Part I: Introduction and CBI Information

CBI

Sector(s) If you chose "Other" as an enduse, please specify here. CBI

AGENCY USE ONLY

OMB Control No.: 2060-0226

Expires: XX/XX/2017

Date of Receipt:

Section C: CONFIDENTIALITY CLAIMS

Via US Postal Service:

SNAP Document Control Officer

U.S. EPA

Mail Code: 6205T

1200 Pennsylvania Ave, NW

Washington DC 20460

Via Delivery Service:

SNAP Document Control Officer

U.S. EPA

Stratospheric Protection Division

4th Floor (MC 6205T)

1201 Constitution Ave., NW

Washington, DC 20004

Case Number:

Section A: Introduction

GENERAL INSTRUCTIONS

This form may be used in conjunction with the Premanufacture Notice (PMN) for new chemical substances (EPA Form 7710-25 (Rev. 1-19)) to submit 

chemicals for review under the Significant New Alternatives Policy program as alternatives to Class I and II ozone-depleting substances. In addition to 

the information provided in the Premanufacture Notice, the Agency is requesting submitters provide information on the following topics. This 

information will assist EPA in assessing the acceptability of the chemical as an alternative to ozone-depleting substances as required by Section 612 of 

the Clean Air Act. Please see the Instructions for the TSCA/SNAP Addendum (“Instructions”) for guidance on completing this form. The Instructions 

document is available at http://www.epa.gov/ozone/snap/submit/index.html. 

To facilitate Agency review of alternatives, both this form and the complete PMN form (including the physical and chemical properties worksheet) 

must be filled out as completely as possible. Please provide all information requested to the extent that it is known or reasonably ascertainable. Make 

reasonable estimates if actual data are unavailable.

Part I: Introduction and CBI Information

1. Name of Alternative. Note: Additional information about the proposed substitute must be provided in Part III, Section A

2. Indicate the sector and end-use for which you are submitting this SNAP Information Notice.

End-Use(s)

Section B: Identification of Alternatives

United States

ENVIRONMENTAL PROTECTION AGENCY

Washington, DC 20460

TSCA/SNAP ADDENDUM

for Significant New Alternatives

When completed send CBI and public versions of this form and attachments electronically via CD or USB drive (preferred), or 

print to:

NOTE: Please [Bracket] the information you wish to claim as confidential

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Part I: Introduction and CBI Information

Anyone submitting data which are to be treated as Clean Air Act Confidential Business Information (CBI), must assert and substantiate a claim of confidentiality at 

the time of the initial submission.. All information claimed as CBI will be treated in a manner consistent with 40 CFR Part 2, Subpart B. Failure to assert a claim of 

confidentiality at the time of submission may result in disclosure of information by the Agency without further notice.

To assert a claim on this form, [bracket] the information you claim as confidential and mark the confidential box in the column on the right-side of the page in the 

corresponding row. Provide substantiation of all CBI claims below. If any information is claimed as confidential, you must provide a “sanitized” version of this notice, 

including attachments, to EPA at the time of the initial submission. 

For any portion of a submission that you claim as confidential, the following information must be included in a Statement of Data Confidentiality Claims. The 

confidential information must also be clearly marked within the submission. If you do not provide the required substantiation when submitting information claimed 

as confidential, EPA may make the complete submitted information available to the public without further notice or may determine that the submission is 

incomplete.

• Identify specifically by page and line number(s) each portion of the document for which you claim confidentiality.

• Give the reasons why the cited passage qualifies for confidential treatment.

• If you assert that disclosure of this information would be likely to result in substantial harmful effects to you, describe those harmful effects and explain why they 

should be viewed as substantial.

• Indicate the length of time - until a specific date or event, or permanently - for which the information should be treated as confidential.

• Identify the measures you have taken to guard against undesired disclosure of this information.

• Describe the extent to which the information has been disclosed, and what precautions have been taken in connection with these disclosures.

• Enclose copies of any determinations of confidentiality previously made by EPA, other Federal agencies, or courts concerning this information. 

