## U.S. ENVIRONMENTAL PROTECTION AGENCY



# __**~_r::DA** 

# PREMANUFACTURE 

# _I:T""I-\ NOTICE Date ofReceipt:


### FORNEW CHEMICAL SUBSTANCES 

# Company Sanitized

....,11...1 un;;;

### llWlluer OJ pages 

### in the PremanufactureN.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 ifyou 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 numbermust also appear on your correspondingfee 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 providethe currentlycorrect Chemical Abstracts (CA) Name ofthe new chemical substance, even ifyou claim the identity as confidential. You may authorize anotherperson 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. Aletter in support ofyour submission should reference yow- TS user fee identification number. You must submit an original and twocopies ofthis notice including all test data. Ifyou claimed any information as confidential, a single sanitized copy mustalso be submitted. Part 11
- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE Ifthere are several manufacture, processing, or use operations to be described in Part II, section Aand Bofthis notice, reproduce the sections as needed. Part III
- LIST OF AITACHMENTS Attach additional sheets ifthere is not enough space to answer aquestion fully. Label each continuation sheet withthe corresponding section heading. In Part Ill, listthese attachments, any test dataor other data andany optional information included inthe notice. OPTIONAL INFORMATION You may include any information thatyou want EPA to consider in evaluating the new substance. Onpage II ofthis form. space has been provided foryou to describe pollution prevention and recycling informationyou may have regarding the new substance. SQ-i:aJled "binding" boxes are included thrOUgllOut this form foryou to indicate your willingness to bebound to certain statementsyou make in this public notice, such as use, production volume, protective equipment ... This option is intended to reduce delays that routinely accompany the development ofconsent orders or SignificantNew Use Rules. Exceptin the case ofexemption applications (such as TMEA, L VE, LOREX) where certain information provided inthis notification is binding onthe submitter whenthe Agency approves the exemption application, checking abinding box in this notice by itselfprohibit the submitterfrom 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 aclaim on the form, mark (X) the confidential box: nex:! to the information that you claim as confidential. To asserta claim in an attachment, circle orbracketthe information you claim as confidential. Ifvouclaim informatipn in the notice

## as confidential. you must also provide a sanitized version ofthe notice (includjng attachments). Foradditional instructions on claiming information asconfidential, read the Instructions Manual. Mark (x) ifany information inthis notice is claimed as confidential. TEST DATA AND OTHER DATA You arerequired to submit all test data in your possession or control and to provide a description ofall other dataknown to orreasonable ascertainable to you, ifthese data are related to the health and environmental effects ofthe manufacture, processing, distribution in commerce, use, or disposal ofthe new chemical substance. Standard literaturecitations may be submitted fordata in the open scientific literature. Complete test data (written in English) not summaries ofdata. must be submitted if they donot appear in thepoen 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 oftest 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 datanot in the possession orcontrol ofthe submitter • Aphysical and chemical properties worksheet is located on the lastpage 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~; t'0 -l f"7l 

# D 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 D L

VE Modification LOREX Modification IS THIS ACONSOLIDATED PMN? Yes 

# 0 # ofchemicals 3 (PrerJOtice Communication # required, enter # on page 3) EPA FORM 7710-25 (Rev. 5-95) Replaces previous editions ofEPA Fonn 7710-25 

# /

### 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 maintainingthe data

### needed. and completing and reviewing the collection of information. Sendcomments 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 bestofmy knowledge and belief: 1. The company named in Part I.

### Section A, subsection 1 a 

### ofthis notice form intends to manufacture or 

### import for a 

### commercial purpose, otherthan in small quantities solely for research and development, the substance identified in Part I, 

### Section B. 

### 2. All information provided in this notice 

### is complete and truthful 

## as ofthedate ofsubmission. 3. 

### (am submitting with this notice all test data 

### in my possession orcontrol and a description ofa1l 

### other data

### known to or reasonably ascertainable byme 

### as required by §720.50

### ofthe Premanufacture Notification Rule. 

### Addition,'Certification Statements: If

### you 

### are-MIbmitting-a f'MN, 

### IntennediatePMN; Consol/datalPMN;l5tSNUN, check thcffolfow.ngllser 

### reeceitffiClition statementthat 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 TheCompany named in Part I, Section Ahas remitted the fee of$1000 

### 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). If

### you are 

### submitting a 

### low vol.meexemptioD (LVE) 

### application in accordance with 40 

### CPR 723.50 

### (c) (1 ) 

### or a Low release and 

### low exposureexemptiOD (LoREX) application in accordance with 40

### CFR 723.50 

### (c) (2),

### check the following certification statements: 

# o The manufacturer submittingthis notice intends to manufacture or importthe new chemical substance for commercial purposes, other

