EPA Form 6300-2

ICR No. 2261.03; OMB Control No. 2070-0171

ATTACHMENT B

DfE Formulator Program: Product Information Form

OMB Control No. 2070-0171

Approval expires 05/31/2014 

The public reporting and recordkeeping burden for this collection of information is estimated to average 10 hours per response, 

including the time for reviewing instructions, gathering information, posting information to the internet, and reviewing and 

completing the application. Send comments on the Agency's need for this information, the accuracy of the provided burden 

estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection 

techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania 

Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed 

application to this address.
EPA Form 6300-2

Safer Detergents 

Stewardship Initiative

Instructions for Application Form

EPA developed the Safer Detergents Stewardship Initiative (SDSI) to recognize environmental 

leaders who voluntarily commit to the use of safer surfactants. Leading product manufacturers 

have made great progress in developing safer, highly effective cleaners. These manufacturers 

believe that producing the safest products possible is important to their role as stewards of the 

environment and public health. A number of U.S. corporations have acted in advance of SDSI to 

use safer surfactants in their entire product lines.

Safer surfactants are surfactants that break 

down quickly to non-polluting compounds1. 

DfE’s Safer Chemical Ingredients List 

contains surfactants that meet DfE’s 

criteria for safer chemicals 

(http://www.epa.gov/dfe/saferingredients.

htm). CleanGredients is also a resource 

for information on safer surfactants 

(www.cleangredients.org).

To be eligible for recognition under SDSI, 

candidates should do the following:

o Complete this application and have 

it signed by a company authority 

(e.g., CEO or vice president for 

health and environment).

o Post a statement on their website 

describing the actions that qualify 

them for recognition under SDSI.

EPA reserves the right to request at any 

time, on a confidential basis, appropriate 

documentation (including but not limited to 

bills of lading, invoices, material safety data 

sheets, and list of ingredients) to confirm 

that candidates have achieved the 

appropriate criteria for recognition. If 

documentation is requested but not 

received within a reasonable time, EPA may 

deny or withdraw recognition from that 

candidate.

 

1

An example of a class of safer surfactants is linear 

alcohol ethoxylates (LAE). LAEs are toxic to aquatic 

life, but break down quickly to non-polluting 

compounds. Nonylphenol ethoxylates, commonly 

referred to as NPEs, are a surfactant class that does 

not meet the definition of a safer surfactant. Both 

NPEs and their breakdown products, such as 

nonylphenol, are toxic to aquatic life.

There are two categories for recognition 

under SDSI: Champion and Partner. 

 Champion is the highest level of 

recognition offered under SDSI. At 

this level, the participant is listed on 

the EPA SDSI website as a 

champion and may use a special 

logo in their literature to help 

explain their participation in the 

program.

 The Partner category provides 

recognition of significant 

accomplishment towards the use of 

safer surfactants. Partners will be 

listed on the EPA SDSI website and 

may be granted recognition as a 

Champion in the future, if 

appropriate. Partner recognition will 

sunset on the commitment date 

provided in Section 3 of the 

Application.

Guidelines for achieving Champion or 

Partner Status are provided in Table 1. 

Both Champions and Partners will receive a 

certificate of recognition from DfE. 

Application Process: The application is 

available online and may be filled out and 

submitted in hard copy by mail or scanned 

and emailed to SDSI@epa.gov. Unless you 

claim information as confidential, all 

applications received will be considered 

public information and no materials 

submitted will be returned. For security 

purposes, confidential information should 

not be submitted electronically. If you 

choose to send the application 
EPA Form 6300-2

electronically, the application and signed 

signature page must be scanned and sent 

to SDSI@epa.gov.

If you choose to submit a hard copy 

application, send your completed 

application via regular / certified mail or 

overnight mail to the following address:

Safer Detergent Stewardship Initiative 

Attn: Laura Romano

4550 Montgomery Avenue, Suite 800 North

Bethesda, MD 20814-5341

301-347-5289

Confirmation of Receipt: EPA will confirm 

receipt of applications, usually by email. If 

you have not received an acknowledgment 

within two weeks of sending your 

applications, please contact David Difiore at 

SDSI@epa.gov or 202-564-8786

Notification: Winners will be notified prior 

to the official public announcement. 

Awards will be presented to the primary 

sponsor of the application. 

