EPA Support Form 

Support Form Report Number Mark (X) if anything is CBI

I. ORIGINAL NOTICE SUBMISSION IDENTIFICATION 

Report Number TS 

Number 

Case 

Number 

Original Submission Date 

Original Submission Media Type 

II. ORIGINAL NOTICE SUBMITTER IDENTIFICATION CBI 

Authorized Official 

Name 

Company Name

Mailing Address 

(Number & Street) 

City State Postal Code 

e-mail Telephone 

(include area code) 

III. CURRENT SUPPORT DOCUMENT IDENTIFICATION INFORMATION CBI 

Mailing Address 

(Number & Street) 

City State Postal Code 

e-mail Telephone 

(include area code) 

IV. TYPE OF SUPPORT (Check One) 

Letter of Support (Mark the certification statement checkbox below)

Withdrawal Request 

Other Correspondence 

TEST DATA (Health/Eco/Fate) 

Amendment (Changes made to PMN pages 1-13, MSDS or Physical/Chemical 

properties) 

Check if requested by EPA/ contractor 

EPA person/ contractor 

Position

(first) (last)

Name 

Position Company Name

(first) (last)

Submitter Signature

Province Country

All information provided in this Letter of Support is complete and truthful

as of the date of the submission.

Form Approved. O.M.B. No. 2070-0173.

DO46130206608360608

DO462W

Feb 6, 2013

CDX

Imogene Treble

Product Regulatory Leader The Dow Chemical Company

trebleie@dow.com 908-431-5934

1803 Building

Midland MI 48674

Imogene Treble

Product Regulatory Leader The Dow Chemical Company

trebleie@dow.com 908-431-5934

1803 Building

Midland MI 48674

USA

X

SANITIZED SUBMISSION

SUP2013P1
V. TEXT / DESCRIPTION OF CHANGES CBI 

Insert Attachment 

Due to the large size of the files the test data will be submitted as 4 support documents.

SANITIZED SUBMISSION

SUP2013P2
LIST OF ATTACHMENTS

# Number 

of Pages 

Associated 

Section 

Number 

CBI 

 

 

 Mark (X) this box if the data continues on the next page.

Attachment Name Attachment Filename 

001 Activated Sludge Public Activated Sludge Public.pdf 35

002 Biodegredation Study Public Biodegredation Study Public.pdf 46

003 Characterization Report Public Characterization Report

Public.pdf

13

004 Chinese Rare Minnow Public Chinese Rare Minnow Public.pdf 74

005 CHO-HGPRT Study Public CHO-HGPRT Study Public.pdf 26

006 Chromosomal Aberation Study CBI Chromosomal Aberation Study

Public.pdf

21

007 Daphnia Public Daphnia Public.pdf 43

008 Earthworm Study Public Earthworm Study Public.pdf 41

009 Green Algal Public Green Algal Public.pdf 40

010 Hydrolysis Public Hydrolysis Public.pdf 16

011 LLNA in Mice Public LLNA in Mice Public.pdf 41

012 Skin Irritation Public 28 Day Skin Irritation Public.pdf 46

SANITIZED SUBMISSION

SUP2013P3
ATTACHMENT HEADER SHEET

Attachment Number 001

Attachment Name

Activated Sludge Public

Associated PMN Section Number

N/A

Does not contain CBI

Report Number

DO46130206608360608

SANITIZED SUBMISSION
ATTACHMENT HEADER SHEET

Attachment Number 002

Attachment Name

Biodegredation Study Public

Associated PMN Section Number

N/A

Does not contain CBI

Report Number

DO46130206608360608

SANITIZED SUBMISSION
ATTACHMENT HEADER SHEET

Attachment Number 003

Attachment Name

Characterization Report Public

Associated PMN Section Number

N/A

Does not contain CBI

Report Number

DO46130206608360608

SANITIZED SUBMISSION
ATTACHMENT HEADER SHEET

Attachment Number 004

Attachment Name

Chinese Rare Minnow Public

Associated PMN Section Number

N/A

Does not contain CBI

Report Number

DO46130206608360608

SANITIZED SUBMISSION
ATTACHMENT HEADER SHEET

Attachment Number 005

Attachment Name

CHO-HGPRT Study Public

Associated PMN Section Number

N/A

Does not contain CBI

Report Number

DO46130206608360608

SANITIZED SUBMISSION
ATTACHMENT HEADER SHEET

Attachment Number 006

Attachment Name

Chromosomal Aberation Study CBI

Associated PMN Section Number

N/A

Does not contain CBI

Report Number

DO46130206608360608

SANITIZED SUBMISSION
ATTACHMENT HEADER SHEET

Attachment Number 007

Attachment Name

Daphnia Public

Associated PMN Section Number

N/A

Does not contain CBI

Report Number

DO46130206608360608

SANITIZED SUBMISSION
ATTACHMENT HEADER SHEET

Attachment Number 008

Attachment Name

Earthworm Study Public

Associated PMN Section Number

N/A

Does not contain CBI

Report Number

DO46130206608360608

SANITIZED SUBMISSION
ATTACHMENT HEADER SHEET

Attachment Number 009

Attachment Name

Green Algal Public

Associated PMN Section Number

N/A

Does not contain CBI

Report Number

DO46130206608360608

SANITIZED SUBMISSION
ATTACHMENT HEADER SHEET

Attachment Number 010

Attachment Name

Hydrolysis Public

Associated PMN Section Number

N/A

Does not contain CBI

Report Number

DO46130206608360608

SANITIZED SUBMISSION
ATTACHMENT HEADER SHEET

Attachment Number 011

Attachment Name

LLNA in Mice Public

Associated PMN Section Number

N/A

Does not contain CBI

Report Number

DO46130206608360608

SANITIZED SUBMISSION
ATTACHMENT HEADER SHEET

Attachment Number 012

Attachment Name

 Skin Irritation Public

Associated PMN Section Number

N/A

Does not contain CBI

Report Number

DO46130206608360608

SANITIZED SUBMISSION