United States Environmental Protection Agency Washington, DC 20460
Section 4 Submission This is an original submission: This is an amendment: CERTIFICATION I hereby certify to the best of my knowledge and belief that (1) all information entered on this form is complete and accurate; and (2) any confidentiality claims are true and correct as to that information for which they have been asserted. Any knowing and willful misinterpretation is subject to criminal penalty pursuant to 18 USC 1001. Signature: Official Title: Director Contact Person: Tracy E. Guerrero Email Address: tracy_guerrero@americanchemistry.com Date Signed: 01/20/2015 PART 1 Contact Information Submission Information Submission Type:

ECA Form Alias: ECA-20150120-13:09:57 EST Federal Register Notice: 79 FR 18822 Chemical Name: Octamethylcyclotetrasiloxane (D4) Date Submitted: 01/20/2015 Submitter Information Company Name:

American Chemistry Council Address: 700 2nd Street, NW Washington, DC, 20002 United States Contact Person: Tracy E. Guerrero
Phone Number: 2022496196 Email Address: tracy_guerrero@americanchemistry.c om Technical Contact Information CBI

Yes: No: Company Name: American Chemistry Council Address: 700 2nd Street, NW Washington, DC, 20002 United States Contact Person: Mrs Tracy E. GuerreroSEC4 Submission Page 2

Phone Number: 2022496196 Email Address: tracy_guerrero@americanchemistry.c om PART 2 Study Plans & Conduct of Testing Principal Test Sponsor CBI

Yes: No: Contact Person: Tracy Guerrero Address: 700 2nd Street, NE Washington, DC, 20002 United States Phone Number: 2022496196
Email Address: tracy_guerrero@americanchemistry.com Sponsor Organizations CBI

Yes: No: Contact Person: Tracy Guerrero Address: 700 2nd St. NE Washington, DC, 20002 United States Phone Number: 2022966196
Email Address: tracy_guerrero@americanchemistry.com Testing Facilities Testing Facility:

ERM Address: 1590 S. Milwaukee Ave. Suite 211 Libertyville, IL, 60048 United States Phone Number: 8475730587

CBI Yes: No: Contact Person: Tracy Guerrero Address: 700 2nd Street NE Washington, DC, 20002 United States Contact Role: PROJECT MANAGER
Phone Number: 2022966196 Email Address: tracy_guerrero@americanchemistry.c om Study Professionals CBI

Yes: No:SEC4 Submission Page 3

Company Name: ACC/SEHSC Address: 700 2nd Street NE Washington, DC, 20002 United States Contact Role: STUDY DIRECTOR
Phone Number: 2022966196 Email Address: tracy_guerrero@americanchemistry.c om Experience: Director, ACC/SEHSC: D4 ECA Monitoring Program PART 3 Additional Information Additional Information File Name:

D4 ECA Schedule Change Request 20-Jan-2015 Final.docx Document Type: Amendment to the Study Plan Attachment Date:

01/20/2015

Paperwork Reduction Act:The Government Paperwork Elimination Act (GPEA) (44 U.S.C. 3501) provides that, when practicable, Federal organizations use electronic forms, electronic filings, and electronic signatures to conduct official business with the public. EPA's Cross-Media Electronic Reporting Regulation (CROMERR) (40 CFR part 3), published in the Federal Register on October 13, 2005 (70 FR 59848) (FRL-7977-1)(Ref. 2), provides that any requirement in title 40 of the Code of Federal Regulations (CFR) to submit a report directly to EPA can be satisfied with an electronic submission that meets certain conditions once the Agency published a notice in the Federal Register announcing that EPA is prepared to receive certain documents in electronic form. For more information about CROMERR, go tohttp://www.epa.gov/cromerr/

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