### than in small quantities solely for research and development, underthe terms of40

### CFR 723.50. 

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

# o Thenew chemical substance for which the notice 

### is submitted meets all applicable exemption conditions 

# o Ifthis 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 ofthedate ofexpiration ofthe 30

### day review period.
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### Cootldential**--------~ ---~**  ....

### ,.----.. 

### -.. 

### SilDatureofagent- (ihpplkable) 

### Date FORM EPA 7110·25 

### (Rev. 5-95) Page 2 

# x

## Part I
-- GENERAL INFORMATION Section A - SUBMITTERIDENTIFICATION 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 ofauthorized official Company Mailing address (number and street) City, State, ZIP Code Position

Telephone Area Code

c. Ifyou are submittingthis notice as part

### ofajoint submission, mark (X)

### this box. Joint Submitter (if applicable)

2. 

### Technical Contact (in U.S.) 

### Name ofauthorized official Company Mailing address (number and street) City, State, ZIP Code Name Company Mailing address (number and street) City, State, ZIP Code 3. 

### Ifyou have had a prenotice communication (PC)

### concerning this notice and EPA assigned a PC 

### Number to this notice, enterthe number. 4. 

### Ifyou have submitted an exemption application for the chemical substance covered by this notice, enter

### the exemption number assigned by EPA. Ifyou previously submitted aPMN for this substance, enterthe PMN number assigned by EPA (i.e. withdrawn 

### orincomplete). 

### 5. Ifyou have submitted anotice of Bonafide inlentto manufacture or import for the chemical substancecovered by this notice, enterthenotice 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)

### ifnone Mark (X)

### ifnone
Mark (X) 

### ifnone

3. 

# D Both

# 0 [X] [!] Confidential 

### X



## X

## Part I - GENERAL INFORMATION
- Continued Yon must provide acurrently com:ct Chemical Abstracts (CA)name ofthe substance based 

## Section B
- CHEMICAL IDENTITY INFORMATION: 011 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 1(Class 1or 2 substances) or2 (Polymers) as appropriate. Complete all other items, Ifanother person will submit chemical identity infonnation for you (foreither item I or 2) mark (X) the box at the right. IdentifY the name, company, and address ofthat person in a continuation sheet. 

# o Confidential I, Class I or 2 chemical substances (for definitions ofclass I and class 2 substances, see the Instructions Manual) a, Class ofsubstance
- 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, ForClass I substances aCA Index name mustbe provided, For Class 2 substances either aCA Index name orCA 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 ofthe Identification 

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

## X CAS # 

### X e .Fora 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 orprocess. (3) Indicate the range ofcomposition and the typical composition (where appropriate), (4) Provide a correct representative orpartial structural diagram, as complete as can be known, ifone can be reasonably ascertained, 

### X

Mark (X) this box ifyou attach a continuation sheet 

### Referto Continuation Sbeet Page 4(a)-1 (Rev, 5-95) Page4(a)

## Continuation Sheet: PartI - GeneralInformation Section B - ChemicalIdentityInformation Subsection B(1)(e)

Page4(a)-1 

# s

## Part I - GENERAL INFORMATION
- Continued You must provide acummtly correct Chemical Abstracts (CA) name ofthe 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. ConfidIfanotherperson will submit chemical identity information for you (foreither item I or 2) mark (X)the box at the right 

# D ential IdentifY the name, company, and address ofthat person in a continuation sheet. I. Class I or 2chemical substances (for definitions ofclass 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) Namethat is consistentwith TSCA Inventory listings for similar substances. For Class 

### I substances a CA Index name must be provided_ ForClass 

### 2 substances either aCA 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 orobtain the specified chemical identity information reported in this notice: (checkone) [] Method I (CAS Inventory Expert Service
- a copyofthe Identification 

# D Method 2 (Other Source) report obtained from the CAS Inventory Expert Service must be submitted as an attachmentto 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 acomplete 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, ifonecan be reasonably 

### X ascertained.

Mark (X)this box ifyou attach a continuation sheet 

### Referto Continuation SbeetPage4(b)-1 FORM EPA 771()"25 (Rev. 5-95) Page4(b)

## Continuation Sheet: Part I - General Information Section B - Chemical Identity Information 

## SubsectionB(1)(e)

Page4(b)-1

## PartI - GENERAL INFORMATION
- Continued You must pr01lide a cummtly correct Cbemical Abstracts (CA) name oftbe subslance based 

## SectionB - CHEMICAL IDENTITY INFORMATION: on !be ninth Collective ('leI)ofCA 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. ConfidIfanotherperson will submitchemical identity information for you (foreitber 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 or2 chemical substances (for definitions ofclass 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. ForClass I substances aCA Index name must be provided. ForClass 2 substances either a CA Index name orCA PreferredName 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 copyofthe 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 (ifa number already exists for the substance) 

### X CAS # 

### X e .For aclass I substance, provide acomplete and correct structural diagram. For a class 2substance
- (I) List the immediate precursor substances with their respectiveCAS RegistryNumbers. (2) Describe the nature ofthe reaction or process. (3) Indicate the range ofcomposition and the typical composition (where appropriate). (4) Provide a correct representative orpartial structural diagram, as complete as can be known, ifone can be reasonably ascertained. 

