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VI 1'1'- 1: VI' rVLLU IIUN PREVENTION AND TOXIC SUBSTANCES, 7407 US EPA. 401 M 

### STREET, SW WASH 

## U.S. ENVIRONMENTAL PROTECTION AGENCY 

# ft

# Er.

I;'"': '"- ; !."! 1'"' F")
D,C. 20460 

## 14 

## GENERAL INSTRUCTIONS 

# Sanitized

You must provide all information requested in this form to theextent that il is known to or reasonably ascertainable byyou. Make reasonable estimates ifyou do not have actual data. • Before you complete this form, you should read the "Instructions Manual for Premanufacture NotificatIOn" (the Instructions Manual is available trom thc Toxic Substances Control Act (TSCA) Information Service by calling 202-554-1404, or faxing 202-554-5603). Ifa userfee has been remitted for this notice (40 CFR 700.45), indicate in theboxes above the TS-user fee identification number you have generated. Remember, your user fee ID number must also appear on yourcorresponding fee remittance, which is sent to EPA, 

### HQ Accounting Operations Branch (PM-226), P.O. 360399M, Pittsburgh, PA 15251-6399, Atm. TSCA User fee.
Part 1-GENERAL INFORMATION You must provide the currentlycorrectChemical Abstracts (CA) Name oftile new chemical substance, even ifyou claim the identity as confidentiaL You may authorize another person to submitchemical identity information for you. but your submission will not be complete and the review will not begin until EPA receives thIS information. A letter in support ofyour submission should reference your TS user fee identification number. You must submit an original and two copies ofthis notice including all testdata. [fyou claimed any information asconfidential, a single sanitized copy must also be submitted.
Part II HUMAK EXPOSURE AND ENVIRONMENTAL RELEASE Ifthere are several manufacture, processing, or use operations to be described in Part II. sections A and B ofthis notice, reproduce the sections as needed, Part III LIST OF ATTACHMEI\TS Attach additional sheets ifthere is not enough space to answera question fully. Label each continuation sheet with the corresponding section heading. In Part Ill,list these attachments. any test data orotherdata and any optional infomiation included in the notice.

OPTIONAL INFORMATION You may include any information that you want EPA to consider in evaluating the new substance. On page I I ofthis fonn, space has been provided for you to described pollution prevention andrecycling infomllltion you may have regarding the new substance, So-called "binding" boxes are included throughom this form lor you to indIcate your willingness to be bound to certain statements you make in this section. 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 Except in the case ofexemption applications (such as TMEA, LYE, LOREX) where certain infomlation provided in such notification is binding 011 the submitter when the Agency approves the exemption application. checking a binding box in this notice d.ocs 110t by itselfprohibitthe 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 assen a claim On the fornI, mark (X) the confidential box next to the infannalion that you claim as confidential. To assert a claimin an attachment, circle orbracket the information vou claim as confidential. !LYQu claim information in the nOllces as qmfidentlai, yot) ;nust**~9** provide a sanitized version orthe oo!!ce, (includn)gJill,,!,hmell!;;l For additional instructions on claiming information as confidentit.tI. read the Instruchons t\·lanuaJ, TESTDAT A A;>lD OTHER DATA You are required to submit all test data in yourpossession or control and to provide a description ofall otherdata known to or reasonably ascertainable byyou, ifthesedata are related to the health and environmental effects on the manufacture, processing, flio.rih,..!innl in commerce, use, ordisposal ofthenew chemical substance. Standard literaturecitations may be submitted for data in the open scientific literature. Complete test data (written in English), not summaries ofdata, mustbe submitted iftheytlo not appear in the open literature. You should clearly identif'y whethertestdata 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 shouldbe submitted according the requirements of**~72050** ofthe Premanufacture Notification Rule (40CFR Part 720)

Test Data (Cheek Below any included in this notice) Environmental fate data DYes Otherdala 

