Form EPA Form 7710-3C EPA Form 7710-3C Chemical Substance Inventory Report Form C

Public reporting burden for this collection of information is estimated to average 2.25 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 or
any other aspect of this collection of information, including suggestions for reducing this burden, to Director, Collection Strategies Division, Office of Environmental
Information (OEI), 1201 Pennsylvania Ave., N.W., Washington, D.C. 20460.
When completed, send this form to: US EPA / OPPT Document Control Officer (7407M), 1201 Pennsylvania Ave., N.W., Washington, D.C. 20460; Attn: Chemical Inventory
Section.

TABLE OF REPORTABLE PRODUCTION RANGES
(Refer to instruction booklet for detailed instructions on how to use this table)
PRODUCTION RANGES
Pounds

CODE
DIGIT
0
1
2
3
4
5
6
7
8
9

0 to 1,000
1,000 to 10,000
10,000 to 100,000
100,000 to 1 million
1 million to 10 million
10 million to 50 million
50 million to 100 million
100 million to 500 million
500 million to 1 billion
Over 1 billion

Kilograms

0 to 454
454 to 4,540
4,540 to 45,400
45,400 to 454,000
454,000 to 4.54 million
4.54 million to 22.7 million
22.7 million to 45.4 million
45.4 million to 227 million
227 million to 454 million
Over 454 million

CERTIFICATION STATEMENT BY FOREIGN SUPPLIER
I hereby certify that, to the best of my knowledge and belief, all information that I have entered on this form, on behalf of the U.S. importer identified in Block III,
is complete and accurate.

CONCERNING EPA DISCLOSURE OF INFORMATION
Any person who submits information to EPA under the Inventory Reporting Regulations (40 CFR 710) should be aware of EPA regulations (40 CFR Part 2) that govern
disclosure of such information. Those regulations provide that such person may, if he or she desires, assert a confidentiality claim covering part or all of the
information submitted. Information covered by such a claim will be publicly disclosed by EPA only to the extent, and by means of the procedures, set forth in 40
CFR Part 2. However, if no such claim accompanies the information when it is received, EPA may make that information public without notifying the submitter.

CONFIDENTIALITY STATEMENTS
Chemical substance identity and other information disclosed to EPA on the front of this form may be claimed confidential by checking the appropriate boxes under
“Confidentiality Claims” in Box V. In certifying this form, the person signing in Block 1 attests to the truth of the following four statements concerning all information
except chemical substance identity that is claimed confidential:
1. My company has taken measures to protect the confidentiality of the information, and it intends to continue to take such measures.
2. The information is not, and has not been, reasonably obtainable without our consent by other persons (other than governmental bodies) by use of
legitimate means (other than discovery based on a showing of special need in a judicial or quasi-judicial proceeding).
3. The information is not publicly available elsewhere.
4. Disclosure of the information would cause substantial harm to our competitive position.
The person signing in Block 1 also attests to the truth of the appropriate statement(s) below concerning other information specifically claimed confidential for the
particular chemical substance. By checking the box under:
(a) Manufacture: I assert that the fact that my company manufactures the chemical substance at the plant site identified in Block III for a commercial
purpose is confidential.
(b) Import: I assert that the fact that my company imports the chemical substance for a commercial purpose is confidential.
(c) Site Limited: I assert that the fact that the chemical substance is not distributed for a commercial purpose outside of the manufacturing site identified
in Block III is confidential.
(d) Production: I assert that the fact that the production range of the chemical substance for the plant site identified in Block III is confidential.
(e) Corporation: I assert that the fact that the link of this chemical substance to the corporation identified in Block II is confidential.
(f) Plant Site: I assert that the link of this chemical substance to the plant site identified in Block III is confidential.
If the identity of the chemical substance is claimed confidential, the box beside “Chemical Substance Identity is Confidential” must be checked. In addition to
providing a written substantiation for such claim and a proposed generic name for the chemical substances identified in Block V, the person signing in Block I must
check the box indicating agreement with the following statement:

CONFIDENTIAL CHEMICAL SUBSTANCE IDENTITY STATEMENT
I agree that EPA may disclose, for the purposed of section 5(a)(1)(A) of the Act (Premanufacture Notification), to any person with a bona fide intent to manufacture
the substance identified on the form (as determined by EPA under 40 CFR 710.7(g)) the fact that the chemical substance is included on the Inventory. Further, I have
or will have available, and agree to furnish to EPA upon request, all information required in 40 CFR 710.7€ for the substance identified on this form.