Page 1 of 1INSTRUCTIONS: Please type or print in ink. Please read carefully the attached instructions and supply the information requested on this form.Use additional sheet(s) if necessary.1. Company Name and Address4. EPA ProductRegistrationOMB Approval 2070-174United States Environmental ProtectionAgency Washington, D.C. 20460DATA CALL-IN RESPONSE3. Date and Type of DCI and NumberGENERIC23-Dec-2014ID # GDCI-069122-308952. Case # and Name0350 ADBACChemical # and Name069122Benzenemethanaminium,N,N-dimethyl-N-(2-(2-(4-(1,1,3,3-tetramethylbutyl)phenox5. I wish tocancel thisproduct registration voluntarily6. Generic Data7. Product Specific Data7a. My product is an MUP andI agree to satisfy the MUPrequirements on the attachedform entitled "RequirementsStatus and Registrant'sResponse."7b. My product is an EUP andI agree to satisfy the EUPrequirements on the attachedform entitled "RequirementsStatus and Registrant'sResponse."6a. I am claiming a GenericData Exemption because Iobtain the active ingredientfrom the source EPA registration number listed below.6b. I agree to satisfy GenericData requirements as indicatedon the attached form entitled"Requirements Status andRegistrant's Response."10. Name of Company11. Phone Number9. Date8. Certification I certify that the statements made on thisform and all attachments are true, accurate, and complete. I acknowledge that anyknowingly false or misleading statement may be punishable by fine, imprisonment or both under applicable law.Signature and Title of Company'sAuthorized Representative__________________________________Benzenemethanaminium,N,N-dimethyl-N-(2-(2-(4-(1,1,3,3-tetramethylbutyl)phenohl idINSTRUCTIONS: Please type or print in ink. Please read carefully the attached instructions and supply the information requested on this form.Use additional sheet(s) if necessary.4. GuidelineRequirementNumber5. Study Title1. Company Name and AddressPage 1 of 2OMB Approval 2070-174United States Environmental ProtectionAgency Washington, D.C. 20460REQUIREMENTS STATUS AND REGISTRANT'S RESPONSE3. Date and Type of DCI and NumberID #GENERIC23-Dec-2014GDCI-069122-308952. Case # and Name0350 ADBAC069122Chemical # and Name8. TimeFrame(Months)9. RegistrantResponse7. TestSubstance6. UsePatternPROTOCOLProgressReports321Applicator Exposure Data Requirements (Antimicrobial)(1 ,2)875.110024TEPDermal exposure--outdoorH, I, A, J, GY(3 ,4)875.120012TEPDermal exposure--IndoorH, I, A, J, GY(5 ,6)875.130024TEPInhalation exposure--outdoorH, I, A, J, GY(7 ,8)875.140024TEPInhalation exposure--indoorH, I, A, J, GYPostapplication Exposure Data Requirements (Antimicrobial)875.280024N/ADescription of human activityH, I, A, J, GN(13 ,14)875.230012TEPIndoor surface residue dissipationH, I, A, J, GYToxicology Data Requirements (Antimicrobial)870.346524TGAI90-day inhalation toxicityH, I, A, J, GN850.130012TGAIDaphnid chronic toxicity testH, I, A, J, GN12. Name of Company13. Phone NumberSignature and Title of Company'sAuthorized Representative__________________________________10. Certification I certify that the statements made on this form and all attachments are true, accurate, and complete. Iacknowledge that anyknowingly false or misleading statement may be punishable by fine, imprisonment or both under applicable law11. DateBenzenemethanaminium,N,N-dimethyl-N-(2-(2-(4-(1,1,3,3-tetramethylbutyl)phenohl idINSTRUCTIONS: Please type or print in ink. Please read carefully the attached instructions and supply the information requested on this form.Use additional sheet(s) if necessary.4. GuidelineRequirementNumber5. Study Title1. Company Name and AddressPage 2 of 2OMB Approval 2070-174United States Environmental ProtectionAgency Washington, D.C. 20460REQUIREMENTS STATUS AND REGISTRANT'S RESPONSE3. Date and Type of DCI and NumberID #GENERIC23-Dec-2014GDCI-069122-308952. Case # and Name0350 ADBAC069122Chemical # and Name8. TimeFrame(Months)9. RegistrantResponse7. TestSubstance6. UsePatternPROTOCOLProgressReports321(18)850.302012TGAIHoney bee acute contact toxicityH, I, A, J, GN(9)850.422512TEPSeedling emergence, Tier IIH, I, A, J, GN(10)850.425012TEPVegetative vigor, Tier IIH, I, A, J, GN(11)850.440012TGAIAquatic plant toxicity test using Lemna spp. Tiers Iand IIH, I, A, J, GN(12)850.540012TGAIAlgal toxicity, Tiers 1 and IIH, I, A, J, GN(15 ,16 ,17)SS12TEPSpecial Aquatic Leaching Study on WoodH, I, A, J, GY(19)SS-ADBAC12TEPDietary Residue in Food from Treating Countertopswith ADBACH, I, A, J, GYInitial to indicate certificationas to information on this page (fulltext of certification is on page one).DateThe following footnotes are referenced in column two (5. Study Title) of the Requirements Status and Registrant's Response form. These footnotes apply in addition to anytest notes included in 40 CFR Part 158 with respect to the particular data requirementCase # and Name:0350 ADBACDCI Number:GDCI-069122-30895Page 