### X

Mark (X)this box ifyou attach a continuation sheet 

### Referto Continuation Sbeet Page 

### 4(crt FORM EPA 7710-25 (Rev. 5-95) Page 4(c)

## Continuation Sheet: PartI - General Information Section B - Chemical IdentityInformation SubsectionB(1 )(e)

Page4(c)-J

## Part I - GENERAL INFORMATION
- Continued Section B - CHEMICAL IDENTITY INFORMATION
- Continued 2. 'Polymers (For a definition ofpolymer, see the Instructions ManuaL) Confidential a. Indicate the number-average weight ofthe lowest molecular weight composition ofthe polymeryou intend to manufacture.

Indicate maximum weight percent oflowmolecular weight species (not including residual monomers, reactants or solvents) below 500 and below 1000 absolute molecularweight ofthat composition. 

# GPCD D (Specify) Describe the methods ofmeasurement or the bases for your estimates: Other i) lowest number average molecularweight: ii) maximum weight % below 500 molecularweight: iii) maximum weight % below 1000 molecular weight: 

### N/A 

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

b. You must make separate confidentiality claims for monomer orother 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(ifa number exists) ofeach monomer orotherreactant used in the manufacture ofthe polymer. (2) - Mark (X) this column ifentry in column (I)is confidential. (3) -Indicate the typical weight percent ofeach monomer orother reactant in the polymer. (4) - Mark (X) the identity column ifyou want a monomer or other reactant used at two weight percent orless to be listed as part ofthe polymerdescription 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 ofeach monomer orother reactant that may be present as aresidual in the polymer as manufactured for commercial purposes. (7) - Mark (X) this column ifentry in column (6)is confidential. Monomerorother 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 ifyou attach acontinuation sheet. c. Please iden

# O which method you used to develop orobtain the specified chemical identity information reported in this notice: (check one)

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

# D Method 2(Other Source) report obtained from the CAS Inventory Expert Service must be submitted as an attachmentto this notice) d. The currently correct Chemical Abstracts (CA) name for the polymerthat is consistentwith TSCA Inventory listings for similarpolymers.

e. Provide a correctrepresentative or partial chemical structure diagram, as complete as can be known, ifone can be reasonably ascertained. 

# D

D Mark (X) this box ifyou 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 ifavailable. Ifthere are unidentified impurities, enter ·unidentified". (b)
- Estimate the maximum weight % ofeach impurity. Ifthere are unidentified impurities, estimate their total weight %. Impurity and CAS RegisII}' Number (a) Maximum percent (b) Confidential 

### None known % % % % % % % 

# D 4. Mark (X)this box ifyou attach acontinuation sheet. Synonyms
- Enter any chemical synonyms for the new chemical substance identified in subsection I or 2. Confidential 

# D Mark (X) this box ifyou 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 ageneric chemical name for yoursubstance that reveals the specific chemical identity ofthe new chemical substance to the maximum extent possible. Referto the TSCAChemical Substances Inventory, 1985 Edition, Appendix B for guidance on developing generic narnes.


### Salt ofmixed 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 ofthe 

### new chemical substance at sites yon control. Provide the CAS Registry Number ifavailable. 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 ifavailable. Ifthere are unidentified impurities, enter ·unidentified". (b)
- Estimate the maximum weight % ofeach impurity. Ifthere are unidentified impurities, estimate their total weight %. Impurity and CAS Registry Number Maximum Confi­ (a) percent (b) dential 

## None known % % % % % % % 

# 0 Mark (X)this box ifyou 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 ifyou attach acontinuation 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 - Ifyou claim chemical identity as confidential, you must provide a generic chemical name for your substance thatreveals the specific chemical identity ofthe new chemical substance to the maximum extent possible. Referto theTSCA Chemical Substances Inventory, 1985 Edition, Appendix B for guidance on developing generic names.


### Salt ofa polyalkylenepolyamine derivative 

# 0 Mark (X)this box ifyou aUach acontinuation 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 ifavailable. Ifthere are unidentified impurities, enter ·unidentified·. (b)
- Estimate the maximum weight % ofeach impurity. Ifthere are unidentified impurities, estimate their total weight %. Impurity and CAS Registry Number 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 ifyou 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 acontinuation 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 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 

### ofmixed fatty amidoamines 

# 0 Mark (X) this box ifyou attach acontinuation 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 Numberifavailable. 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 nextto any item you claim as confidential. I. 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% new chemical substance basis. Fora Low Volume Exemption application, 

### if you choose to haveyournotice reviewedata lowerproduction volume than 10,000kglyr, specifythe volume andmark (x) in the binding box. 

