5900-213 GreenChill Instructions and Forms
Green Chill Advanced Refrigeration Partnership (Renewal)
GreenChill_InstalledRefrigerant-Emissions_Reporting Form_RY2016_postICR.xlsx
GreenChill Advanced Refrigeration Partnership
OMB: 2060-0702
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 2060-0702 can be found here:
Document [xlsx]
Download: xlsx | pdf
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| I. General Partner Information | |||||||||||||||
| Company Name: | This Reporting Year: | Number of Stores: | Partner Base Year:* | ||||||||||||
| 2016 | |||||||||||||||
| * Selected by the Partner - Partner may select the first reporting year or up to two years prior to the first reporting year. | |||||||||||||||
| Provide this data aggregated across all stores. | |||||||||||||||
| II. Corporate-Wide Installed Refrigerant | III. Corporate-Wide Refrigerant Emissions | ||||||||||||||
| Note: Report aggregate information for all retail stores under the same Partner and/or banner name. Include offices, break-rooms, etc. co-located inside retail stores. Do not include separate office buildings, distribution centers, warehouses, etc. Do not include refrigerant stored in cylinders on or off site. Include other refrigerants not listed by using extra lines at the bottom of the table. | Note: Report aggregate information for all retail stores under the same Partner and/or banner name. Include offices, break-rooms, etc. co-located inside retail stores. Do not include separate office buildings, distribution centers, warehouses, etc. Do not include refrigerant recovered/recycled from equipment retired, but do include known emissions from those systems. Do not include first-fill charging when installing new systems or after remodels. Include other refrigerants not listed by using extra lines at the bottom of the table. | ||||||||||||||
| Refrigerant | Commercial Refrigeration | Air-Conditioning | Refrigerant | Commercial Refrigeration | Air-Conditioning | ||||||||||
| Charge > 50 Pounds | Charge < 50 Pounds | Charge > 50 Pounds | Charge < 50 Pounds | ||||||||||||
| REQUIRED | OPTIONAL | OPTIONAL | REQUIRED | OPTIONAL | OPTIONAL | ||||||||||
| EP-88 | EP-88 | ||||||||||||||
| R-11 | R-11 | ||||||||||||||
| R-12 | R-12 | ||||||||||||||
| R-13 | R-13 | ||||||||||||||
| R-134a | R-134a | ||||||||||||||
| R-143A | R-143A | ||||||||||||||
| R-22 | R-22 | ||||||||||||||
| R-23 | R-23 | ||||||||||||||
| R-290 (Propane) | R-290 (Propane) | ||||||||||||||
| R-401A (MP 39) | R-401A (MP 39) | ||||||||||||||
| R-401B (MP 66) | R-401B (MP 66) | ||||||||||||||
| R-402A (HP 80) | R-402A (HP 80) | ||||||||||||||
| R-402B (HP 81) | R-402B (HP 81) | ||||||||||||||
| R-404A (HP 62) | R-404A (HP 62) | ||||||||||||||
| R-407A (Klea 60) | R-407A (Klea 60) | ||||||||||||||
| R-407B (Klea 61) | R-407B (Klea 61) | ||||||||||||||
| R-407C (Klea 66; Suva 9000) | R-407C (Klea 66; Suva 9000) | ||||||||||||||
| R-407F (Gen. Performax LT) | R-407F (Gen. Performax LT) | ||||||||||||||
| R-408A (FX-10) | R-408A (FX-10) | ||||||||||||||
| R-409A (FX-56) | R-409A (FX-56) | ||||||||||||||
| R-410A (AZ-20, Puron) | R-410A (AZ-20, Puron) | ||||||||||||||
| R-414A (GHG-X4) | R-414A (GHG-X4) | ||||||||||||||
| R-414B (Hot Shot) | R-414B (Hot Shot) | ||||||||||||||
| R-416A (FR 12) | R-416A (FR 12) | ||||||||||||||
| R-417A (NU-22, Isceon MO29) | R-417A (NU-22, Isceon MO29) | ||||||||||||||
| R-421A (Choice R421A) | R-421A (Choice R421A) | ||||||||||||||
| R-422A (Isceon 79) | R-422A (Isceon 79) | ||||||||||||||
| R-422B (XAC1) | R-422B (XAC1) | ||||||||||||||
| R-422C (XLT1) | R-422C (XLT1) | ||||||||||||||
| R-422D (Isceon MO29) | R-422D (Isceon MO29) | ||||||||||||||
| R-427A (Forane 427A) | R-427A (Forane 427A) | ||||||||||||||
| R-437A (ISCEON MO49 Plus) | R-437A (ISCEON MO49 Plus) | ||||||||||||||
| R-438A (ISCEON MO99) | R-438A (ISCEON MO99) | ||||||||||||||
| R-441A (HC blend) | R-441A (HC blend) | ||||||||||||||
| R-448A (Solstice N-40) | R-448A (Solstice N-40) | ||||||||||||||
| R-449A (Opteon XP 40) | R-449A (Opteon XP 40) | ||||||||||||||
| R-449B (Forane 449B) | R-449B (Forane 449B) | ||||||||||||||
| R-450A (Solstice N-13) | R-450A (Solstice N-13) | ||||||||||||||
| R-502 | R-502 | ||||||||||||||
| R-507A (AZ-50) | R-507A (AZ-50) | ||||||||||||||
| R-513A (Opteon XP 10) | R-513A (Opteon XP 10) | ||||||||||||||
| R-600a (Isobutane) | R-600a (Isobutane) | ||||||||||||||
| R-717 (NH3) | R-717 (NH3) | ||||||||||||||
| R-744 (CO2) | R-744 (CO2) | ||||||||||||||
| [INSERT OTHER] | [INSERT OTHER] | ||||||||||||||
| [INSERT OTHER] | [INSERT OTHER] | ||||||||||||||
| [INSERT OTHER] | [INSERT OTHER] | ||||||||||||||
| [INSERT OTHER] | [INSERT OTHER] | ||||||||||||||
| [INSERT OTHER] | [INSERT OTHER] | ||||||||||||||
| [INSERT OTHER] | [INSERT OTHER] | ||||||||||||||
| Total | 0 | 0 | 0 | Total | 0 | 0 | 0 | ||||||||
| 0 | 0 | ||||||||||||||
| 0 | 0 | ||||||||||||||
| Reported values are in (select one): | Kilograms | Reported values are in: | |||||||||||||
| Pounds | Pounds | Pounds | |||||||||||||
| "I certify with my signature that the data reported herein represent the Reporting Party’s best estimates and are the result of a good faith effort to obtain and report accurate information." | |||||||||||||||
| Signature: | Date: | ||||||||||||||
| Name (please print): | |||||||||||||||
| Please return completed forms by March 31, 2017 by email to: | You may also send a copy of completed forms by email to EPA: | ||||||||||||||
| Joe Donahue, Abt Associates | Tom Land, EPA GreenChill Partnership | ||||||||||||||
| [email protected] | [email protected] | ||||||||||||||
| Phone: 303-381-8205 | Phone: 202-343-9185 | ||||||||||||||
| OMB Control No.: 2060-0702 | Approval Expires: 31 May 2019 | EPA Form No.: 5900-213 | ||||||||||||||
| The public reporting and recordkeeping burden for this collection of information is estimated to average [4.2 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 Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address. | |||||||||||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |
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