### 0 Yes Health efTects data DYes Risk assessments Environmental efTects data 

# o Yes Structure/activity relationships ,.,..." Physical;Chemical Properties· 

# o Yes Test**da~t** in the possession or cOlltrCiiifthe submitter ""T1
..... A phvsical and chemical properties worksheet is located all thftil;tpage·iJIt

### £Ii!iJform CO**-:)~** TYPE OF ;';OTlCE (Check Only One)
-

# -=~ --1-' 

## rn PM;'; (Premanufacture Notice) : t·' ';, 

# o !:vrERMEDIATEPMN (submitted in sequence

### witl~1 productrlvfN) 

# ... ; 

# o 

# o SNC'J (Significant New Use Notice) 

### Ul 

# o TMEA (Test Marketing Exemption Application) 

# o LVE (Low Volume Exemption) i.'§ 40 CFR 723.50(c)(l) 

# o lOREX (Low Release/Low Exposure Exemption)

## !~I' 40 CFR 723,50(c)(2) 

# o I\,E \1odification 

# o LOREX Modification IS THIS A CONSOLIDATED PMN'! Yes t; ofchemicals

__ ______**~** Mark (x) ifany infomlatioll in this notice" claimed as confidential. (Prellotice Communication # required, enter # on page 3)

EPA FORM 7710-25 (Rev. 5-95) Page 1 Replaces prevIous editions of EPA Form 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 maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate orany 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 thatto the bestofmy knowledge andbelief: 1. The companynamed in Part I, section A, subsection 1 a ofthis notice form intends to manufacture or import for a commercial purpose, other than in small quantities solely for research and development, the substance identifiedin Part I, Section B. 2. All informationprovided in this notice is complete and truthful as ofthe date ofsubmission. 3. I am submitting with this notice all test data in mypossession orcontrol and a description ofall other data known to or reasonably ascertainable by me as required by §720.50 ofthe Premanufacture Notification Rule. Additional 

## Certification Statements: Ifyou are submitting a PMN, Intermediate PMN, ConsolidatedPMN, or SNUN, check the following user fee certification statementthat applies: 

# DThe Companynamed in Part I, Section Ahasremitted the fee of$2500 specified in 40 CFR700.45(b), or 

# D The Company named in

## Part I, Section Ahas remitted the fee of$1000 for an Intermediate PMN (defined @ 

## 40 CFR 700.43) in accordance with 40 CFR700.45(b), or 

# D The Company named in PartI Section A is a small business concern under 40 CFR 700.43 and has remitted a fee of$100 in accordance with 40 CFR700.45(b). Ifyou are submitting a low volume exemption (L

## VEl applicationin accordance with 40 CFR 723.50{c)(1) or a Low release and low exposure exemption (LoRex) application in 

## accordance with 40 CFR723.50{c)(2), checkthe following certification statements: 

# D The manufacturer submitting this notice intends to manufacture orimport the new chemical substance for commercial purposes, other than in smallquantities solely for research and development, under the terms of40 CFR 723.50. 

# DThe manufacturer is familiar with the terms ofthis section and will comply with those terms; and 

# DThe new chemical substance for which the notice is submitted meets all applicable exemption conditions. 

# D Ifthis application is for an LVE in accordance with 40 CFR 723.50(c)( 1), the manufacturer intends to commence manufacture ofthe exempted substance for commercial purposes within 1year ofthe date ofthe expirationofthe 30 day review period. The accuracy ofthe statements you make in this notice should reRect your best prediction ofthe anticipated facts regarding the chemical substance described herein. Anv knowing and willful misinterpretation i$ subject to criminal penaltv pursuant to 18 

### lise 1001. Confidential Signature and title ofAuthorized Official (Original Signature Required) Date 

# x Signature ofagent (ifapplicable) Date 

# x

EPA FORM 77)0-25 (Rev. 5-95) Page 2

# xConfidential la. Person Submitting Notice (in U.S.)

b. Agent 

### (if applicable) Company Mailing address (number and street) City, ZIP Code
Name of Company Mailing address and street) City, State, ZIP Code Telephone

c. Ifyou are submitting this notice as part ofajointsubmission, mark (X) this box.