### if granted, you are boundto thisvolume. 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 ofuse, the percent ofproduction volume devoted to each

category, the formulation ofthe new substance, and other use information. Mark (X) the "Confidential" box nextto any item you claim as confidential. a. (I) Describe each intended category ofuse ofthe 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 ofuse. (5) Mark (X) this column ifentry in column (4) is confidential business information (CBI). (6) Estimate the percentofthe 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 %ofproductvolume expected for the listed "use" sectors. Mark more than one box ifappropriate. 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 ofUse (I) (by function and application, i.e. adispersive dye for finishing polyester fibers) CBI (2) Binding Option Mark (X) (3) Production%

(4) CBI (5) %inFormulation

(6) CBI (7) %ofsubstance expected per use (8) CBI (9)Sitelimited 'Consumer Industrial Commercial Binding Option 

### X 

## X X X

• Ifyou have identified a ·consumer" use, please provide on a continuation sheet a detailed description ofthe use(s) ofthis chemical substance in consumer products. 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 the consumer product. 

# o Mark (X) this box jfyou attach a continuation sheet. b. Generic Ifyou claim any category ofuse description in subsection 2a as confidential, entera generic description ofthat 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 ofany hll23fd warning statement, label, material safety data sheet, orother

information which will be provided to any person who is reasonably likely to be exposed to this substance regarding protective equipment or []ticesfor the safe handling, transport, use, or disposal ofthe new substance. List in part

## mhll23fd information you include. Mark (X) this box ifyou attach hll23fd information. 

### Referto Continuation Sbeet Page 7(a)-t BindingOption Mark (X)
FORM EPA 7710-25 (Rev. 5-95) Page 7(a)

## Continuation Sheet: PartI - GeneralInformation Section C - Production,Import and Use Information Subsection 

## CO)
- ProductionVolume

Page 7(a)-] 

# /S

## Part I - GENERAL INFORMATION
- Continued Section C - PRODUCTION, IMPORT AND USE INFORMATION Mark (X) the "Confidential" box nextto 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 duringthe first three years ofproduction. Estimates should be on 100% new chemical substance basis. Fora Law Volume Exemption application, 

### if you choose to haveyournotice reviewedata lowerproductionvolume than 10,000kg/yr. specifythe volumeandmark (x) in the binding box. 

### If granted. youare 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 ofuse, the percent ofproduction volume devoted to each

category, the formulation ofthe 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 ofuse ofthe 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 10 each category ofuse. (5) Mark (X) this column ifentry in column (4) is confidential business information (CBI). (6) Estimate the percent ofthe new substance as formulated in mixtures, suspensions, emulsions, solutions or gels as manufactured for commercial purposes at sites underyour 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 information 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- 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

• Ifyou have identified a "consumer" use, please provide on a continuation sheet a detailed description ofthe use(s) ofthis chemical substance in consumer products. 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 the consumer product. 

# D Mark (X) this box ifyou attach a continuation sheet b. Generic Ifyou claim any category ofuse description in subsection 2a as confidential, enter a generic description ofthat category. Read the Instructions

use Manual for examples ofgeneric use descriptions. description i 

### Processingaid 

# I 

# D Mark (X) this box ifyou attach a continuation sheet. 3. Hazard Information
- Include in the notice a copy ofreasonable facsimile ofany hazard warning statement, label, material safety 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]ticesfor the safe handling, transport, use, or disposal ofthe new substance. List in part III hazard information you include. Mark (X) this box ifyou attach hazard information. 

### Referto Continuation SheetPage 7(b)-1

# /~ FORM EPA 7110·25 (Rev. 5-95) Page 7(b)

## Continuation Sheet: PartI - General Information Section C - Production, Importand Use Information Subsection C(l)
- ProductionVolume

Page 7(b)-1

## PartI - GENERAL INFORMATION
- Continued Section C - PRODUCTION, IMPORT AND USE INFORMATION Mark (X) the ·Confidential" box nextto any item you claim as confidential. I. Production volume
- Estimate the maximum production volume duringthe 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% new chemical substance basis. For a Low Volume Exemption application, 

## if yOu choose tohaveyournotice reviewedata lowerproduction volume than J 0,000kglyr, specify the volumeandmark (x) in the binding box. 