Information submitted as CBI may be accessed by companies designated as Authorized Representatives of the United States Environmental Protection Agency (EPA) 

under an EPA contract for the purpose of assisting EPA in the development and implementation of national regulations for the protection of stratospheric ozone, 

including the evaluation of SNAP Information Notices. These Authorized Representatives may have access to any information received by the Stratospheric 

Protection Division within the EPA’s Office of the Atmospheric Programs. Access to such information is necessary to ensure that these companies can complete the 

work required by the contract. Such Authorized Representatives of the Administrator are subject to the provisions of 42 U.S.C. 7414(c) respecting confidential 

business information as implemented by 40 CFR 2.301(h).

STATEMENT OF DATA CONFIDENTIALITY CLAIMS

NOTE: Please [Bracket] the information you wish to claim as confidential

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Part II: Contact Information

Name of Authorized Official Title CBI

CBI

Mailing Address Telephone Number CBI

CBI

Name of Authorized Official Title CBI

CBI

Mailing Address Telephone Number CBI

CBI

Is this person granted full access to Confidential Business Information?

Name of Authorized Official Title CBI

CBI

Mailing Address Telephone Number CBI

CBI

Is this person granted full access to Confidential Business Information?

Name of Authorized Official Title CBI

4. Joint Submitter (if applicable): Identify the joint submitter, if any, who is authorized by the primary submitter to provide some of the information 

required in the notice.

Company/Organization

3. Technical Contact (in U.S.): If applicable, identify a person who can provide EPA with additional technical information on the substitute during the 

review period. If the authorized agent is also the technical contact, include that person's information in both locations.

Email Address

Company/Organization

Email Address

Email Address

2. Agent (if applicable): Complete only if you authorize an agent to assist you in preparing this notice. The agent must also sign the certification. 

Company/Organization

United States

ENVIRONMENTAL PROTECTION AGENCY

Washington, DC 20460

Part II: Contact Information

Section A - Submitter Contact Information

1. Person Submitting Notice (in U.S.): Enter information for the official who signs the certification in Part XIV Certification.

TSCA/SNAP ADDENDUM

NOTE: Please [Bracket] the information you claim as confidential

1 of 2
Part II: Contact Information

CBI

Mailing Address Telephone Number CBI

CBI

Is this person granted full access to Confidential Business Information?

CONFIDENTIALITY CLAIMS: All contacts listed on this page will be granted access to CBI, unless otherwise noted. 

Company/Organization

Email Address

NOTE: Please [Bracket] the information you claim as confidential

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Part III: General Information

(b) Percent composition (by 

weight)

(c) Chemical Abstracts Service 

(CAS) registry number (d) Molecular formula CBI

CBI

CBI

Supporting documentation 

attached? CBI

Proposed substitute 

(If blend, include GWP of each 

constituent)

CBI

Supporting documentation 

attached?

Supporting documentation 

attached? CBI

Sector End-Use Application Mark all end-uses and 

applications that apply

(a) New (N) Equipment, 

Retrofit (R)Equipment, or both 

(N,R)? Please disregard if 

proposed substitute is not a 

refrigerant.

(b) ODS and other substances 

being replaced

(c) Replacement ratio 

(lb: lb) CBI

Centrifugal

Positive Displacement Chillers 

(includes Reciprocating, Screw, 

Scroll, Rotary Compressors) 

Industrial Process Refrigeration (IPR)

Industrial Process Air Conditioning

Ice Skating Rinks

Cold Storage Warehouses

Refrigerated Trailers (Reefers) 

Refrigerated Shipping 

Containers 

2. Commercial/trade name(s) of alternative:

(a) ODP relative to CFC-11

4. Ozone-depletion potential (ODP): Provide the 100-year ODP of the proposed substitute relative to CFC-11. If the substitute is a blend, provide the ODPs of the individual constituents. Reference the source for each ODP.

