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Reporting and Recordkeeping Requirements of the HCFC Allowance System (Renewal)
ICR 201803-2060-005 · OMB 2060-0498 · Object 81718401.
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| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
|---|---|
| File Title | Reporting and Recordkeeping Requirements of the HCFC Allowance System (Renewal) |
| Author | Emily Golla |
| Last Modified By | Calc |
| File Modified | 2017-12-06 |
| File Created | 2026-09-22 |
| Conversion State | complete |
Extracted Text
U.S. Environmental Protection Agency Stratospheric Ozone Protection Program Request for Additional Class II Consumption Allowances (Sec 82.20) Version 1.0 Last Updated: December 2017 Proceed to Section 1 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. Additio 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 #5900-201 OMB Control Number: 2060-0498 Expiration Date: 4/30/2019 U.S. Environmental Protection Agency Request for Additional Class II Consumption Allowances Date Prepared: 9/22/2026 Section 1: Report Identification Information Complete all fields below. No fields may be left blank. Company Name: Submission Type: Reporting Year: Employer Identification Number (EIN): Instructions Proceed to Section 2 U.S. Environmental Protection Agency Request for Additional Class II Consumption Allowances Company Name: Reporting Period: Section 2: Export Transaction Data In the table below, enter export transaction data for each class II controlled substance for which additional consumption allowances are being requested. For all export transactions, all fields are required unless otherwise indicated. As a reminder, if the material was produced or imported by a company other than the exporter,a written s was produced or imported with expended allowances must be provided to EPA along with the submission of this report. Additionally, for each export transaction, a copy of the invoice and bill of lading documenting the sale and indicating the net quantity shipped must be provided to EPA. If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions. Transaction Number Autopopulated 1 Date of Export Recipient Company Date Text 1/15/2018 Company A Recipient Company Street Address Text 1 Main Street Recipient Company City Recipient Company Country Text Melbourne Selection Australia Recipient Company Postal Code Text 3000 Recipient Company Contact Name Text John Smith Recipient Company Phone Number Text 011 46 8 508 280 00 Name of the Class Quantity of the Port of Exit II Chemical Class II Chemical Commodity Code from the United Shipment EIN Exported Exported States Selection HCFC-22 kg 1,000.00 Text 2903.71.0000 Text Miami, FL Number 12345678900 x x Return to Section 1 Proceed to Summary mported by a company other than the exporter,a written statement from the producer or importer stating that the material to EPA. If Produced in the U.S. If Imported into the U.S. Company that Produced the Company that Imported Class II Chemical the Class II Chemical Text Text Company B Source Country Date Purchased Selection Date New Zealand 3/7/2018 x U.S. Environmental Protection Agency Request for Additional Class II Consumption Allowances Company Name: Reporting Period: Summary 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 Return to Section 2 Total Consumption Allowances Requested (kg) Prepare Submission U.S. Environmental Protection Agency Request for Additional Class II Consumption Allowances Reference List Copying and Pasting Data: If data is pasted into this reporting form from another spreadsheet, the formatting of specific cells must be EPA’s ODS tracking system. When copying and pasting data into the form, please ensure consistency with the formatting of the lists pr Chemical Name List: The table below lists the valid chemical names that may be used when entering data into Section 2 of this form. HCFC-22 HCFC-142b Class II Chemicals with Allowances HCFC-123 HCFC-124 HCFC-225ca HCFC-225cb Commodity Code List: The table below lists the commonly used class II commodity codes that may be used when entering data into Se 2903.71.0000 2903.72.0020 2903.72.0050 2903.73.0000 2903.74.0000 2903.75.0000 2903.79.9030 2903.79.9070 3824.74.0000 Class II Commodity Codes/Description Chlorodifluoromethane (HCFC-22) Dichlorotrifluoroethane (HCFC-123) Other Dichlorotrifluoroethanes (HCFC-123a, HCFC-123b) Dichlorofluoroethanes (HCFC-141b) Chlorodifluoroethanes (HCFC-142b) Dichloropentafluoropropanes (HCFC-225ca, HCFC-225cb) Monochlorotetrafluoroethane (HCFC-124) Other HCFCs Mixtures containing hydrochlorofluorocarbons (HCFCs) but not containing chlorofluorocarbons (CFCs) Return to Section 2 spreadsheet, the formatting of specific cells must be consistent with the requirements of the form in order to be accepted into ensure consistency with the formatting of the lists provided below. Country List: The table below lists the valid country names that may be used when entering data into Section 2 of this form. Source Country Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia (Plurinational State of) Bosnia and Herzegovina Botswana Brazil Brunei Darussalam British Virgin Islands Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China 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 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 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 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 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 Uruguay Uzbekistan Vanuatu Venezuela (Bolivarian Republic of) Viet Nam Yemen Zambia Zimbabwe