### If granted, youare boundto thisvolume. 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 ofthe category ofuse, the percentofproduction volume devoted to each

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

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

(2) Mark (X) this column ifentJy 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 percentofthe new substance as formulated in mixtures, suspensions, emulsions, solutions or gels as manufactured for commercial purposes at sites underyour 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 information provided in (8) binding. (9) Mark (X)this column ifentJy(ies) in column (8) is (are) confidential business information (CBI). Category ofUse (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

• Ifyou have identified a "consumer" use, please provide on a continuation sheet a detailed description ofthe use(s) ofthis chemical substance in consumer products. In addition include estimates ofthe concentration ofthe new chemical substance as expected in consumer products and describe the chemical reactions by which this substance loses its identity in the consumer product. 

# o Mark (X)this box ifyou attach a continuation sheet. b. Generic Ifyou claim any category ofuse description in subsection 2a as confidential, enter a generic description ofthat category. Read the Instructions

use Manual for examples ofgeneric use descriptions. description 

### Processing aid 

# o Mark (X)this box ifyou attach a continuation sheet. 3. Hazard Information
- Include in the notice a copy ofreasonable facsimile ofany hazard warning statement, label, material safety data sheet, orother BindingOption

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, ordisposal ofthe new substance. List in part IIIhazard information you include. Mark (X)this box ifyou attach hazard information. 

### Refer to Continuation Sbeet

### Page7(c)-1 FORM EPA7710-25 (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 ofmanufacture, processing oruse operation involving the new chemical substance at industrial sites you control. Importers do not have to complete this section for operations outside the U.S.; however, you may still have reporting requirements ifthere are further industrial processing or use operations after import. You must describe these operations. See instructions manual. I. Operation Description



### a. Identity
- Enterthe identity ofthe site at which the operation will occur. Name Site address (number and street) City, County, State, ZIP Code Ifthe same operation will occur at more than one site, enterthe number ofsites. IdentitY the additional sites on a continuation sheet, and ifany ofthe sites have significantly different production rates oroperations, 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) Diagramthe majorunit 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 approximateweight (by kglday 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 orper batch). (3) IdentitY by numberthe points ofrelease, including small or intermittent releases, to the environment ofthe new chemical substance.

[] Mark (X)this box ifyou attach acontinuation sheet. 

### Refer to Continuation Sheets 

### 8(a)-1 and 8(a)-2 FORM EPA 7710-25 (Rev. 5-95) Page 8(a)

## Continuation Sheet: PartII
- Human Exposure and EnvironmentalRelease 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 outsidethe 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
- Enterthe identity ofthe site at which the operation will occur. Name Site address (number and street) City, Connty, State, ZIP Code Ifthe same operation will occur at more than one site, enterthe number ofsites. IdentifY the additional sites on a continuation sheet, and ifany ofthe sites have significantly different production rates oroperations, 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 ifnotused daily orperbatch). (3) IdentifY by numberthe points ofrelease, including small 

### or intermittent releases, to the environment ofthe 

### new chemical substance.

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

### Referto 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 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. You must describe these operations. See instructions manual. I. Operation Description Confida. Identity
- Enterthe identity ofthe site at which the operation will occur. ential Name 

# x Site address (number and street) City, County, State, ZIP Code Ifthe same operation will occur at more than one site, enterthe number ofsites. Identify the additional sites on a continuation # ofsites 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. 

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

# D Manufacturing Processing Use 

# D 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 5gallon 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 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 ofrelease, including small or intermittent releases, to the environment ofthe 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: PartII
- Human Exposure andEnvironmentalRelease Section A - Industrial Sites Controlled bythe 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 ofworker activity, physical form ofthe new chemical substance, number ofworkers exposed, and duration ofactivity. 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 (ifpart of a 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. (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 peryear. (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., bagdumping, 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 intotank Gloves & face shield, trucks long sleeve shirt X 1 X

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

### Referto Continuation Sheet Page 9(a)-1 3. Environmental Release and Disposal- You must make separate confidentiality claims for the release number and the amount ofthe new chemical substance released and other release and disposal information. Mark (X) the "Confidential" box next to each item you claim as confidential. (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, orother (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 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 whether the waste is subject to secondary ortertiary 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 (CBI). (7)
- Identify the destination(s) ofreleases to water. Please supply NPDES (National Pollutant Discharge Elimination System) #s for direct dischargers orNPDES numbers ofthe POTW (Publicly Owned Treatment Works). Mark (X) ifthe POTW name orNPDES # is confidential business information (CBI). Release Amount ofnew substance CBI**~edia** ofRelease 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. 