1 of 2Footnotes:Key:United States Environmental ProtectionAgency Washington, D.C. 20460FOOTNOTES AND KEY DEFINITIONS FOR GUIDELINE REQUIREMENTSTEP = Typical End Use Product [TEP]; TGAI = Technical Grade Active Ingredient [TGAI]; N/A = Not applicableUse Categories Key:A-G -H -Terrestrial food cropAquatic non-food residentialGreenhouse food cropI -J -Greenhouse nonfood cropForestry use1Indoor hard surfaces (mop, wipe, trigger pump spray, aerosol spray, and liquid pour); Air deodorization (aerosol spray); carpets (low pressure spray); uses requiring liquid pour of formulatedproducts; dehumidifiers; low and high pressure sprays for disinfectants (such as vehicle treatment); non-pressure treatment ofwood (e.g., industrial sapstain treatments, airless sprayer of woodfor existing structures); and pressure treatment of wood.2Aprotocol must be submitted to the Agency for approval prior to the start of the study. The draft protocol must be submitted tothe Agency within 90 days of receipt of this DCI.3Indoor hard surfaces (mop, wipe, trigger pump spray, aerosol spray, and liquid pour); Air deodorization (aerosol spray); carpets (low pressure spray); uses requiring liquid pour of formulatedproducts; dehumidifiers; low and high pressure sprays for disinfectants (such as vehicle treatment); non-pressure treatment ofwood (e.g., industrial sapstain treatments, airless sprayer of woodfor existing structures); and pressure treatment of wood.4Aprotocol must be submitted to the Agency for approval prior to the start of the study. The draft protocol must be submitted tothe Agency within 90 days of receipt of this DCI.5Indoor hard surfaces (mop, wipe, trigger pump spray, aerosol spray, and liquid pour); Air deodorization (aerosol spray); carpets (low pressure spray); uses requiring liquid pour of formulatedproducts; dehumidifiers; low and high pressure sprays for disinfectants (such as vehicle treatment); non-pressure treatment ofwood (e.g., industrial sapstain treatments, airless sprayer of woodfor existing structures); and pressure treatment of wood.6Aprotocol must be submitted to the Agency for approval prior to the start of the study. The draft protocol must be submitted tothe Agency within 90 days of receipt of this DCI.7Indoor hard surfaces (mop, wipe, trigger pump spray, aerosol spray, and liquid pour); Air deodorization (aerosol spray); carpets (low pressure spray); uses requiring liquid pour of formulatedproducts; dehumidifiers; low and high pressure sprays for disinfectants (such as vehicle treatment); non-pressure treatment ofwood (e.g., industrial sapstain treatments, airless sprayer of woodfor existing structures); and pressure treatment of wood.8Aprotocol must be submitted to the Agency for approval prior to the start of the study. The draft protocol must be submitted tothe Agency within 90 days of receipt of this DCI.9Data are needed only for rice (Oryza sativa).10Data are needed only for rice (Oryza sativa).The following footnotes are referenced in column two (5. Study Title) of the Requirements Status and Registrant's Response form. These footnotes apply in addition to anytest notes included in 40 CFR Part 158 with respect to the particular data requirementCase # and Name:0350 ADBACDCI Number:GDCI-069122-30895Page 2 of 2Footnotes:Key:United States Environmental ProtectionAgency Washington, D.C. 20460FOOTNOTES AND KEY DEFINITIONS FOR GUIDELINE REQUIREMENTSTEP = Typical End Use Product [TEP]; TGAI = Technical Grade Active Ingredient [TGAI]; N/A = Not applicableUse Categories Key:A-G -H -Terrestrial food cropAquatic non-food residentialGreenhouse food cropI -J -Greenhouse nonfood cropForestry use11Data are required if algal studies show toxicity at less than 1 ppm.12Data are required on 4 species: Anabaena flosaquae, Navicula pelliculosa, Skeletonema costatum, and Selenastrum capricornutum.13Carpets, flooring, textiles (laundered clothing/diapers), treated wood; and musical instruments (mouthpiece/reed). Note: 100% residue transfer will be used in lieu of surface residue studies.14Aprotocol must be submitted to the Agency for approval prior to the start of the study. The draft protocol must be submitted tothe Agency within 90 days of receipt of this DCI.15Results from a study conducted according to American Wood Protection Association (AWPA) Standard E11-06 or E11-12 (Standard Method of Determining the Leachability of WoodPreservatives) will satisfy this data requirement.16Aprotocol must be submitted to the Agency for approval prior to the start of the study. The draft protocol must be submitted tothe Agency within 90 days of receipt of this DCI.17For wood treatment uses only.18For wood treatment uses only.19Aresidue transfer protocol must be submitted to the Agency for approval prior to the start of the study. The draft protocol must be submitted to the Agency within 90 days of receipt of this DCI.