release 

Section A - Industrial Sites Controlled by the Submitter 

SUbsection A(2) - Occupational Exposure 

Page 9(c)-1 

JS 

Page 9(c)-2 
Part II - HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE - Continued 

Section, B - INDUSTRIAL SITES CONTROLLED BY OTHERS 

Complete section B for typical processing or use operations involving the new chemical substance at sites you do not control. Importers do not have to complete this 

section for opemtions outside the U.S.; however, you must report any processing or use activities after import. See the Instructions Manual. Complete a separate 

section B for each type ofprocessing or use operation involving the new chemical substance. Ifthe same opemtion is performed at more than one site, describe the 

typical operation common to these sites. Identify additional sites on a continuation sheet. 

1. Operation Description -- To claim information in this section as confidential, circle or bmcket the specific information that you claim as confidential. 

(1) Diagram the major unit opemtion steps and chemical conversions, including interim stomge and transport containers (specify - e.g. 5 gallon pails, 55 gallon 

drums, rail cars, tank trucks, etc.). On the diagram, identify by letter and briefly describe each worker activity. (2) Provide the identity, the approximate weight 

(by kg/day or kglbatch, on a 100% new chemical substance basis) and entry point of all feedstocks (including reactants, solvents, and catalysts, etc.) and of all 

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 of the new chemical substance. (4). Please enter the number of sites (remember to identify the 

locations of these sites on a continuation sheet); 

--­

# of sites 

~ Mark (X) this box if you attach a continuation sheet Refer to Continuation Sbeet Page 100a)-1 

2. Workr:r EXp05urelEnvironmental Release 

(l) ­ From the diagram above, provide the letter for each worker activity. Complete 2-8 for each worker activity described, 

(2) ­ Estimate the number ofworkers exposed for all sites combined. 

(4) -- Estimate the typical dumtion ofexposure per worker in (a) hours per day and (b) days per year. 

(6) - Describe physical form ofexposure and % new chemical substance (ifin mixture), and any protective equipment and engineering controls used to protect 

workers. 

(7) -- Estimate the percent of the new substance as formulated when packaged or used as a final product 

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

(10) - 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 kglbatch). 

(12) -- Describe media of release i.e. stack air, fugitive air (optional - see 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 release of the new substance to the environment 

(14) -Identify byproducts which may result from the operation. 

(3), (5), (8), (11), (13), and (15) - Mark (X) this column if any of the preceding entries are confIdential business information (CBI). 

Letter of #of CBI Duration of CBI Protective EquipJ %in CBr Release Amount ofNew CBr Control Technology CBr 

Activity Workers Exposure Engineering Controls! Form- Number Substance Released 

Exposed Physical Form and % ulation 

new substance (12) 

(I) (2) (3) (4a) (4b) (5) (6) (7) (8) (9) (lOa) (lOb) (lJ) (13) 

(14) - Byproducts (15) 

D Mark (X) this box ifyou attach a continuation sheet Refer to Continuation Sbeet Page 100a)-l 

FORM EPA 7710-25 (Rev. 5-95) Page 100a) 

37 

Page lO(a)-1 
Part II - HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE - Continued 

Section B - INDUSTRIAL SITES CONTROLLED BY OTIIERS 

Complete section B for typical processing or use operations involving the new chemical substance at sites you do not control. Importers do not have to complete this 

section for operations outside the U.S.; however, you must report any processing or use activities after import. See the Instructions Manual. Complete a separate 

section B for each type ofprocessing or use operation involving the new chemical substance. If the same operation is performed at more than one site, describe the 

typical operation common to these sites. Identify additional sites on a continuation sheet. 

1. Operation Description - To claim information in this section as confidential, circle or bracket the specific information that you claim as confidential. 

(I) Diagram the major unit operation steps and chemical conversions, including interim storage and transport containers (specify - e.g. 5 gallon pails, 55 gallon 

drums, rail cars, tank trucks, etc.). On the diagram, identify by letter and briefly describe each worker activity. (2) Provide the identity, the approximate weight 

(by kg/day or kglbatch, on a 100% new chemical substance basis) and entry point of all feedstocks (including reactants, solvents, and catalysts, etc.) and ofall 

products, recycle streams, and wastes. Include cleaning chemicals (note frequency if not used daily or per batch). (3) Identify by number the points ofrelease, 

including small or intermittent releases, to the environment of the new chemical substance. (4). Please enter the number of sites (remember to identify the 

locations of these sites on a continuation sheet): 

--­

1/ of sites 

[] Mark (X) this box ifyou attach a continuation sheet. Refer to Continuation Sbeet Page lO(b)-l 

2. Worker ExposurelEnviroDmental Release 

(I) ­ From the diagram above, provide the letter for each worker activity. Complete 2-8 for each worker activity described. 