### Referto Continuation Sbeet Page 9(a)-1 FORM EPA 7710-25 (Rev. 5-95) Page 9(a)

## Continuation Sheet: PartII
- Human Exposure and EnvironmentalRelease Section A - IndustrialSites Controlled by the Submitter SubsectionA(2)
- Occupational Exposure

Page9(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 ofworker activity, physical fonn ofthe new chemical substance, number ofworkers exposed, and duration ofactivity. 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 infonnation (CBI). (3)
­ Describe any protective equipment and engineering controls used to protectworkers. (4) and (6) -Indicateyour willingness to have the infonnation provided in column (3) or (5) binding. (5) -Indicatethe physical fonn(s) ofthe 

### new chemical substance (e.g. solid: crystal, granule, powder, ordust) and % new chemical substance (ifpart of a mixture) at the time ofexposure. (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 ifentry in column (8) is confidential business infonnation (CBI). (10) and (II)
-- Estimate the maximum duration ofthe activity for any worker in hours per day and days peryear. (12)
-- Mark (X) this column ifentries in column (10) and (II) are confidential business infonnation (CBI).

WorkerActivity CBI Protective Equipment! Binding Physical fonn(s) Binding CBI # of CBI Maximum Duration CBI (eg., bag dumping, filling drums) EngineeringControls 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. 

### Referto Continuation SheetsPages 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 ofthe new chemical substance released and otherrelease and disposal infonnation. Mark (X) the "Confidential" box next to each itemyou 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 tothe environment or(b) into control technology (in kg/day orkglbatch). (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, orother (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 limitthe release ofthe new substance to the environment. Forreleases 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 whether the waste is subject to secondary ottertiary 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 infonnation (CBI). (7)
-- IdentifY the destination(s) ofreleases to water. Please supplyNPDES (National Pollutant Discharge Elimination System) #s for direct dischargers orNPDES numbers ofthe POTW (Publicly Owned Treatment Works). Mark (X) ifthe POTW name orNPDES # 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) Mark (X) the 

# D POTW provide name(s) below: CBI 

# D Navigable 

# D Other
- SpecifY destination(s) of**~** releases to water. Waterway 

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

### Referto Continuation Sbeets Pages 9(b)-J and 9(b)-2 FORM EPA 7710-25 (Rev. 5-95) Page 9(b) 

# 3/

## Continuation Sheet: PartII
- Human Exposure and Environmental Release Section A - Industrial Sites Controlled by the Submitter SubsectionA(2)
- Occupational Exposure

Page 9(b)-1 

# 32

### Page 9(b)-2 

# 33

## PartII
- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE
- Continued SectionA - INDUSTRIAL SITES CONTROLLED BY THE SUBMITTER
- Continued 2. (ktupational Exposure
- You must make separate confidentiality claims for the description ofworker activity, physical form ofthe new chemical substance, number ofworkers exposed, and duration ofactivity. Mark (X) the ·Confidential" box 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) -Indicatethe physical formes) ofthe new chemical substance (e.g. solid: crystal, granule, powder, or dust) and 0/. new chemical substance (ifpart of a 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. (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 peryear. (12)
-- Mark (X) this column jfentries in column (10) and (II)are confidential business information (CBJ).

WorkerActivity (eg., bag dumping, filling drums) (I) CBI (2) Protective Equipment! EngineeringControls (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 X long sleeve shirt 1

Mark (X) this box ifyou 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 ofthe new chemical substance released and otherrelease and disposal information. Mark (X) the 'Confidential" box next to each item you claim as confidential. (I)- Enterthe numberofeach release point identified in the process description, part II, section A, subsection I d (3), (2)
-- Estimate the amount ofthe new substance released (a) directlyto 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, orother (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 ofon land, characterize the disposal method and slate 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-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 orNPDES numbers ofthe POTW (Publicly Owned Treatment Works). Mark (X) ifthe POTW name orNPDES # is confidential business information (CBI). Release Amount ofnew substance CBI**~edia** ofRelease Control technology and efficiency (you may wish to optionally attach efficiency data) CBI· Number 

### (os. stack air) (4) I (2b) (2a) (Sa) I Binding (5b) (3) (I) (6) 

### i**~** I I I I I**~** I I CBI (7) Mark (X) the 

# D POTW provide narne(s) below: Provide NPDES # CBI destination(s) of 

### I--­ 

# D Navigable 

# D Other
- Specify Waterway releases towater. Mark (X) this box ifyou attach a continuation sheet. 

### Referto Continuation Sheets Pages 9(e)-1 and 9(e)-2 

# [] FORM EPA 7710-25 (Rev. 5-95) Page 9(c) X

## Continuation Sheet: PartII
- Human Exposure andEnvironmentalRelease Section A - Industrial Sites Controlled by the Submitter 

## SUbsection A(2)
- 

## Occupational Exposure

Page 9(c)-1 

# JS

### Page 9(c)-2

## PartII
- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE
- Continued Section, B - INDUSTRIAL SITES CONTROLLED BY OTHERS Complete section Bfor 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 mustreport any processing or use activities after import. See the Instructions Manual. Complete a separate section B foreach type of processing oruse operation involving the newchemicalsubstance. 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 thatyou claim as confidential. (1) Diagram the major unit opemtion steps and chemical conversions, including interim stomge and transport containers (specify
- e.g. 5gallon 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 ofall feedstocks (including reactants, solvents, and catalysts, etc.) and ofall products, recycle streams, and wastes. Include cleaning chemicals (note frequency ifnot used daily orper batch). (3) Identify by numberthe points ofrelease, including small or intermittent releases, to the environment ofthe new chemical substance. (4). Please enter the number ofsites (rememberto identify the locations ofthese sites on acontinuation sheet);



