5900-150 Class I Importer Quarterly Report

Recordkeeping and Periodic Reporting of the Production, Import, Export, Recycling, Destruction, Transhipment, and Feedstock Use of Ozone-Depleting Substances (Renewal)

Class I Importer_v1.0.xlsm

Recordkeeping and Periodic Reporting of the Production, Import, Export, Recycling, Destruction, Transhipment, and Feedstock Use of Ozone-Depleting Substances (Renewal)

OMB: 2060-0170

Document [xlsx]
Download: xlsx | pdf

Overview

Instructions
Section 1
Section 2
Section 3
Summary
Reference List

Sheet 1: Instructions




U.S. Environmental Protection Agency

Stratospheric Ozone Protection Program




Class I Importer Quarterly Report (Sec 82.13)

Version 1.0

Last Updated: December 2017




Instructions

Complete this form by filling in the data fields that are highlighted in blue. Guidance on how to complete individual data fields are provided in comment bubbles. Use the arrows to navigate between the tabs. Once completed, use the 'prepare submission' button on the Summary tab to generate your CSV file.

Copying and Pasting Data: If data are pasted into this reporting form from another spreadsheet, the formatting of specific cells must be consistent with the requirements of the form in order to be

accepted into EPA’s ODS Tracking System. Refer to the Reference List to identify the valid naming scheme for specific data fields. Additionally, select "Paste As Values" when pasting data into the form.

Report Submission: This Excel file, the generated CSV file, and all supporting attachments should be submitted to EPA through the Central Data Exchange (CDX). Refer to EPA's website for additional information on form submission:

https://www.epa.gov/ods-phaseout/ods-recordkeeping-and-reporting




All information submitted to EPA will be treated as confidential in accordance with 40 CFR Part 2, Subpart B, and will only be disclosed by the means set forth in the subpart.

The public reporting and recordkeeping burden for this collection of information is estimated to average 4 hours per response. 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 Avenue NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.




EPA Form #5900-150

OMB Control Number: 2060-0170

Expiration Date: 10/31/2018




Sheet 2: Section 1









U.S. Environmental Protection Agency






Class I Importer Quarterly Report












Date Prepared:













Section 1: Report Identification Information






Complete all fields below. No fields may be left blank.





The company name must match the organization name under which this report is submitted to EPA through CDX. Company Name:

1



Submission Type:

1



Reporting Year:

1



Reporting Quarter:

1



Per Customs and Border Patrol, this number could be the: - Internal Revenue Service (IRS) Employer Identification Number (EIN): NN-NNNNNNN; - IRS EIN with suffix: NN-NNNNNNNXX; - Social Security Number (SSN): NNN-NN-NNNN; or - CBP assigned number: YYDDPP-NNNNN. Importer Number:

1












Original Submission






Re-Submittal





Sheet 3: Section 2




















U.S. Environmental Protection Agency














Class I Importer Quarterly Report





























Company Name:












Reporting Period:





























Section 2: Import Transaction Data














In the table below, enter data for each import transaction containing a class I controlled substance that took place during the reporting period. If no controlled substances were imported, the table may be left blank. For all controlled substances that are imported, all fields are required unless otherwise indicated. As a reminder, if material was imported for global lab, other essential uses (EU), second party transformation, or second party destruction, a copy of the transformation verification, destruction verification, and/or essential use certification from each company for whom material was imported must be provided to EPA along with the submission of this report.





If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions.









The transaction number is autopopulated. Transaction Number Enter the date for when the shipment entered the United States. Date of Import Select the country from which the shipment was imported. If copying and pasting data into the table, please refer to the Reference List for the valid list of countries. Source Country Select the name of the chemical imported. If copying and pasting data into the table, please refer to the Reference List for the valid list of chemical names. Name of the Class I Chemical Imported Enter the total quantity (kg) of the chemical imported. Quantity of the Class I Chemical Imported Enter the 10-digit commodity code of the chemical imported as it appears on Customs documentation. Refer to the Reference List for a list of commonly used commodity codes for class I chemicals. Commodity Code Enter the name of the port where the shipment entered the United States. Port of Entry into the United States Enter the Customs Entry Summary Number for the shipment. This number identifies the specific shipment. The Customs Entry Summary Number is generally three (3) letters followed by nine (9) digits. Customs Entry Summary Number Enter the Importer Number of the shipment. Your company's Importer Number as entered in Section 1 of this report will automatically populate for each transaction entered. Revise the number if the Importer Number for the shipment is different from your company's Importer Number. The number entered should have no dashes. Shipment Importer Number Select the transaction type of the material. The transaction type can be New, Used, or Heels. If copying and pasting data into the table, please refer to the Reference List for the valid list of transaction types. Transaction Type Select the intended use of the material. Note that the Transaction Type in Column L must be selected prior to completing this field. - If the material is New, the intended use can be Global Lab, Other Essential Uses (EU), In-House Transformation, 2nd Party Transformation, In-House Destruction, or 2nd Party Destruction. - If the material is Used, the intended use can be In-House Transformation, 2nd Party Transformation, In-House Destruction, 2nd Party Destruction, Halon Aircraft Bottles, or Other. - If the material is a Heel, the intended use can be Included in Future Shipment, Transformation, Destruction, or Non-Emissive Use. If copying and pasting data into the table, please refer to the Reference List for the valid list of intended uses. Intended Use Enter the date of the non-objection notice or acknowledgement letter issued by EPA for the shipment if the material imported is used. Date of Non-Objection Notice or Acknowledgement Letter