(2) - Estimate the number of workers exposed for all sites combined. 

(4) - Estimate the typical duration of exposure per worker in (a) hours per day and (b) days per year. 

(6) - Describe physical form of exposure and % new chemical substance (ifin mixture), and any protective equipment and engineering controls used to protect 

workers. 

(7) - Estimate the percent of the new substance as formulated when packaged or used as a final product. 

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

(10) ­ 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 kglbatch). 

(12) - Describe media ofrelease i.e. stack air, fugitive air (optional- see Instructions Manual), surface water, on-site or off-site land or incineration, 

POTW, or other (specify) and control technology, ifany, that will be used to limit the release of the new substance to the environment. 

(14) - Identify byproducts which may result from the operation. 

(3), (5), (8), (II), (13), and (15) - Mark (X) this column if any ofthe preceding entries are confidential business information (CBI). 

Letter of #I of CBI Duration of CBI Protective Equip.! %in CBI Release Amount of New CBI Control Technology CBI 

Activity Workers Exposure Engineering Controls! Form- Number Substance Released 

Exposed Physical Form and % ulation 

new substance (12) 

(I) (2) (3) (4a) (4b) (5) (6) (7) (8) (9) (lOa) (lOb) (11) (13) 

(14) - Byproducts (I 5) 

D Mark (X) this box ifyou attach a continuation sheet. Refer to Continuation Sbeet Page IO(b)-1 

3' 

FORM EPA 7710-25 (Rev. 5-95) Page 100b) 
Page 1 O(b)-1 
Part II - HUMAN EXPOSURE AND ENVIRONMENTAL REcEASE - Continued 

Section B - INDUSTRIAL SITES CONTROLLED BY OTHERS 

Complete section B for typical processing or use operations involving the new chemical substance at sites you do not control. Importers do not have to complete this 

section for operations outside the U.S.; however, you must report any processing or use activities after import. See the Instructions Manual. Complete a separate 

section B jor each type ojprocessing or use operation involving the new chemical substance. If the same operation is performed at more than one site, describe the 

typical operation common to these sites. IdentifY additional sites on a continuation sheet. 

1. Operation Description - To claim information in this section as confidential, circle or bracket the specific information that you claim as confidential. 

(I) Diagram the major unit operation steps and chemical conversions, including interim storage and transport containers (specifY - e.g. 5 gallon pails, 55 gallon 

drums, rail cars, tank trucks, etc.). On the diagram, identifY by letter and briefly descrihe each worker activity. (2) Provide the identity, the approximate weight 

(by kg/day or kglbatch, on a 100"10 new chemical substance basis) and entry point ofall feedstocks (including reactants, solvents, and catalysts, etc.) and of all 

products, recycle streams, and wastes. Include cleaning chemicals (note frequency ifnot used daily or per batch). (3) IdentifY by numher the points ofrelease, 

including small or intermittent releases, to the environment ofthe new chemical substance. (4). Please enter the number of sites (remember to identifY the 

locations ofthese sites on a continuation sheet): 

--­

# of sites 

~ Mark (X) this box ifyou attach a continuation sheet. Refer to Continuation Sbeet Page 10(c:)-1 

2. Worker ExposureJEnvironmental Release 

(I) -- From the diagram above, provide the letter for each worker activity. Complete 2-8 for each worker activity described. 

(2) -- Estimate the number ofworkers exposed for all sites combined. 

(4) ­ Estimate the typical duration of exposure per worker in (a) hours per day and (b) days per year. 

(6) -- Describe physical form of exposure and % new chemical substance (if in mixture), and any protective equipment and engineering controls used to protect 

workers. 

(7) - Estimate the percent of the new substance as formulated 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 of the new substance released (a) directly to the environment 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 or off-site land or incineration, 

POTW, or other (specifY) and control technology, ifany, that will be used to limit the release ofthe new substance to the environment. 

(14) -IdentifY byproducts which may result from the operation. 

(3), (5), (8), (II), (13), and (15) - Mark (X) this column if any of the preceding entries are confidential business information (CBI). 