Questions: Questions about eligibility, 

nomination procedures, or the Safer 

Detergent Stewardship Initiative should be 

directed to David Difiore of EPA’s Design for 

the Environment Program at SDSI@epa.gov 

or 202-564-8796

Paperwork Burden Estimate 

The public reporting and recordkeeping 

burden for this collection of information is 

estimated to average 10 hours per 

response, including the time for reviewing 

instructions, gathering information, posting 

information to the internet, and reviewing 

and completing the application. An agency 

may not conduct or sponsor, and a person 

is not required to respond to, a collection of 

information unless it displays a currently 

valid OMB control number. The OMB 

control number for this collection is 2070-

0171. Approval expires on 05/31/2014.

Send comments on the Agency’s need for 

this information, the accuracy of the 

provided burden estimates, and any 

suggested methods for minimizing 

respondent burden, including through the 

use of automated collection techniques to 

the Director, Collection Strategies Division, 

U.S. Environmental Protection Agency 

(2822T), 1200 Pennsylvania Ave., NW, 

Washington, D.C. 20460. Include the OMB 

control number in any correspondence. Do 

not send the completed application to 

this address.
EPA Form 6300-2

Additional notes about Table 1 guidelines:

 DfE’s Safer Chemical Ingredients List and CleanGredientsTM are resources for information 

on safer surfactants.

 Products include those whose use routinely results in their discharge to the environment 

(e.g., all-purpose cleaners, laundry detergents, pesticides, airplane de-icers, fire-fighting 

foams and gels).

 An example of a strategy is a letter that is sent to suppliers requiring them to provide 

products with only safer surfactants. The retailer/distributor or institutional purchaser will 

not be eligible for Champion recognition until only safer surfactants are sold or purchased.

 Examples of efforts that would qualify include developing means for surfactant users to 

identify safer surfactants, taking action to educate industry or the public about safer 

surfactants, and encouraging business to move toward safer surfactants. 

Participant 

Type

Table 1: Guidelines for Achieving:

Champion Status Partner Status

Chemical 

Manufacturers

 Demonstrate that you only 

manufacture safer 

surfactants

 Document a strategy for 

ensuring that you 

manufacture only safer 

surfactants

 Commit to manufacturing only safer 

surfactants by a date that is reasonable for 

your circumstances

 Document a strategy for ensuring that you 

will manufacture only safer surfactants

Formulators

 Demonstrate that you only 

use safer surfactants in 

products

 Document a strategy for 

ensuring that only safer 

surfactants are used in 

products

 Commit to using only safer surfactants in 

your products by a date that is reasonable 

for your circumstances

 Document a strategy for ensuring that only 

safer surfactants will be used in products

Retailers / 

Distributors

 Demonstrate that only 

safer surfactants are 

included in products 

intended for sale

 Document a strategy for 

ensuring that only safer 

surfactants are included 

in products intended for 

sale

 Commit to sell only products containing 

safer surfactants by a date that is 

reasonable for your circumstances 

 Document your active encouragement of 

the use of safer surfactants

Institutional 

Purchasers

 Demonstrate that you only 

purchase products 

containing safer 

surfactants

 Document a strategy for 

ensuring that purchased 

products only contain 

safer surfactants

 Commit to only use products that only 

contain safer surfactants by a date that is 

reasonable for your circumstances

 Document your active encouragement of 

the use of safer surfactants

Others (e.g., 

non-profits, 

unions, 

academia)

 Demonstrate outstanding 

efforts to encourage the 

use of safer surfactants

 Document your active encouragement of 

the use of safer surfactants
EPA Form 6300-2

Safer Detergents Stewardship Initiative OMB No. 2070-0171

SECTION 1a:

Enter requested 

information for the 

authorized 

representative

Organization Name

Contact Name

Address

Address

Phone Fax

Email

Website

SECTION 1b:

Indicate your type 

of organization

Chemical Manufacturer – Manufactures surfactants

Formulator – Purchases and blends chemicals (including surfactants) to create 

an end-use product for retailers and/or distributors

Retailer / Distributor – Sells products containing surfactants

Institutional Purchaser – Purchases or specifies cleaning products for use in 

multiple facilities (e.g., janitorial service provider)

Other – Influences use of surfactants (e.g., non-profit, trade association, 

academia)

SECTION 1c: 

Indicate the level of 

recognition for 

which you are 

applying (refer to 

the instructions for 

a description of 

Champion and 

Partner status for 

each organization 

type)

Champion (go to Section 2)

Partner (go to Section 3)
EPA Form 6300-2

 Safer Detergents Stewardship Initiative Page 2 of 5

SECTION 2:

Fill out this section if

you are applying for 

recognition as a 

Champion

If you are a... Demonstrate in SECTION 2a that... And then go to...