_______________________... Joint Submitter (if applicable) Name ofauthorized official Company Mailing address (number and street)

2. Technical Contact (in U.S.) City, State, ZIP Code
Name ofauthorized official

Mailing address (number and street) City, State, ZIP Code
3. Ifyou commun and EPA assigned a PC Number to the notice. enter the number.
: 4 !fyou previously submitted all exemption application for the chemical sOOstance covered by this notice. enter the exemption number assignedby EPA. Ifyou previously submitteda PMN for this substance enler the PMN number assigned by EPA (i.e. withdrawn or incomplete).**~** 5. Ifyou have submitteda notice ofBona fide intent to manufacture or import for the chemical suhstance covered by this notice. enter the notice number assigned by EPA.**~** I. 6. Type ofNotice Mark (X) 

# D Manufacture Only Binding Option Mark Position

Telephone
Position

Telephone

Mark (X) ifnone Mark (X) ifnone Mark (X) 

# • ifnone 

### 2. Import 

### 3. Both Only 

# 0 Binding Option Mark (X) 

# 0 X 

# 0 X 

# 0 X

EPA FORM 7710-25 (Rev. 5-95) Page JComplete ei Ifanotherperson will submitchemical identity information for you (for either Item I or 2), mark (X) the box at the right Confithe and address ofthat in a continuation sheet dential I. Class I or 2 chemical substances (fordefinitions I and class 2 substances, the Instructions Manual) 

# x a, Class ofsubstance
- Mark (X) I Class I or 2 Class 2 b. Chemical name (Currently correct Chemical Abstracts (CA) Name that is consistent with TSCA Inventory listings for similar substances. ForClass I substances a CA Index Name mustbe provided. ForClass 2 substances eithera C A Index Name orCA Preferred Name must 

# x be provided, which everis appropriate based on CA 9CI nomenclature rules and conventions).

c, Please reported in notice: (check one). 

# D Method 1 (CAS Inventory Expert Service - a copyofthe Identification Method 2 (Other Source) report obtained from the CAS Inventory Expert Services mustbe as an attachment to this 

### d, Molecular formula and CAS Registry Number (ifa number already exists for the substance) 

# x CAS# 

# x

e. a class 1 substance, a complete and correct structure diagram For a class 2 immediate precursor substances with their respective CAS Registry Numbers. (2) Describe the nature ofthe reaction orprocess. (3) Indicate the 

# x range ofcomposition and the typical composition (where appropriate). (4) Provlde a correct representative orpartial chemical structure diagram, as complete as can be known, ifone can bereasonably ascertained.


## This page is not applicable.

Mark (X) this box ifyOll attach a continuation sheet.
EPA FORM 7710-25 (Rev. 5-95) Page 4

# xConfidential a. Indicate the number-average weight ofthe lowest molecular weight composition ofthe polymer you intend to manufacture. Indicate maximum weight percent oflow molecular weight species (not including residual monomers, reactants, or solvents)below 500 and below 1,000 absolute molecular weight ofthat composition. Describe the methods ofmeasurement orthe basis for your estimates: GPC

# 0 Other 

# 0: (Specify)

___ i) 

### lowest number average molecular wcight: ii) maximum weight % 

### below 500 molecular weight: iii) maximum .weight % 

### below 1000 molecular weight: attach a continuation sheet. must separate confidentiality claims for monomerorother reactant identity, composition information, and residual information. Mark 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 monomeror otherreactant used in the manufacture of thepolymer. (2) 

### Mark (X)

### this column ifentry in column (I)

### is confidential. (3)
- 

### Indicate the typical weight percent ofeach monomer or otherreactant in the polymer. (4) 

### Mark (X) 

### the identity column ifyou want a monomer or other reactantused attwo weightpercentorless to be listed 

### as part ofthe polymer description 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 or otherreactant thatmay be present as aresidual in the polymer as manufactured for commercial purposes. Mark this column ifen 

