Pesticide Report for Pesticide-Producing and Device-Producing Establishments (EPA Form 3540-16)

EPA Use Only:
OMB Control No. 2070-0078
Expires on 1/31/2020

United States Environmental Protection Agency
Instructions for Completing EPA Form 3540-16
Pesticide Report for Pesticide-Producing and Device-Producing
Establishments Reporting Year January 1, 2018 through December 31, 2018
Reporting Deadline on or before March 1, 2019
It is unlawful to knowingly falsify all or part of any pesticide or device production information
reported on EPA Form 3540-16. (FIFRA §12(a)(2)(M))

Optional Electronic Reporting
EPA has created an optional electronic reporting system for pesticide establishments using the Section
Seven Tracking System (SSTS). Once registered pesticide establishments will be able to use EPA’s
Central Data Exchange (CDX) to quickly register new establishments (EPA Form 3540-8) and/or
submit Annual Pesticide Production Reports (EPA Form 3540-16).
To sign up for electronic reporting, go to:
https://www.epa.gov/compliance/electronic-reporting-pesticide-establishments

General Information
Read all instructions before completing this form. Type or print clearly in dark ink. This form
may also be filled out on-line and printed. Use the “Add additional page” button at the bottom of the
on-line screen-fillable form and add as many pages as necessary to report all products. Each
“Additional” page has space for four (4) products. If you add too many pages, click the “Remove Extra
Page” button to remove the last page added. See the Pesticide Establishment Registration and Reporting
web page for the instructions and the form.
http://www.epa.gov/compliance/pesticide-establishment-registration-and-reporting.
1. Who must report?
•

All active domestic and foreign producing establishments, regardless of whether or not the
establishment produced or distributed a pesticide, active ingredient or device must submit a
report. (FIFRA §§7 and 17)

•

Active establishments with zero production or distribution in 2018. If your establishment did
not produce or distribute products subject to this report in 2018:
o Complete Items 1-41.
o Check “No” in Item 18.

•

Active establishments that closed, went out of business or ceased production.
o Report all production and distribution during 2018.
o See Number 6 for information on terminating your establishment’s registration.
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2. What must be reported?
•

Each producer operating an establishment must submit the following information for each
pesticide, active ingredient or device produced at your establishment: (Please note that
production and distribution of unregistered pesticides must be reported. See 40 CFR
§152.30).
o Types and amounts produced in 2018.
o Types and amounts sold or distributed in 2018, regardless of when the product
was produced.
o An estimate of the amount expected to be produced in 2019.

•

DO NOT REPORT:
o Production, distribution or sale of products NOT produced or repackaged by
your establishment (e.g., no changes are made to the product formulation,
container or label).
o Products shipped from your supplier directly to your customer.
o Any products for which Items 50, 51 and 52 are zero.
o Pesticides that are applied by your staff.
o Custom-blended products.

3. When to report:
Annual Reports are due: On or before March 1, 2019, even if there has been no production.
Initial Reports: FIFRA §7 requires all registered establishments to submit an initial report to the
U.S. EPA 30 days after receipt of notification of establishment registration.
4. Completing the Report:
•
•
•
•
•
•
•

Enter the company official’s or authorized agent’s Name and Title (Items 36 and 37).
An original signature of a company official or authorized agent is required on the report in
Item 38.
Enter the date in Item 39.
Enter the Telephone Number and Email of a company official or authorized agent is
required on the report in Items 40 and 41.
For all pages complete at the bottom: “This is Page
of
.”
Submit completed reports as directed on Page 9. Please make a copy of the report for your
records.
EPA will not accept any copies, faxes or emails of establishment initial or annual
reports.

5. What if I fail to file the production report?
Failure to file the initial or annual report is an unlawful act and may result in civil penalties up to
$18,750 per violation or termination of the establishment’s registration.
6. How to terminate an establishment’s registration:
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•

If you wish to terminate your establishment number at your request, the establishment is out
of business or has ceased production of pesticides, active ingredients or devices, please
attach your letter of intent to terminate your establishment number on company letterhead.
• State that the establishment either is out of business or has ceased production of
pesticides, active ingredients or devices
• The company official requests that the establishment number be terminated
• Include the last (2018) pesticide report and
• Write “Terminate Establishment” on the report.

•

If EPA terminates your domestic establishment registration, it is illegal to produce any
pesticide, active ingredient or device in the United States or to export a product out of the
United States. If EPA terminates your foreign establishment registration, it is illegal for you
to import any pesticide, active ingredient or device into the United States.