Autopopulated Date Selection Selection kg Text Text Text Number Selection Selection Date





1 1/15/2018 Australia CFC-13 5,000.00 2903.77.0020 Miami, FL abc123456789 12345678900 New In-House Trans








































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































1




















x x




x x








Afghanistan CBM




New Global Lab








Albania CCL4




Used Other EU








Algeria CFC-11




Heels In-House Trans








Andorra CFC-12





2nd Party Trans








Angola CFC-13





In-House Dest








Antigua and Barbuda CFC-111





2nd Party Dest








Argentina CFC-112





In-House Trans








Armenia CFC-113





In-House Dest








Australia CFC-114





Aircraft Halon Bottles








Austria CFC-115





Other








Azerbaijan CFC-211





Future Shipment








Bahamas CFC-212





Transformation








Bahrain CFC-213





Destruction








Bangladesh CFC-214





Non-Emissive Use








Barbados CFC-215















Belarus CFC-216















Belgium CFC-217















Belize CH3CCL3















Benin Halon 1202















Bermuda Halon 1211















Bhutan Halon 1301















Bolivia (Plurinational State of) Halon 2402















Bosnia and Herzegovina HBFCs















Botswana
















Brazil
















Brunei Darussalam
















British Virgin Islands
















Bulgaria
















Burkina Faso
















Burundi
















Cambodia
















Cameroon
















Canada
















Cape Verde
















Central African Republic
















Chad
















Chile
















China
















Colombia
















Comoros
















Congo
















Cook Islands
















Costa Rica
















Côte d'Ivoire
















Croatia
















Cuba
















Cyprus
















Czech Republic
















Democratic Republic of the Congo
















Denmark
















Djibouti
















Dominica
















Dominican Republic
















Ecuador
















Egypt
















El Salvador
















Equatorial Guinea
















Eritrea
















Estonia
















Ethiopia
















European Union
















Fiji
















Finland
















France
















Gabon
















Gambia
















Georgia
















Germany
















Ghana
















Greece
















Grenada
















Guatemala
















Guinea
















Guinea-Bissau
















Guyana
















Haiti
















Holy See
















Honduras
















Hong Kong
















Hungary
















Iceland
















India
















Indonesia
















Iran (Islamic Republic of)
















Iraq
















Ireland
















Israel
















Italy
















Jamaica
















Japan
















Jordan
















Kazakhstan
















Kenya
















Kiribati
















Kuwait
















Kyrgyzstan
















Lao People's Democratic Republic
















Latvia
















Lebanon
















Lesotho
















Liberia
















Libya
















Liechtenstein
















Lithuania
















Luxembourg
















Madagascar
















Malawi
















Malaysia
















Maldives
















Mali
















Malta
















Marshall Islands
















Mauritania
















Mauritius
















Mexico
















Micronesia (Federated States of)
















Monaco
















Mongolia
















Montenegro
















Morocco
















Mozambique
















Myanmar
















Namibia
















Nauru
















Nepal
















Netherlands
















New Zealand
















Nicaragua
















Niger
















Nigeria
















Niue
















North Korea (Democratic People's Republic of Korea)
















Norway
















Oman
















Pakistan
















Palau
















Panama
















Papua New Guinea
















Paraguay
















Peru
















Philippines
















Poland
















Portugal
















Qatar
















Republic of Moldova
















Romania
















Russian Federation
















Rwanda
















Saint Kitts and Nevis
















Saint Lucia
















Saint Vincent and the Grenadines
















Samoa
















San Marino
















Sao Tome and Principe
















Saudi Arabia
















Senegal
















Serbia
















Seychelles
















Sierra Leone
















Singapore
















Slovakia
















Slovenia
















Solomon Islands
















Somalia (Federal Republic of)
















South Africa
















South Korea (Republic of Korea)
















South Sudan
















Spain
















Sri Lanka
















Sudan
















Suriname
















Swaziland
















Sweden
















Switzerland
















Syrian Arab Republic
















Tahiti
















Taiwan
















Tajikistan
















Thailand
















The Former Yugoslav Republic of Macedonia
















Timor-Leste
















Togo
















Tonga
















Trinidad and Tobago
















Tunisia
















Turkey
















Turkmenistan
















Tuvalu
















Uganda
















Ukraine
















United Arab Emirates
















United Kingdom of Great Britain and Northern Ireland
















United Republic of Tanzania
















#NAME?
