# x x 

# x x x x 

# x x x 

# x x 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 report 

# 0 Method 

### 2 (other source) obtained from CAS Inventory Expert Service must be submitted as as attachment to this 

# x x 

# x x x 

# x

d. The currently correct Chemical Abstracts (CA) name for the polymer that is consistent with TSCA Inventory listings for similar polymers.

e. Provide 

### a correctrepresentative orpartial chemical structure diagram, as complete as can be known, ifone can

### be reasonably ascertained.

Mark (X) 

### this box if YOll 

### attach a continuation sheet EPA FORM 7710-25 (Rev. 5-95) Page 5

# Part I -- GENERAL INFORMATION -- Continued**Secti~!IH** 

## -- CHEMICAlIDEN'nIY IN..' IwMA.TION Continued 3. Impurities (a) 

### - Identify each impurity that may be reasonably anticipated to be present In the chemical substance as manufactured for commercial purpose. Provide the CAS Registry Number ifavailable. Ifthere are unidentified impurities. enter "unidentified'" (b) 

### - Estimate the maximum weight % ofeach impurity. Ifthere are unidentitled,,,f'u,;';"" estimate their total weight %. Impurity and CAS Registry Number Confipercent Maximum dential (b) (a) 

## X X X X X X X 

# [ ] Mark (X)this boxifyou attach a sheet. Confidential 4. Synonyms
- Enter any chemical synonyms for the new chemical identified in subsection I or 2. 

## X 

# D Mark (X) this box ifyou attach a continuation sheet. 5. Trade 

### 'U"""""QUV" - List trade names for the new chemical substance identified in ",h",ctinn I or 2. 

## X 

# D Mark (X) this box ifyou attach a continuation sheet. 6. Generic chemical name - Ifyou claim chemical identify as confidential, you mustprovide a generic name for your substance that reveals the specific chemical identity ofthe new chemical substance to the maximum extent possible. Refer to the TSCA Chemical Substance Inventory, 1985 Edition, Appendix B for guidance on developing generic names.


## Alkyl ethoxylate 

# 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. Provide the CAS Registry Number ifavailable. Bypr?duct CAS Regis!ry Number (I) (2)

# ~e~~~~ X X X X 

# [ ] Mark (X) this box ifyou attach a continuation sheet. EPA FORM 7710-25 (Rev. 5-95) Page 6

# PartI
-- GENERAL INFORMATION
-- Continued Section C
-- PRODUCTION,IMPORT,AND USE INFORMATION: Mark (X)the "Confidential"box next to 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-monthperiod during the first three years ofproduction. EstImates should be on 100% new chemical substance basis. For a Low Volume Exemption application, ifyou choose to have your notice reviewed at a lowerproduction volume than 10.000kg/yr, specify the volume and mark (x) in the binding box. Ifgranted, you are bound to this volume Maximum first 12-month production (kg/JT) Maximum l2-monthproduction (kg/yr) Confi- Binding (100% new chemical substance basis) (100% new chemical substance basis) dcntial Option Mark (x) 

### X 2_ Use Information
-- You must make separate confidentiality claims for the description ofthe categoryofuse, the percent ofproduction volume devoted to each category, the formulation of the new substance, and other use information. Mark (X) the "Confidential" Box next 10 

### any item you claim as confidential. a. (I) 

### Describe each intended category ofusc ofthe new chemical substance by function and application.. (2)
-­ Mark (X) this column ifentrycolumn (I)

### is confidential business information (CBI). (3) 

### Indicate your willingness to have the information provided in colunm (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 colunm (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 under your control associated with each category ofuse. 