3. Generic name: If the name of the proposed substitute is claimed as Confidential Business Information, provide a generic name. The name should reveal the chemical identity or alternative process description to the maximum extent possible

Information sources

Chillers (Commercial Comfort AC)

Refrigerated Transport

Attachment name

1. Specific End-Use(s): Identify each end-use that may be reasonably anticipated for the alternative. If the alternative is a refrigerant, indicate whether the refrigerant is a candidate for use in retrofits of existing equipment, for use in new 

equipment only, or both. Identify the ODS and other alternatives used in the end-use or application and the quantity of proposed substitute needed to replace it for each end use (i.e., the replacement ratio). 

Note: If the proposed substitute can be used both as a retrofit and in new equipment, these uses should be treated as separate end-uses throughout this form. The applications listed below are not meant to be all-inclusive and do not reflect 

regulatory requirements. The purpose of defining these applications is to inform the Agency's understanding of how the alternative being submitted to SNAP will be used.

(b) Provide any additional data on the ODP of the proposed substitute (e.g. chlorine or bromine loading potentials). Reference the source of this 

information and attach any supporting documentation.

5. Global Warming Characteristics: Provide the alternative's global warming potential relative to carbon dioxide over a 100-year time horizon and atmospheric lifetime. Reference the Fourth Assessment Report of the Intergovernmental 

Panel on Climate Change (IPCC AR4). Alternate sources may include the 2010 World Meteorological Organization (WMO) Scientific Assessment of Ozone Depletion or the peer-reviewed literature. If the substitute is a blend, provide the GWPs 

of the individual constituents and an estimate of the blend at its nominal composition.

Proposed substitute 

(If blend, include ODP of each constituent )

Section A: Alternative-Specific Information

1. Identify Proposed Substitute

(a) Chemical name (preferably IUPAC nomenclature)

(b) Atmospheric lifetime

(d) If the proposed substitute or any components of a blend is captured as a byproduct of 

another manufacturing or industrial process, indicate the source of the alternative.

United States

ENVIRONMENTAL PROTECTION AGENCY

Washington, DC 20460

TSCA/SNAP ADDENDUM

Section B: End-Use and Application Information

(c) Provide any additional data on the GWP of the alternative, including infrared 

absorption spectrum and infrared absorption capacity. 

(a) 100-year GWP 

(Relative to carbon dioxide)

Information sources

Part III: General Information

NOTE: Please [Bracket] the information you claim as confidential

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Part III: General Information

Refrigeration Equipment within 

Motorized Vehicle (e.g., food 

delivery, ice cream truck, ship 

hold)

Remote Rack System, Direct

Remote Rack System, Indirect

Stand-alone Units (selfcontained equipment such as 

individual reach-in coolers, 

glass door merchandisers, etc.)

Remote Condensing Units for 

Walk-in Coolers or Multiple 

Reach-in Coolers

Beverage Dispensers (e.g., 

fountain beverage dispenser, 

frozen beverage dispenser)

Vending Machines

Built-in Water Fountain

Stand-alone Water Coolers 

Self-contained Ice Machines

Remote Ice Machines

Household Refrigerator and 

Freezers

Small Refrigerated Household 

Appliances (e.g., chilled kitchen 

drawers, wine coolers, and minifridges) 

Room Air Conditioners (such as 

window units, packaged 

terminal air conditioners (PTAC) 

and heat pumps (PTHP), and 

portable self-contained air 

conditioners)

Mini-Splits, Non-Ducted

Multi-Splits, Non-Ducted

Split-Systems, Ducted, 

Household (Central A/C)

Split-Systems, Ducted, Light 

Commercial (Central A/C)

Packaged Rooftop Units 

Water-Source Air Conditioning 

and Heat Pumps

Ground-Source Air Conditioning 

and Heat Pumps

Residential Dehumidifiers

Light-duty Vehicles (e.g., 

passenger cars)

Light-duty Trucks (e.g., 

minivans, full size pick-up 

trucks, and full-size SUVs)