Letter of #of CBI Duration of CBI Protective Equip.! %in CBI Release Amount ofNew CBI Control Technology CBI 

Activity Workers Exposure Engineering Controls! Form- Number Substance Released 

Exposed Physical Form and 0/0 ulation 

new substance (12) 

(I) (2) (3) (4a) (4b) (5) (6) (7) (8) (9) (lOa) (lOb) (II) (13) 

(14) - Byproducts (15) 

D Mark (X) this box ifyou attach a continuation sheet. Refer to Continuation Sbeet Page 10(c:)-1 

FORM EPA 7710-25 (Rev. 5-95) Page 100c) 

41 

Page 1O(c)-1 
OPTIONAL POLLUTION PREVENTION INFORMATION 

To claim infonnation in this section as confidential circle or bracket the specific infonnation 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 PMN substance. Please include new 

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

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

includes the reduction in the amount oftoxicity ofchemical wastes by technological 

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 be treated or released as air emissions or water 

discharges, or land disposal. Descriptions ofpollution prevention, source reduction and 

recycling should emphasize potential risk reduction subsequent to compliance with existing 

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

this information to assess overall net reductions in toxicity of 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 on the 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 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 (I) 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 of human exposure and/or environmental release; (5) an increase in product perfonnance, a decease in the cost ofproduction and/or 

improved operation efficiency ofthe 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 human health or the 

environment. 

D Marl!: (X) this box if you attach a continuation sheet. 

FORM EPA 7710·25 (Rev. 5.95) Page 11 
Part III -- LIST OF ATTACHMENTS 

Attach continuation sheets for sections ofthe form and test data and other data (including physical/chemical properties and structure/activity information), and 

optional information after this page. Clearly identify the attachment and the section ofthe form to which it relates, if appropriate. Number consecutively the 

pages of the attachments. In the column below, enter the inclusive page numbers ofeach attachment. 

Mark (X) in the "Confidential" box next to any attachment name you 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 of the notice form a sanitized version ofany attachment in which you 

claim information as confidential 

Attachment name Attachment page Confinumbers(s) dential 

Preliminary Material Safety Data Sheet: PMN Substance Attachment 1 X 

Preliminary Material Safety Data Sheet: PMN Substance Attachment 2 X 

Preliminary Material Safety Data Sheet: PMN Substance Attachment 3 X 

Inventory Expert Service (IES) Report: PMN Substance Attachment 4 X 

Inventory Expert Service (lES) Report: PMN Substance Attachment 5 X 

Inventory Expert Service (IES) Report: PMN Substance Attachment 6 X 

o Mark (X) this box if you attach a continuation sheet. Enter the attachment name and number. 

FORM EPA 7710-25 (Rev. 5-95) Page 12 
PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET 

To assist EPA's review of physical and chemical properties data, please complete the following worksheet for data you provide and include it in the notice. 

IdentifY the property measured, the page of the notice on which the property appears, the value of the property, the units in which the property is measured (as 

'necessary), and whether or not the property is claimed as confidential. The physical state of the neat substance should be provided. These measured properties 

should be fur the neat (100",4 pure) chemical substance. Properties that are measured for mixtures or formulations should be so noted (% PMN substance in ->. 

You are not required to submit this worksheet; however, EPA strongly recommends that you do so, as it will simplifY review and ensure that confidential 

information is properly protected. You should submit this worksheet as a supplement to your submission of test data. This worksheet is not a substitute for 

submission of test data. 

Property Mark (X) Page Value Measured Confiif provided number or Estimate dential 

(b) (MorE) Mark(X) 

(a) (c) (d) 

Physical state of neat substance __(s) _X_(I) __(g) 

Vapor pressure 

@Temperature °C 

Density I relative density glcm1 

Solubility 

@ Temperature °C 

Solvent gil 

Solubility in water @ Temperature °C °C 

Melting temperature °C 

Boiling I sublimation temperature @ torr pressure 

Spectra 

Dissociation constant 

Particle size distribution 

Octanoll water partition coefficient 

Henry's Law constant 

Volatilization from water 

Volatilization from soil 

pH @ concentration X 

flammability 

ExplodabiJity 

Adsorption I coefficient 

Other 

Page 13(a) 
PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET 

To assist EPA's review of physical and chemical properties data, please complete the 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 of the property, the units in which the property is measured (as 

'necessary), and whether or not the property is claimed as confidential. The physical state of the neat substance should be provided. These measured properties 

should be for the neat (100".10 pure) chemical substance. Properties that are measured for mixtures or formulations should be so noted (% PMN substance in .-J. 

You are not required to submit this worksheet; however, EPA strongly recommends that you do so, as it will simplify review and ensure that confidential 

information is properly protected. You should submit this worksheet as a supplement to your submission of test data. This worksheet is not a substitute for 

submission of test data. 