### (7)­ Mark (X) this colunm ifentryin colunm (6) is confidential business information (CBJ). (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 use type provided in (8) binding. (9)
-­ Mark (X) this colunm ifentry(ies) in colunm (8) is (are) confidential business information (CBI). Category ofuse (l) 

### Binding Produc­ %in % ofsubstance expected per use CBI Option tion% CBI Form­ eBJ (8) CBI (by function and application i.e. a dispersive dye Mark (x) ulation Site- Con-* Indus- Com- Binding for finishing polyester fibers) (2) (3) (4) (5) (6) (7) 

### limited sumer trial mercial Option (9) 

## X X X 

## X X 

## X X X X X X 

## X X X X X 

## X X X 

## X X 

## X X 

## X X 

## X X 

## X * Ifyou have identified a "consumer" use, please provide on a continuation sheet a detailed description ofthe users) ofthis chemical substance in consumerproducts,

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 consumerproduct. OMark (X) this box iryou attach a continuation sheet. 

### b. Generic use Ifyou claimany category ofuse description in subsection 2a as confidentlal, enter a generic deSCription ofthat category. Read the description Instructions Manual for examples ofgeneric use descriptions.



### Surfactant 

# 0 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 Binding

information which will be provided to any person who is reasonably likely to be exposed to this substance regarding protective equipment or practices Option for the safe handing. transport, use, or disposal ofthe new substance. List in part III hazard information you include Mark (x) 

# 0 Mark (X) this box if

### you attach hazard information. 

# D EPA FORM 7710-25 (Rev 5-(5) 

### Page 7each type
use You must describe these 

### I.

attach a continuation sheet. 

### Processing 

# Part 11-­ Section A -- INDUSTRIAL SITES CONTROLLED BY THE SUBMITTER Mark (X) the "Confidential" box next to any item you claimas confidential processing, or use operation involving the newchemical substance at industrial sites you control. Importers do this section for operations outside the U.S.; however, YOll may still have reporting requirements ifthere are further industrial processing or See instructions Confiofthe site at which the will occur. dential 

# x Site address (number and street) City, County, State, ZIP code 

### Ifthe same operation wi

### 11 occur at more than one site, enterthe number ofsites. Identify the additional sites on a continuation sheet, and ifany ofthe sites have significantlydifferent productionrates oroperations, include all the information requested in this section for those sites as attachments.



### b. Batches/year 

# x I. Batch Maximumkg/day (100% new Hours/day Days/year chemical substance) 

# x 2. Continuous d. Processdescription Mark (X) to indicate your willingness to have yourprocess description binding. (I) Diagram the major unit operation steps and chemical conversions. Include interim storage and transport containers (specify- e.g. 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 substancebasis), and entry pointofall starting materials and feedstocks (including reactants, solvents, catalysts. etc.), and ofall products. recycle streams, and wastes. Include cleaningchemicals (note frequency ifnot used daily or perbatch) 

### (3) Identifyby number the points ofrelease, including small or intermittent releases, to the environmentofthe newchemical substance.

Mark (X) this box ifyou attach a continuation sheet EPA FORM**77\o~25** (Rev 5-95) Page 8r----. 

# Part 11-- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE
-- Continued Section A
-- INDUSTRIAL SITES CONTROLLEDBY THE SUBMITTER
-- Continued 2. Occupational Exposure
­ You must make separate confidentiality claims for the description ofworker activity, physical form ofthe newchemical substance, number ofworks exposed. and duration ofactivity. Mark (X) the "Confidential" box next to any item you claim as contidential. (I)
-- Describe the activities (i.e. bag dumping, tote filling, unloading drums, sampling. cleaning, etc.) in which workers may be exposed to the 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 formes) ofthe new chemical substance (e.g.• solid: crystal, granule, powder, or dust) and 

### % new chemical substance (ifpart ofa 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 for all sites combined. 

### (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 per year. (12)
-- Mark (X) this column ifentries in columns (10) and (II)are confidential business information (CBI). Physical Worker activity CBI Protective Equipment! Binding forms (s) Binding CBI 