### --­ # ofsites

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

### Referto 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 peryear. (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 percentofthe new substance as formulated when packaged or used as afinal 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 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 oroff-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) -Identifybyproducts which may result from the operation. (3), (5), (8), (11), (13), and (15)
-Mark (X) this column ifany ofthe 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 

### Referto Continuation Sbeet Page 100a)-l

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

# 37

### Page lO(a)-1

## PartII
- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE
- Continued Section B - INDUSTRIAL SITES CONTROLLED BY OTIIERS Complete section Bfor typical processingor use operations involvingthe new chemical substance at sites you do not control. Importers do not have to complete this section for operations outside the U.S.; however, you must report any processingoruse activities after import. See the Instructions Manual. Complete a separate sectionB for each type of processingor use operation involving the newchemicalsubstance. Ifthe same operation is performed at more than one site, describe the typical operation common to these sites. Identify additional sites on acontinuation sheet. 1. OperationDescription
- To claim information in this section as confidential, circle or bracket the specific information thatyou claim as confidential. (I) Diagram the majorunit operation steps and chemical conversions, including interim storage and transport containers (specify
- e.g. 5gallon 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 orkglbatch, on a 100% new chemical substance basis) and entry pointofall feedstocks (including reactants, solvents, and catalysts, etc.) and ofall products, recycle streams, and wastes. Include cleaning chemicals (note frequency ifnot used daily or perbatch). (3) Identify by numberthe points ofrelease, including small or intermittent releases, to the environment ofthe new chemical substance. (4). Please enterthe number ofsites (remember to identifythe locations ofthese sites on a continuation sheet):



## --­ 1/ ofsites



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

### Referto Continuation Sbeet Page lO(b)-l 2. WorkerExposurelEnviroDmental 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 ofexposure per worker in (a) hours per day and (b) days peryear. (6) - Describe physical form ofexposure and % new chemical substance (ifinmixture), and 

### any protective equipment and engineering controls used to protect workers. (7)
- Estimate the percent ofthe new substance as formulated when packaged or used as a final product. (9) - From the process diagram above, enterthe numberofeach release point. Complete 9-13 for each release point identified. (10)
­ Estimate the amount ofthe new substancereleased (a) directly to the environmentor (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 or incineration, POTW, orother (specify) and control technology, ifany, that will be used to limit the release ofthe new substance to the environment. (14)
- Identify byproducts which may result from the operation. (3), (5), (8), (II), (13), and (15)
- Mark (X) this column ifany ofthe precedingentries are confidential business information (CBI). Letter of #I 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 % ulation new substance (12) (I) (2) (3) (4a) (4b) (5) (6) (7) (8) (9) (lOa) (lOb) (11) (13)

(14)
- Byproducts (I5) 

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

### RefertoContinuation Sbeet Page IO(b)-1 

# 3' FORM EPA 7710-25 (Rev. 5-95) Page 100b)

### Page 1 O(b)-1

## PartII
- HUMANEXPOSURE AND ENVIRONMENTAL REcEASE
- Continued Section B - INDUSTRIAL SITES CONTROLLED BY OTHERS Complete section Bfor 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 oruse activities after import. See the Instructions Manual. Complete a separate section Bjoreach type oj processing or use operation involving the new chemicalsubstance. Ifthe 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 bracketthe 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 ofall products, recycle streams, and wastes. Include cleaning chemicals (note frequency ifnotused 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 ofsites (remember to identifY the locations ofthese sites on a continuation sheet):



## --­ #ofsites

# ~ Mark (X) this box ifyou attach acontinuation sheet. 

### Referto 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 ofexposure per worker in (a) hours per day and (b) days peryear. (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 ofthe new substance as formulated when packaged or used as afinal 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 substancereleased (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) -IdentifYbyproducts which may result from the operation. (3), (5), (8), (II),(13), and (15)
- Mark (X) this column ifany ofthe 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 SubstanceReleased 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. 

### Referto Continuation SbeetPage 10(c:)-1

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

# 41

### Page 1O(c)-1

## OPTIONAL POLLUTIONPREVENTION INFORMATION To claim infonnation in this section as confidential circle orbracket the specific infonnation that you claim as confidential. 