Property Mark (X) Page Value Measured Confiif provided number or Estimate dential 

(b) (M orE) Mark(X) 

(a) (c) (d) 

Physical state of neat substance __(s) --X-(I) __(g) 

Vapor pressure 

@Temperature °C 

Density I relative density glcml 

Solubility 

@ Temperature °C 

Solvent gIL 

Solubility in water@ Temperature °C °C 

Melting temperature °C 

Boiling I sublimation temperature @ torr pressure 

Spectra 

Dissociation constant 

Particle size distribution 

Octanoll water partition coefficient 

Henry's Law constant 

Volatilization from water 

Volatilization from soil 

pH @ concentration X 

Flammability 

Explodability 

Adsorption I coefficient 

Other 

Page 13(b) 
PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET 

To assist EPA's review of physical and chemical propenies data, please complete the following worksheet for data you provide and include it in the notice. 

Identify the propeI1y measured, the page of the notice on which the propeny appears, the value ofthe propeny, the units in which the propeny is measured (as 

. necessary), and whether or not the propeny is claimed as confidential. The physical state ofthe neat substance should be provided. These measured propenies 

should be for the neat (100% pure) chemical substance. Propenies that are measured for mixtures or formulations should be so noted (% PMN substance in ~. 

You are not required to submit this worksheet; however, EPA strongly recommends that you do so, as it will simplify review and ensure that confidential 

information is properly protected. You should submit this worksheet as a supplement to your submission of test data. This worksheet is not a substitute for 

submission oftest data 

Propeny Mark (X) Page Value Measured Confiif provided number or Estimate dential 

(b) (M orE) Mark(X) 

(a) (c) (d) 

Physical state ofneat substance __(s) _X_(I) __(g) 

Vapor pressure 

@ Temperature °C 

Density I relative density glcml 

Solubility 

@ Temperature °C 

Solvent gIL 

Solubility in water@Temperature °C °C 

Melting temperature °C 

Boiling I sublimation temperature @ torr pressure 

Spectra 

Dissociation constant 

Particle size distribution 

Octanoll water partition coefficient 

Henry's Law constant 

Volatilization from water 

Volatilization from soil 

pH @ concentration X 

Flammability 

Explodability 

Adsorption I coefficient 

Other 

Page 13(c) 

47 

Attachment 1 


Preliminary Material Safety Data Sheet: PMN Substance 


2 Pages - TSCA CDI 

Attachment 2 


Preliminary Material Safety Data Sheet: PMN Substance 


2 Pages - TSCA CDI 

Attachment 3 


Preliminary Material Safety Data Sheet: PMN Substance 


2 Pages - TSCA CDI 

Attachment 4 


Inventory Expert Service Report: PMN Substance 

CLE: Inventory Expert t;:enilice 


,-,-------------------------------------­ A division of the Am ,rlam Chemial SoCiery Phone: 800-631-1884, 61~M7·3600 (ext.l308) 

Fax:6f++t7-J7,,7 

E"1'13l1; answan@caJ.Ol"& 

INVENTORY EXPERT SERVICE REPORT 

Plel! lie ]:l'int the above CA lJU1ex NaJDe 011 the app:ropriate page of yow: i'lIf. 

c :::£ ~hl. l:JOK i. ch.alted, CJ.S ha, JUa. correct.ion(a) ma:C''II:~ in r:ed to 

1;'our ms order. 1»1••8. make 1:he SBDIC correation(s) eQ your pm befC:.t'Q 

1,ubaJ.tting it to the 1».2\. 

P.O, lIoot l],43 

coo Ii'J sv~ LtLe Lt. tIS IVd ~O:tl lad to/tT/tO 
Attachment 5 


Inventory Expert Service Report: PMN Substance 

ern Inventory Expert Service 


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

Fax: 61+447-37"7 

E-mail: answers@cas.org 

INVENTORY EXPERT SERVICE REPORT 

IES-ORDER NUMBER: 

REGISTRY NUMBER: 

'. CA INDEX NAME 

Please pri~t the above CA I~dex Kame o~ the appropriate page of your PMH. 

~ -/.fthis _ i8 chocked, CAS .... IIOde conectiOllC.) _ked in red to!our IES order. Please make the sama correctio~(8) to your PKN before 

submitting it to the EPA. 

P.O. Bax ])., CoIumbua. OhM) 4)210.0334 
Attachment 6 


Inventory Expert Service Report: PMN Substance 

ern Inventory Expert Service 


A diVision of the AmerIcan Chemical Society Phone: 800-631-1884. 614-447-3600 (ext. 2308) 

Fax: 614-447-3747 

E-mail: answer5@c:as.org 

INVENTORY EXPERT SERVICE REPORT 

lES-ORDER NUMBER: 


REGISTRY NUMBER: 


CA INDEX NAME 

.-...- .. --------. 

please print the above CA Index Name on the appropriate page of your PHR. 

this bas i ••backed. CAS bas mad••orr8.t100(0) marked La rad to

~ur IES order. Pleas. make the same correction(s) to your PMH before 

submitting it to the EPA. 

P.o.loIc lJ4)