Heavy-duty Vehicles (e.g., heavyduty pickup trucks and vans, 

and commercial medium and 

heavy-duty on-highway 

vehicles)

Off-road Vehicles (e.g., farm 

and construction equipment)

Buses and Passenger Rail 

Thermosiphon 

Recirculating Coolers 

Mechanical Heat Transfer Organic Rankine Cycle (ORC)

Very Low Temperature Refrigeration

Uranium Isotope Separation 

Processing 

Ice Cream Makers

Rigid Polyurethane: Appliance

Rigid Polyurethane: Spray

Rigid Polyurethane: Commercial 

Refrigeration

Rigid Polyurethane: Sandwich Panels

Rigid Polyurethane: Slabstock and Other

Rigid Polyurethane & Polyisocyanurate 

Laminated Boardstock

Flexible Polyurethane

Integral Skin Polyurethane

Polystyrene: Extruded Sheet

Polystyrene: Extruded Boardstock & 

Billet

Other (specify)

Residential and Light Commercial Air 

Conditioning and Heat Pumps

Motor Vehicle Air Conditioning

Non-mechanical Heat Transfer 

Refrigeration and Air Conditioning

Foam Blowing

Retail Food Refrigeration

Drinking Water Coolers

Commercial Ice Machines

Household Refrigerators and Freezers

NOTE: Please [Bracket] the information you claim as confidential

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Part III: General Information

Polyolefin

Phenolic Insulation Board & Bunstock

Other (specify)

Metal cleaning

Electronics cleaning

Precision cleaning

Normally Occupied Areas

Normally Unoccupied Areas

Streaming Applications

Consumer

Technical

Medical

Consumer

Technical

Medical

Sterilization Sterilant

Adhesives

Coatings

Inks

Tobacco Expansion Tobacco Expansion

End-Use Application Status (e.g., under 

development, final) CBI

End-Use Application

(b) Capital costs associated 

with proposed substitute, 

alternative process, new 

equipment, and/or new 

materials

(c) Changes in labor and 

energy costs

(d) Ongoing operational 

costs of equipment CBI

End-Use Application

(a) Year proposed substitute or 

technology will be available (or 

note if currently available)

(b) Anticipated first year 

annual production for 

end-use (kg)

(c) Years until maximum 

market penetration

(d) Maximum annual 

production at market 

penetration

(e) Anticipated market 

share at market penetration 

(%)

CBI

End-Use Application CBI

CBI

ppm or %

ppm or %

°C

kJ/kg

atm

Joules

°C

atm

(e) Maximum pressure of combustion (refrigeration and air conditioning, and cleaning solvents only) 

Total Flooding Agents

Propellants

Solvents

Cleaning Solvents

Fire Suppression and Explosion 

Protection

Aerosols

1. Flammability-Related Physical and Chemical Properties. Provide information on the physical and chemical properties relevant to evaluating the flammability of the proposed substitute. Please note: If a property is only required for specific 

sectors, it is noted in parentheses. Also, if any parameter has also been provided in the PMN form, it does not need to be repeated here.

(a) Lower flammability limit (LFL) (using ASTM E681) 

(c) Flashpoint 

Section C: Flammability

Adhesives, Coatings, and Inks

5. Energy Efficiency: Provide the alternative’s impact on energy efficiency relative to the substance it is replacing in similar applications for refrigeration, air conditioning, or foam blowing. Attach documentation, if available.

4. Production and Market Share: Provide estimated information on production of the proposed substitute by end-use. If possible, estimate the percentage of the market held by the ODS being replaced that will be captured by this proposed 

substitute.

American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE) 

(e.g., ASHRAE 15)

Underwriters Laboratories (UL) (e.g., UL 484, UL 250)

Society of Automotive Engineers (SAE) International

Other (e.g., International Electrochemical Commission (IEC), International 

Organization for Standardization (ISO)), National Fire Protection Association (NFPA)

Standard-Setting Organization Standard number and title 

(a) Technology changes to use alternative and address 

material compatibility issues when retrofitting

(g) Minimum ignition energy (refrigeration and air conditioning only)

(h) Critical temperature (refrigeration and air conditioning only)

(i) Critical pressure (refrigeration and air conditioning only)

(b) Upper flammability limit (UFL) (using ASTM E681) 

2. End-Use Specific Standards: List any standard-setting organizations (U.S. or ANSI/ISO) that will evaluate the proposed substitute and/or equipment in the proposed end-use(s) and identify the associated standard. 