### # of CBI Maximum Duration CBI (i.e., bag dumping, filling drums) Engineering Controls Option and 

### % new Option Workers Hrs/day Days/yr Mark (x) substance Mark (x) Exposed (I) (2) (3) (4) (5) (6) (7) (8) 

### (9) (10) (II) (12) 

### X X X X X X X X X X X X X X X X X X X X 

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

### 3. Environmental Release and Disposal-- You must make separate confidentialityclaims for the release number and the amount ofthe newchemical 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 Il, section A, subsection Id(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 (stack air, fugitive air (optional-see Instruction Manual), surface water, on-site or off-site land or incineration, POTW, or other (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 or tertiary 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) numbers for direct discharges or NPDES numbers ofthe POTW (Publicly Owned Treatment Works). Mark (X) ifthe POTW name or NPDES 

### # is confidential business information (CBI). Release Amount ofnew substance Media ofrelease Number released CBI e.g. stack air Control technology and efficiency (you may wish to optionally attach efficiency data) CBI

(I) (2a) (2b) (3) (4) (5a) Binding (5b) (6) Mark (X) 

### X X X X X X X X X X (7) Mark (X) the 

## D POTW provide name(s) below: CBI 

## D Navigable 

## D Other
­ provide NPDES 

### # CBr destination (s) ofreleases 

### - waterway Specify to water

--­ 

### X X 

# D Mark (X) this box ii'you attach a continuation sheet. EPA FORM 7710-25 (Rev 5-95) Page l)

# Part 11-- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE -- Continued Section B -- INDUSTRIAL SITES CONTROLLED BY OTHERS Complete section B for 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 B for each type a/processing. oruse operation involving the newchemicalsubstance. Ifthe same operation is performed at more than one site describe the t}'!)ical 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 bracket the 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 describe each worker activity. (2)
-- Provide the identity, the approximate weight (by kg/day or kglbatch, on an 100% new chemical substance basis), and entry point ofall feedstocks (including reactants, solvents and catalysts, etc) and all 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 intermittentreleases, to the environment ofthe new chemical substance. (4) Please enterthe # ofsites (remember to identify the locations of these sites on a continuation sheet):



### --­ # ofsites


## Confidential Business Information has been removed.



# D Mark (X) this box ifyou attach a continuation sheet. 2, 

### Worker Exposure/Environmental Release (I) -- From the diagram above, provide the letterfor 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 perday and (b) days per year. (6)
-- Describe physical form ofexposure and % new chemical substance (ifin mixture), and any protective equipment and engineering controls, ifany, 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, enter the number ofeach release point. Complete 9-I 3 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, 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 proceeding entries are confidential business information (CBI). Protective Equip. / Amount of Letter # of Duration Engineering Controls/ %in New Media ofRelease

of Workers of Physical Foml and % Foml- Release Substance & Control Activity Exposed CEI Ex,osure CBI new substance uIation CBI Number Released CBI Technology CEI

(I) (2) (3) (4a) (4b) (5) (6) (7) (8) (9) (lOa) (lOb) (II) (12) ( 13) 

### X X X X X X X X X X X X X X X X X X X X (14)
-- Byproducts: (15) 

### X 

# D Mark (X) this box ifyou attach a continuation sheet, EPA FORM 7710-25 (Rcv. 5-95) Page 10

# OPTIONAL POLLUTION PREVENTION INFORMATION To claiminfonnation in this section as confidential circle or bracket the specific information that you claimas confidential. 