Uruguay
















Uzbekistan












Sheet 4: Section 3










U.S. Environmental Protection Agency





Class I Importer Quarterly Report










Company Name:




Reporting Period:










Section 3: Shipment/Sales Data






Identify the recipient company(s) of the material imported for second party transformation, second party destruction, global lab, and/or other essential uses (EU), and the amount shipped to or purchased by each company during the quarter.




Note: Due to a potential time lag between the date of import and the date of shipment, it is recognized that for a given quarter the information in Section 3 may not match the information reported in Section 2 for second party transformation and second party destruction; however, it is expected that all material imported for second party transformation and second party destruction will eventually be shipped to a second party and must be reported as such in the applicable quarterly report.



If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions.



As a reminder, a copy of the transformation verification, destruction verification, or essential use certification from each second party for whom material was imported must be provided to EPA along with the submission of this report.



Select the chemical name from the dropdown list if the controlled substance was imported during the reporting period and subsequently shipped to a second party for transformation or destruction, or purchased by a company for lab use or other EU. If the material was shipped to or purchased by more than one company, enter the chemical name in more than one row. If copying and pasting data into the table, please refer to the Reference List for the valid list of chemical names. Chemical Name Enter the name of the company that received or purchased material during the quarter for transformation, destruction, global lab, or other EU. Recipient Company Name Enter the quantity (kg) of the chemical shipped to or purchased by the recipient company during the reporting period. Quantity Identify whether the material will be (1) transformed (2) destroyed, (3) distributed for global lab, or (4) used for other essential uses. Purpose



Selection Text kg Selection



CFC-11 Company A 200.00 Global Lab



















































































x

x



CBM

Global Lab



CCL4

Other EU



CFC-11

Transformation



CFC-12

Destruction



CFC-13






CFC-111






CFC-112






CFC-113






CFC-114






CFC-115






CFC-211






CFC-212






CFC-213






CFC-214






CFC-215






CFC-216






CFC-217






CH3CCL3






Halon 1202






Halon 1211






Halon 1301






Halon 2402






HBFCs




Sheet 5: Summary















U.S. Environmental Protection Agency










Class I Importer Quarterly Report




















Company Name:









Reporting Period:


















Import Totals











The values in the table below are calculated based on data entered in Section 2. If the totals appear to be incorrect, please return to Section 2 to review your data.


Chemical Name New Imports (kg) Total Used Imports (kg) Total Heel Imports (kg)


Global Lab Other EU In-House Transformation Second Party Transformation In-House Destruction Second Party Destruction Gross Imports















































































































































Sheet 6: Reference List



















































U.S. Environmental Protection Agency
















































Class I Importer Quarterly Report














































Reference List






























































































Copying and Pasting Data: If data is pasted into this reporting form from another spreadsheet, the formatting of specific cells must be consistent with the requirements of the form in order to be accepted into EPA’s ODS tracking system. When copying and pasting data into the form, please ensure consistency with the formatting of the lists provided below.









































Chemical Name List: The table below lists the valid chemical names that may be used when entering data into Section 2 and Section 3 of this form.
Country List: The table below lists the valid country names that may be used when entering data into Section 2 of this form.



























































































Class I Chemicals
Source Country









































CFC-11 CFC-114 CFC-215 Halon 2402
Afghanistan Greece Papua New Guinea









































CFC-12 CFC-115 CFC-216 CBM
Albania Grenada Paraguay









































CFC-13 CFC-211 CFC-217 CCL4
Algeria Guatemala Peru









































CFC-111 CFC-212 Halon 1202 CH3CCL3
Andorra Guinea Philippines









































CFC-112 CFC-213 Halon 1211 HBFCs
Angola Guinea-Bissau Poland









































CFC-113 CFC-214 Halon 1301

Antigua and Barbuda Guyana Portugal














































Argentina Haiti Qatar









































Transaction Type List: The table below lists the valid transaction types that may be used when entering data into Section 2 of this form.
Armenia Holy See Republic of Moldova










