3. Technology Changes and Costs: Describe any new equipment technology changes and associated costs that will be necessary in order to use the proposed substitute. 

Energy efficiency (+/- X%) relative to substance(s) being replaced Supporting documentation attached?

(f) Maximum rate of pressure increase during combustion (refrigeration and air conditioning only)

(d) Heat of combustion

NOTE: Please [Bracket] the information you claim as confidential

3 of 4
Part III: General Information

ppm or %

@ 20°C 

Attached? CBI

CBI

For All Flammable Substitutes

(a) Results of ASTM E681 for flammability limits in air (include temperature at which test was conducted in summary of 

results)

(b) Additional analyses (optional)

For Flammable Refrigerants Only

(c) Fault Tree Analysis or Failure Mode and Effects Analysis (for each end-use )

(d) Risk assessment for all end-uses, consumer and occupational (technician) exposure

(e) Fractionation during Leakage (required only for blends with flammable components)

Summary of results

(a) Detail any abatement techniques that are used to minimize the risks associated with flammable substances or 

mixtures:

(c) Additional information on flammability concerns and mitigation measures: 

(j) Explosive range (LEL/UEL) (aerosols, sterilants, and adhesives coatings and inks only)

Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission must be submitted with the bracketed information 

redacted or removed.

3. Flammability Concerns and Mitigation: Provide any information on flammability concerns and mitigation measures.

Attached?

(b) For flammable foam blowing agents used in spray foam, provide a training program that addresses flammability 

concerns 

2. Flammability Assessments and Test Data. 

(k) Vapor pressure (aerosols, sterilants and adhesives, coatings, and inks only)

NOTE: Please [Bracket] the information you claim as confidential

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Part IV: Sector-Specific Information

End-Use Application (a) Equipment Lifetime (years) (b) Typical charge size (kg) (c) Maximum charge size (kg) (d) Equipment capacity 

(kWh, tons) CBI

End-Use (d) Typical room size (m3

) (e) Minimum room size (m3)

(f) Anticipated room air 

exchange rate (ACH) CBI

CBI

CBI

End-Use (a) Typical amount of blowing agent

(kg)

(b) Maximum amount of blowing 

agent (kg)

(c) Typical room size 

(m3)

(d) Minimum room size (m3)

(e) Anticipated room air 

exchange rate (ACH) CBI

CBI

End-Use CBI

CBI

CBI

Part IV: Sector-Specific Information

Section D: Fire Suppression

1. Application of Proposed Substitute. If the substitute is proposed for use the cleaning solvent sector (as specified in Part III, Section B, Number 1), please provide information on the following. Note: If you provide personal 

monitoring data, you are not required to respond to questions (a) through (b) below.

Section B: Foam Blowing

2. Additional End-Use Description: Please describe the specific uses for which you are applying. For example, what type of work pieces will be cleaned? What type of equipment will be used to perform cleaning (e.g., open 

top vapor degreaser, vacuum sealed equipment, conveyorized equipment)? Where will the cleaning occur (e.g., commercial or industrial setting)? Please note that this end-use does not include manual cleaning or textile 

cleaning.

(a) Provide information on the leak-tightness of the equipment (e.g., typical and maximum leak rate of equipment) (b) Anticipated room air exchange rate (ACH)

2. Additional End-Use Description: Please describe the specific uses for which you are applying. For example, what is the equipment layout and where is the refrigerant located? Is it a direct expansion unit and/or does it use 

a secondary loop? In what types of locations will the equipment be used (e.g., for refrigeration this could include supermarkets, convenience stores, and/or restaurants)? Is the equipment for low, medium or high 

temperature refrigeration or air conditioning? Is air conditioning for the purpose of human comfort cooling or another application?