## In this section you may provide information not reported elsewhere in this form regardingyour efforts to reduce or minimize 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 saferprocesses orproducts 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, productreformulation, raw materials substitution, and/or inventory control. Recycling refers to the reclamation ofuseful chemical components from wastes thatwould otherwise be treated orreleased as air emissions orwater discharges, or land disposal. Descriptions ofpollution prevention, sourcereduction and recycling should emphasize potential riskreduction subsequent to compliance with existing regulatory requirements and can be either quantitative orqualitative. The EPA is interested in this information to assess overall net reductions in toxicity ofenvironmental releases and exposures, not the shifting ofrisks to other environmental media ornon-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 beprovided. 

## All information provided in this section will be taken into consideration duringthe review ofthis substance. See therevised InstructionsManual that includes a Pollution Prevention manual for guidance and examples. Describethe expected net benefits, such as (I) 

### an overall reduction in risk to human health orthe environment; (2) a reduction in the volume manufactured; (3) a reduction in the generation ofwaste materials through recycling, sourcereduction orothermeans; (4) a reduction in potential toxicity ofhuman 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 similarapplications; 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 ifyou attach a continuation sheet. FORM EPA 7710·25 (Rev. 5.95) Page 11

# Part III -- LIST OFATTACHMENTS Attach continuation sheets for sections ofthe form and test data and otherdata (including physical/chemical properties and structure/activity information), and optional information afterthis page. Clearly identify the attachment and the section ofthe form to which itrelates, ifappropriate. Number consecutively the pages ofthe 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 ofthe notice form a sanitized version ofany attachment in which you claim information as confidential Attachmentname Attachment page Confinumbers(s) dential 

### Preliminary Material Safety Data Sheet: PMN Substance Attachment 1 

### X Preliminary Material Safety Data Sheet: PMN Substance Attachment2 

### 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 ifyou attach a continuation sheet. Enterthe attachment name and number. FORM EPA 7710-25 (Rev. 5-95) Page 12

## PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET To assist EPA's review ofphysical and chemical properties data, please complete the following worksheet for data you provide and include it in the notice. IdentifY the property measured, the 

### page ofthe notice on which the property appears, the 

### value ofthe property, the 

### units in which the 

### property is measured (as 'necessary), and whether or notthe 

### property is claimed as confidential. The physical state ofthe neat substance should be provided. These measuredproperties 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 submitthis worksheet; however, EPA strongly recommends thatyou do so, as it will simplifY review and ensure that confidential information is properly protected. You should submit this worksheet as asupplementto your submission oftest data. This worksheet is not asubstitute for submission oftest data. Property Mark (X) 

### Page Value Measured 

### Confiifprovided number orEstimate 

### dential (b) (MorE) 

### Mark(X) (a) (c) (d) Physical state ofneat substance

__ (s) _X_(I)

__ 

### (g) Vaporpressure @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

### waterpartition 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 ofphysical and chemical properties data, please complete the following worksheet for data you provide and include it in the notice. Identify the property measured, the page ofthe notice on which the property appears, the value ofthe property, the units in which the property is measured (as 'necessary), and whether or not the property is claimed as confidential. The physical state ofthe 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 supplementto your submission oftest data. This worksheet is not a substitute for submission oftest data. Property Mark (X) Page Value Measured Confiifprovided number or Estimate dential (b) (M orE) Mark(X) (a) (c) (d) Physical state ofneat substance

__ (s) --X-(I)

__ (g) Vaporpressure @ Temperature °C Density Irelative density glcml Solubility @Temperature °C

Solvent 

### gIL Solubility in water@Temperature °C °C Melting temperature °C Boiling I sublimation temperature @ torrpressure Spectra Dissociation constant Particle size distribution Octanollwaterpartition 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 ofphysical 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 ofthe notice on which the propeny appears, the value ofthe propeny, the 

### units in which the 

### propeny is measured (as

. necessary), and whetherornot 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 orformulations shouldbe so noted (% 

### PMN substance in**~.** 

### You are not required to submit this worksheet; however, EPA strongly recommends thatyou do so, as it will simplify review and ensure that confidential information is properly protected. You should submitthis worksheet as asupplementto your submission oftest data. This worksheet is not a substitute for submission oftest data 

### Propeny Mark (X) Page Value Measured 

### Confiifprovided number orEstimate 

### 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 @ torrpressure Spectra Dissociation constant Particle size distribution Octanollwaterpartition 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 PreliminaryMaterialSafetyData Sheet: PMN Substance 2 Pages
- TSCA CDI

## Attachment 3 Preliminary Material Safety Data Sheet: PMN Substance 2 Pages
- TSCA CDI

## Attachment 4 InventoryExpert Service Report: PMN Substance

# CLE: InventoryExpert 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 ExpertService Report: PMN Substance

# ern InventoryExpert Service
A division of

### theAmerican 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.



# -/.f this _ 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 ExpertService Report: PMN Substance

# ern InventoryExpertService
A diVision oftheAmerIcan 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)