7. Definitions
•

Producer—any person, as defined by FIFRA, “who produces any pesticide,
active ingredient, or device (including packaging, repackaging, labeling and
relabeling).” (40 CFR §167.3)

•

Produce—“manufacture, prepare, propagate, compound or process any pesticide,
including any pesticide product pursuant to FIFRA §5, any active ingredient or
device, or to package, repackage, label, relabel or otherwise change the container
of any pesticide or device.” (40 CFR §167.3)

•

Establishment—Includes:
o Any site where a pesticidal product, active ingredient or device is produced.
o Sites that are independently owned or operated regardless of whether such site
is domestic and producing a pesticidal product for export only or whether the
site is foreign and producing a pesticidal product for import into the United
States.
(40 CFR §167.3)
o Sites that produce a pesticidal product for use under an Experimental Use
Permit, FIFRA Section 18 Emergency Exemption or Section 24(c) Special
Local Needs registration, must report. (40 CFR §167.20)
o Sites that produce unregistered pesticidal products for export from the US.

•

Custom Blender—any facility that provides the service of mixing registered
pesticides to a customer’s specifications, specifically:
o
o
o

a pesticide-pesticide blend
a pesticide-fertilizer blend
a pesticide-animal feed

mixture when
o the blend is not held in inventory
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o the pesticide used in producing the blend bears labeling that does not prohibit the
use of the pesticide in the blend
o the blend is delivered to the end-user with a copy of the labeling of the pesticide
used in producing the blend and a statement specifying the composition of the
mixture
If these conditions are not met, the establishment does not meet the definition of “custom
blender” and must comply with FIFRA Section 7 requirements.

NOTE: A facility where only custom blending activities take place is not considered a
pesticide-producing establishment and therefore does not need to be registered. Please see the
Pesticide Establishment Registration and Reporting FAQ for more information.
https://compliancegov.zendesk.com/hc/en-us/categories/201457388

General Instructions (Please complete all required fields).
Establishment Information: (Items 1 through 18)

NOTE: For items 7, 13, 24 and 30—Foreign country abbreviation codes are available at:
http://www.epa.gov/compliance/country-codes-foreign-pesticide-establishments Please contact
U.S. EPA Headquarters 011-202-564-2084 if you do not see the appropriate country code listed.
https://compliancegov.zendesk.com/hc/en-us/articles/211428748-What-are-the-abbreviationsused-to-represent-the-locations-of-my-establishment•
•
•
•
•
•
•

•

Item 1—Establishment Name: Enter the producing establishment name. Required field
Item 2—Establishment Number: Enter the producing establishment number. Required field
Item 3 to 8—Establishment Site Address: Enter the SITE address, not a post office box or
route number, where your establishment is located. Required field
Item 9 to 14—Establishment Mailing Address: Enter the mailing address for the
establishment if different from the site address. Required field
Item 15—Telephone Number: Enter the phone number for the establishment. For foreign
establishments, please provide the country code. Required field
Item 16—Email: Enter your email address. Required field
Item 17—If the establishment name or site address has changed from the previous year,
enter a check (X) in the box. Please note that if you change your address you must update
your EPA Establishment Coordinator within 30 days of that change:
https://www.epa.gov/compliance/pesticide-establishment-registration-and-reporting-contacts
Item 18—Did you produce or distribute in 2018? Check the appropriate box. Note: If you checked
the “No” box, do not fill in Items 42 through 53. Required field

Company Information: (Items 19 through 35)
• Item 19—Company Name: Enter the company name. Required field
• Item 20 to 25—Company Site Address: Enter the company’s headquarter address. Required field
• Item 26 to 31—Company Mailing Address: Enter the mailing address for the company
if different from the company site address. Required field
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•
•
•
•

Item 32—Telephone Number: Enter the phone number for the company. For foreign
companies, please provide the country code. Required field
Item 33— Email: Enter your email address. Required field
Item 34—If company name or site address has changed from the previous year, enter a check
(X) in the box. Required field
Item 35 — If Authorized Agent name or mailing address has changed from the previous
year, enter a check (X) in the box. Please attach your company’s request to change the
authorized

agent on company letterhead and send to the appropriate EPA office listed on Page 9.
Pesticide Production Information: (Items 42 through 53) Required field
Pesticide Production Information: (Items 42 through 53)
NOTE: Foreign Establishments—You must report production for products exported to or
marketed in the United States or its territories. If your establishment produced a pesticide, active
ingredient or device and sold some of the product in countries other than the United States, do
not report this portion of your production and distribution. For example, if you produce 10,000
pounds of a product and sell 9,000 pounds to other countries and 1,000 pounds to the United
States; you should report 10,000 pounds produced and 1,000 distributed into the United States.
•

Item 42—Product Code (Required field):
o
o
o
o
o
o

•

Enter 1 — if product is registered with EPA.
Enter 2 — if product registration is pending.
Enter 3 — if product is an Experimental Use Permit.
Enter 4 — if product is a device.
Enter 5 — if product is a Special Local Need (SLN) registration.
Enter 6 — if product is an Unregistered Pesticide. Attach the formulation of the product
to the end of the report showing the product’s active and inert ingredients; their common
names; their CAS Registry numbers (if available); and the percentage, by weight, of each
ingredient (must total 100%). Multiple formulations may appear on the same page;
clearly identify each by product name. For electronic reporters once you select Product
Code 6, a new Formulation Box will appear, add each ingredient one at a time and click
the blue plus mark to add a new line, repeat until all ingredients are entered and total
100%.