2. Additional End-Use Description: Please describe the specific uses for which you are applying. For example, what type of material will be blown? What method or type of equipment is used for foam blowing? Who will be 

using the foam blowing agent/equipment? Will the foam blowing agent be used by consumers or restricted to commercial use? For spray foams, how many components are used? Will the alternative be used in high or low 

pressure spray foam? 

3. Compressor Oil: If the proposed substitute is a refrigerant, provide information on the chemical class of refrigerant oil you anticipate will be used (e.g., polyalkylene glycol, polyolester, mineral oil, etc.) and information on 

refrigerant/oil solubility. 

1. Application of Proposed Substitute. If the substitute is proposed for use in the foam blowing sector (as specified in Part III, Section B, Number 1), please provide information on the amount of blowing agent, associated room size, 

and associated equipment size anticipated. Note: If you provide personal monitoring data, you are not required to respond to questions (c) through (e) below .

Section A: Refrigeration and Air Conditioning

United States

ENVIRONMENTAL PROTECTION AGENCY

Washington, DC 20460

TSCA/SNAP ADDENDUM

3. Compatibility: Provide information on the compatibility of the proposed substitute with metals and plastics. 

1. Application of Proposed Substitute. If the substitute is proposed for use in the refrigeration and air-conditioning sector (as specified in Part III, Section B, Number 1), please provide information on the equipment lifetime, 

charge size, associated room size, and associated equipment size anticipated. Note: If personal monitoring data is provided, you are not required to respond to questions (d) through (f) below.

Application

Section C: Cleaning Solvents

NOTE: Please [Bracket] the information you claim as confidential

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Part IV: Sector-Specific Information

End-Use (a) Typical charge size 

(kg)

(b) Maximum charge size 

(kg)

(c) Identify the discharge 

rate (g/s) of the fire 

extinguishing device

CBI

End-Use

(d) Typical room size 

(m3)

(e) Minimum room size (m3)

(f) Anticipated room air 

exchange rate (ACH) CBI

CBI

X

End-Use Application (a) Typical amount of substitute per 

can (g)

(b) Maximum amount of 

substitute per can (g)

(c) Typical total weight of 

aerosol Can (g)

(d) Maximum total weight 

of aerosol can (g) CBI

CBI

CBI

End-Use CBI

CBI

End-Use Application (a) Typical amount per dispenser 

(g or %)

(b) Maximum amount per 

dispenser (g or %)

(c) Typical total weight of 

dispenser (g)

(d) Maximum total weight 

of dispenser (g) CBI

CBI

CBI

2. Additional End-Use Description: Please describe the specific uses for which you are applying. For example, in what type of products will the substitute be used (e.g., personal care, automotive, electrical contact cleaner, 

degreaser, medical adhesive spray, MDI)? 

2. Additional End-Use Description: Please describe the specific uses for which you are applying. For example, what is the method of distribution (e.g., localized, sprinkler system, handheld, gaseous)? Is it a clean agent? Is the 

agent aerosolized? Where will the fire suppression system be installed (e.g., marine, aviation, data center)? Where will handheld extinguishers be intended for use (e.g., residential, commercial, aviation)?

Application

Application

1. Application of Proposed Substitute. If the substitute is proposed for use in the sterilants sector (as specified in Part III, Section B, Number 1), please provide information on the amount and associated room size 

anticipated.

2. Additional End-Use Description: Please describe the specific uses for which you are applying. For example, how is the sterilant applied (e.g., sterilization chambers)?

1. Application of Proposed Substitute. If the substitute is proposed for the adhesives, coatings, and inks sector (as specified in Part III, Section B, Number I), please provide information on the associated dispenser size 

anticipated for the proposed substitute in the proposed end-use(s). 