Australia Honduras Romania














































Austria Hong Kong Russian Federation









































Transaction Type

Azerbaijan Hungary Rwanda









































New Used Heels

Bahamas Iceland Saint Kitts and Nevis














































Bahrain India Saint Lucia









































Intended Use Lists: The tables below list the valid intended uses that may be used when entering data into Section 2 of this form.
Bangladesh Indonesia Saint Vincent and the Grenadines










































Barbados Iran (Islamic Republic of) Samoa














































Belarus Iraq San Marino









































Intended Uses - If Transaction Type = New

Belgium Ireland Sao Tome and Principe









































Global Lab In-House Trans 2nd Party Trans

Belize Israel Saudi Arabia









































Other EU In-House Dest 2nd Party Dest

Benin Italy Senegal














































Bermuda Jamaica Serbia









































Intended Uses - If Transaction Type = Used
Bhutan Japan Seychelles









































Transformation Destruction Aircraft Halon Bottles Other
Bolivia (Plurinational State of) Jordan Sierra Leone














































Bosnia and Herzegovina Kazakhstan Singapore









































Intended Uses - If Transaction Type = Heels
Botswana Kenya Slovakia









































Future Shipment Transformation Destruction Non-Emissive Use
Brazil Kiribati Slovenia














































Brunei Darussalam Kuwait Solomon Islands









































Commodity Code List: The table below lists the commonly used class I commodity codes that may be used when entering data into Section 2 of this form. A complete list of commodity codes can be found in the Official Harmonized Tariff Schedule.
British Virgin Islands Kyrgyzstan Somalia (Federal Republic of)










































Bulgaria Lao People's Democratic Republic South Africa










































Burkina Faso Latvia South Korea (Republic of Korea)














































Burundi Lebanon South Sudan









































Class I Commodity Codes/Description
Cambodia Lesotho Spain









































2903.77.0010 Trichlorofluoromethane (CFC-11)
Cameroon Liberia Sri Lanka









































2903.77.0020 Trichlorotrifluoroethanes (CFC-113)
Canada Libya Sudan









































2903.77.0030 Dichlorotetrafluoroethane (CFC-114)
Cape Verde Liechtenstein Suriname









































2903.77.0040 Monochloropentafluoroethane (CFC-115)
Central African Republic Lithuania Swaziland









































2903.77.0050 Dichlorodifluoromethane (CFC-12)
Chad Luxembourg Sweden









































2903.77.0080 Other CFCs
Chile Madagascar Switzerland









































2903.14.0000 Carbon tetrachloride
China Malawi Syrian Arab Republic









































2903.76.0010 Bromotrifluoromethane (Halon 1301)
Colombia Malaysia Tahiti









































2903.76.0050 Bromochlorodifluoromethane (Halon 1211) and dibromotetrafluoroethanes (Halon 2402)
Comoros Maldives Taiwan











































Congo Mali Tajikistan









































2903.79.1000 Bromochloromethane (CBM)
Cook Islands Malta Thailand









































2903.19.6010 Methylchloroform (1,1,1-Trichloroethane)
Costa Rica Marshall Islands The Former Yugoslav Republic of Macedonia









































3824.71.0100 Mixtures containing chlorofluorocarbons (CFCs)
Côte d'Ivoire Mauritania









































3824.72.0000 Mixtures containing bromochlorodifluoromethane (Halon 1211),
bromotrifluoromethane (Halon 1301), or dibromotetrafluoroethanes (Halon 2402)
Croatia Mauritius Timor-Leste











































Cuba Mexico Togo











































Cyprus Micronesia (Federated States of) Tonga









































3824.73.0000 Mixtures containing hydrobromofluorocarbons (HBFCs)
Czech Republic Monaco Trinidad and Tobago









































3824.75.0000 Mixtures containing carbon tetrachloride
Democratic Republic of the Congo Mongolia Tunisia









































3824.76.0000 Mixtures containing 1,1,1-trichloroethane (methyl chloroform)


Denmark Montenegro Turkey














































Djibouti Morocco Turkmenistan














































Dominica Mozambique Tuvalu














































Dominican Republic Myanmar Uganda














































Ecuador Namibia Ukraine














































Egypt Nauru United Arab Emirates














































El Salvador Nepal United Kingdom of Great Britain and Northern Ireland














































Equatorial Guinea Netherlands














































Eritrea New Zealand United Republic of Tanzania














































Estonia Nicaragua Uruguay














































Ethiopia Niger Uzbekistan














































European Union Nigeria Vanuatu














































Fiji Niue Venezuela (Bolivarian Republic of)














































Finland North Korea (Democratic People's Republic of Korea) Viet Nam














































France Yemen














































Gabon Norway Zambia














































Gambia Oman Zimbabwe














































Georgia Pakistan















































Germany Palau















































Ghana Panama



























































































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