# In this section you mayprovide informationnot reported elsewhere inthis form regarding your efforts to reduce orminimizepotential risks associated with activities surrounding manufacturing, processing, use and disposal ofthe PMN substance. Please include new informationpertinentto pollutionprevention, including source reduction, recycling activities and saferprocesses or products available due to the new chemical substance. Source reduction includesthereduction in the amount ortoxicity ofchemical wastesbytechnological modification, process and proceduremodification,productreformulation, raw materials substitution, andlor inventorycontrol. Recyclingrefers to the reclamation ofuseful chemical components from wastes that would otherwise be treated orreleased as air emissions orwaterdischarges, orland disposal. Descriptions ofpollution prevention, source reduction and recycling should emphasizepotential risk reduction subsequent to compliance with existingregulatoryrequirements and canbe eitherquantitative or qualitative. TheEPAis interested in the informationto assess overallnetreductions in toxicity orenvironmental releases and exposures, not the shifting ofrisks to other environmental media ornon-environmental areas (e.g., occupational orconsumer exposure). In addition, information onthe relative costorperformance characteristics ofthe PMN substance to potential alternatives maybeprovided. 

# All information provided in this section will be taken into consideration duringthe review ofthis substance. See Instructions Mannal andPollution Prevention Guidance manual for guidance and examples. Describe the expected net benefits, such as (1) an overall reduction inrisk to human health orthe environment; (2) a reduction in the volume manufactured; (3) 

## a reduction inthe generation ofwaste materials throughrecycling, sourcereduction or othermeans; (4) a reduction in potential toxicityorhuman exposure and/or environmentalrelease; (5) an increase in productperformance, a decrease in the cost ofproduction and/orimproved operation efficiency ofthe new chemical substance in comparisonto existingchemical substances used in similar application; or (6) the extent to which the new chemical substance maybe a substitute for anexisting substance that poses a greater overallrisk to humanhealth or the environment.

Confidential Business Information has been removed
.



# • D Mark (X) thIS box if

## you attach a continuation sheet. EPA FORM 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 after this page. Clearly identify the attachment and the section ofthe form to which it relates, ifappropriate. Number consecutively the pages ofthe attachments. In the column below, enter the inclusive page numbers ofeach attachment. Mark (X)the "Confidential" box next to any attachment name you claim as confidential. Read the Instructions Manual for guidance on howto claim any information in an attachment as confidential. You must include with the sanitized copy ofthenotice form a sanitized version ofany attachment in which you claim information as confidential. Attachment name Attachment Contipagenumber(s) dential 

## Physical and Chemical Properties Worksheet 

## 13 X X X X X X X X X X X X X X X X X X X X X X X 

# D Mark (Xl this box ifyou attach a contmllation sheet. l:nter the attachment name and number.

EPA FORM 7710-25 (Rev 5-95) Page 12

## PHYSICAL AND CHEMICALPROPERTIES WORKSHEET To assist EPA'5 review ofphysical and chemical properties data. please complete the followmg 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 whetheror 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% pure) chemical substance. Properties that are measured for mixtures orfonnulations should be so noted (% PMN substance in You are not reqUired to submit this worksheet; however. EPA strongly recommends that you do so, as it will simplifyreview ensure that confidential infonnation is properly protected. You should submit this worksheet as a supplement to your submission oftest data. This worksheet is not a substitutefor submission oftest data. Property Mark Page Value Measured Confi­ (X) if number or dential provided Estimate Mark (X) (a) (b) (c) (M or E) (d) 

## Physical state ofneat substance (s) (I) (g) 

## X Vaporpressure 

## X @ Temperature 

## °C Ton Density/relative density 

## g/cm3 X Solubility @ Temperature



# ---°C X Solvent 

## gil Solubility in water @ Temperature 

## °C giL X Melting temperature O( 

## X Boiling/ sublimation temperature@ torrpressure 

## °C Spectra 

## X Dissociationconstant 

## X Particle size distribution 

## X Octanoll water partition coefficient 

## X Henry's Law constant 

## X Volitalization from water 

## X Volitalization from soil 

## X pH @ 

## concentration 

## X Flammability 

## X Explodability 

## X Adsorption I 

## coefficient 

## X Other Specify 

## X X X

EPA FORM 7710-25 (Rev 5-95) 

### Page I:} Replaces previous editions ofEPA Form 7710-25

## Confidential Business Information



## Pages 14 through 37 have been removed as confidential business information.

EPA FORM 7710-25 (Rev. 5-95) Page 14