1. Application of Proposed Substitute. If the substitute is proposed for use in the aerosols sector (as specified in Part III, Section B, Number 1), please provide information on the charge size and associated aerosols can size 

anticipated.

3. Consumer Use: Please indicate whether the proposed substitute will be used for consumer use. If yes, describe the anticipated consumer applications.

Section G: Adhesives, Coatings & Inks

Section F: Sterilants

Section E: Aerosols

1. Application of Proposed Substitute. If the substitute is proposed for use in the fire suppression and explosion protection sector (as specified in Part III, Section B, Number 1), please provide information on the charge size, 

associated room size, and associated equipment size anticipated. Note: If personal monitoring data is provided, you are not required to respond to questions (d) through (f) below.

Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission must be submitted with the bracketed 

information redacted or removed.

(a) Provide information on the leak-tightness of the equipment (e.g., maximum and typical leak rate of equipment) (b) Anticipated room air exchange rate (ACH)

3. Consumer Use: Please indicate whether the proposed substitute will be used for consumer use. If yes, describe the anticipated consumer applications.

2. Additional End-Use Description: Please describe the specific use for which you are applying. For example, in what type of products will the substitute be used for adhesives (e.g., laminate, hardwood flooring, flexible 

foam, tire patch, metal to rubber, marine); coatings (e.g., metal coatings, wood stains, aerospace coating), or inks (e.g., flexographic printing, rotogravure printing)? What is the application method (e.g., spray gun, aerosol 

can, dip tank)?

NOTE: Please [Bracket] the information you claim as confidential

2 of 2
Part V: Additional Information

Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission 

must be submitted with the bracketed information redacted or removed.

United States

ENVIRONMENTAL PROTECTION AGENCY

Washington, DC 20460

Part V: Additional Information

Please provide any additional information in this section.

NOTE: Please [Bracket] the information you claim as confidential

1 of 1
Part VI: Attachments

# Attachment Name/Citation Associated Section of TSCA/SNAP Addendum 

(Part/Section/Question) Number of Pages CBI

Note: Information claimed as confidential should be placed in [brackets] and marked as CBI. If information is claimed as CBI, then a public version of the submission 

must be submitted with the bracketed information redacted or removed.

United States

ENVIRONMENTAL PROTECTION AGENCY

Washington, DC 20460

Part VI: Attachments

Identify attachments below. 

Select (X) in the CBI box next to any attachment that contains information you claim as confidential. The public version of the submission form 

must include the attachment name/citation at a minimum. All claims of confidentiality must be substantiated in Part I. 

TSCA/SNAP ADDENDUM

NOTE: Please [Bracket] the information you claim as confidential

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Part VII: Certification

Part VII: Certification

Signature of Authorized Official (Original Signature Required): Date 

Print Name and Title of Authorized Official: Date 

Signature of Agent (Where Applicable): Date

Print Name and Title of Authorized Official: Date 

United States

ENVIRONMENTAL PROTECTION AGENCY

Washington, DC 20460

I certify to the best of my knowledge and belief that:

1. All information provided in this notice is complete and truthful as of the date of the submission.

2. I am submitting with this notice all test data in my possession or control and a description of all other data known to or reasonably ascertainable by me.

3. If this is a submission of a new alternative, the company named in Part I, Question 1a of this notice:

 (a) intends to manufacture, formulate, import, market, or use a new alternative to a Class I or Class II ozone-depleting substance which is identified in Part I, 

Section B, Question 2.

 (b) seeks an acceptability determination on a new alternative(s) to a Class I or Class II ozone-depleting substance, which is identified in Part I, Section B, Question 

2.

4. The accuracy of the statements made in this notice reflects my best prediction of the anticipated facts regarding the alternative described herein. Any knowing 

and willful misinterpretation is subject to criminal penalty pursuant to section 113(c) of the Clean Air Act and 18 U.S.C.§1001.

A printed copy of this signature page, with original signature, must be submitted with CD or paper submission.

TSCA/SNAP ADDENDUM

NOTE: Please [Bracket] the information you claim as confidential

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