Chemical 

Manufacturer

You only manufacture safer surfactants Section 2b

Formulator You only use safer surfactants in products Section 2b

Retailer / 

Distributor

Only safer surfactants are included in 

products intended for sale

Section 2c

Institutional 

Purchasers

All the products you purchase contain only 

safer surfactants

Section 2c

Other You have made outstanding efforts to 

encourage the use of safer surfactants

Go to Section 4

SECTION 2a:

Use this space to 

explain how you meet 

the above

requirements.

Please include 

supporting documents 

when appropriate and 

note these documents 

in your statement. You 

may attach extra 

sheets as needed.

To be eligible for 

recognition, candidates 

should post a 

statement on their 

website stating that 

they manufacture, use, 

or purchase products 

containing only safer 

surfactants. Use this 

space to provide the 

URL for that section of 

your website describing 

the actions that qualify 

you for recognition:
EPA Form 6300-2

Safer Detergents Stewardship Initiative Page 3 of 5

SECTION 2b (Chemical 

Manufacturers and 

Formulators only): 

Indicate or describe 

your product 

stewardship strategy for 

ensuring the 

manufacture or use of 

safer surfactants

 Use DfE’s Safer Chemical Ingredients List or CleanGredientsTM to choose 

surfactants

 Other, please describe2:

 

SECTION 2c 

(Retailers/ 

Distributors and 

Institutional 

Purchasers only):

Document your 

strategy for 

ensuring that all of 

your purchased 

products contain 

only safer 

surfactants. You 

may attach extra 

sheets as needed.*

If you are a... Document a strategy for ensuring that...

Retailer / 

Distributor

Only safer surfactants are included in products intended for sale

Institutional 

Purchaser

Purchased products contain only safer surfactants

* An example of a strategy would be the establishment of a policy that requires suppliers to provide 

products that contain only safer surfactants. This strategy may be evidenced by a letter that is sent to 

suppliers requiring them to provide products with only safer surfactants, or a comparable statement 

posted on a company’s website. The retailer / distributor will not be eligible for Champion recognition 

until it sells products with only safer surfactants.

 

2

For SDSI recognition, your strategy description should include an explanation of your due diligence in 

selecting safer surfactants. Along with the non-use of NPE surfactants, examples of due diligence 

include: Only using surfactants from DfE’s Safer Chemical Ingredients List

(http://www.epa.gov/dfe/saferingredients.htm); only using surfactants from CleanGredientsTM

(www.cleangredients.org); only using surfactants that meet the DfE or CleanGredients surfactant screens 

(see DfE screen at http://www.epa.gov/dfe/pubs/projects/gfcp/index.htm); or only using surfactants 

that meet criteria similar to the DfE or CleanGredientsTM screens (e.g., the EU Detergents Directive). In 

addition, a description of in-house criteria that ensures the use of safer surfactants may also qualify as 

due diligence.
EPA Form 6300-2

 Safer Detergents Stewardship Initiative Page 4 of 5

SECTION 3:

Fill out this section 

if you are applying 

for recognition as a 

Partner

If you are a... Document in SECTION 3a your commitment to...

Chemical 

Manufacturer

Produce only safer surfactants

Formulator Use only safer surfactants in your products

Retailer / 

Distributor

Only sell products that only contain safer surfactants

Institutional 

Purchasers

Only purchase products that only contain safer surfactants

Other

(e.g., trade 

association, 

NGO, etc.)

encouragement of safer surfactants

SECTION 3a:

Use this space to 

describe how you 

meet the above

requirements.*

To be eligible for 

recognition, 

candidates should 

post a statement on 

their website 

stating their 

commitment to 

completely 

transitioning to 

safer surfactants. 

Use this space to 

provide the URL for 

that section of your 

website describing 

the actions that 

qualify you for 

recognition:

* You should describe your commitment to a complete transition to safer surfactants by a date that is 

reasonable for your circumstances. Please state this date explicitly and explain briefly why it is a 

reasonable date for your circumstances.3 Include supporting materials when appropriate and note these 

materials in your statement. You may attach extra sheets as needed.

 

3 Please note that Partner recognition will sunset on the commitment date. After this date, companies will need to 

apply for Champion recognition. 
EPA Form 6300-2

 Safer Detergents Stewardship Initiative Page 5 of 5

SECTION 4:

Certification of 

Application

Please have the appropriate company authority (e.g., CEO, vice president for health and 

environment, division head, or other authorized signatory) sign here to verify the accuracy 

of the application’s content.

Signature of Authorizing Entity Date

Printed Name and Title Date

I hereby affirm that the contents of this application are true and accurate to the best of my 

knowledge, and that I am an authorized representative of the company or organization named 

above and am duly authorized to sign this application.