Item 43—EPA Product Registration Number Information (Required field):
o Product Code 1— Enter EPA Registration No. (as it appears on product label)
(See NOTE below on reporting production of multiple distributor
registrations).
o Product Code 2 — Enter EPA File Symbol assigned to product.
o Product Code 3 — Enter the Experimental Use Permit number.
o Product Code 4 — For devices, leave Item 43 blank.
o Product Code 5 — For stand-alone SLN Registrations, enter the SLN registration number
in Item 43 (e.g., SLN-CA-890022). A “stand-alone” SLN is one for
which there are no uses other than the 24(c) uses.
o Product Code 6 — For Unregistered Pesticides, leave Item 41 blank.
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NOTE: Reporting Distributor Registrations—If you produce multiple pesticide products
under the same basic EPA registration number (such as distributor products):
Report the total quantities for all distributor products under the basic EPA registration number,
and following the product name add “and supplementals.” On a separate paper, list the basic
registration number with each distributor company number and brand name and attach it to the
report. For those submitting reports electronically, please use the Comments Box to list the above
mentioned information.
•

Item 44—Product Name (Required field):
List the most common brand name. If marketed under alternate brand names (ABN), add
“ABN” and report total production under all names for the formulation.

•

Item 45—Product Classifications (Required field): Enter the code that best describes the
product’s use.
o Classification for Devices
51 Device
o Classifications for Pesticides
04 Insect Repellant
18 Sterilizer
27 Fungicide
34 Herbicide
38 Antifoulant
54 Rodenticide
61 Molluscicide (e.g. slug bait)

07
20
28
36
43
57
69

Antimicrobial
Disinfectant
Nematocide
Defoliant
Insecticide
Animal Repellant
Water Purifier

09
21
29
37
49
59

Attractant
Sanitizer
Fumigant
Desiccant
Plant Growth Regulator
Algaecide

99 Multi-Use Active Ingredient (Chemicals that have both pesticidal and non-pesticidal
uses). These chemicals do not have an EPA Reg. No. (This classification is rarely
appropriate. Producers are required to register both the product and their
establishment(s) and report production on an annual basis under FIFRA §7, if a
producer has actual or constructive knowledge that a chemical or substance they
produce is used or intended for use as an active ingredient in the manufacture of a
pesticide. These producers are required to report only the amount of the chemical or
substance manufactured and distributed or sold for pesticidal purposes.
•

Item 46—Product Type (Required field):
o Enter 1 — Technical formulations or active ingredient for Manufacturing Use
Only products.
o Enter 2 — End-use product (this includes products where the formulation has
been blended, diluted, or changed).
o Enter 3 — Repackaged or relabeled (does not include any blending, dilution or
change in the formulation).
o Enter 4 — Device.
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Item 47—Market Sold or Distributed To (Required field):
o Enter 1 — if all the product was marketed in the United States.
o Enter 2 — if the product was marketed both in the United States and exported from the
United States.
o Enter 3 — if all the product was exported from the United States.

•

Item 48—RUP Status (Required field):
o Enter 1 — Product label states RESTRICTED USE PESTICIDE at the top of the front
label panel.
o Enter 2 — All other products.

•

Item 49—Unit of Measurement (Required field):
o
o
o
o
o
o

@ = Each
G = Gallons
K = Kilograms
L = Liters
P = Pounds
T = Tons

o U = Units
•

(registered pesticides that are sold in a unit such as petri dishes)
(liquid chemical product)
(dry, solid, liquid or gaseous chemical product)
(liquid chemical product)
(dry, solid, liquid or gaseous chemical product)
(short ton = 2,000 lbs. or 907.2 kilograms) (dry, solid or gaseous
chemical product)
(devices)

Item 50—Amount Produced in 2018 (Required field):
o Do not include amounts that are custom blended, placed directly into application
equipment, or applied to a crop, commodity or site by your staff.
o Round all quantities to the nearest whole number.

•

Item 51—Amount Sold or Distributed in 2018 - United States (Required field):
o Enter only those products sold or distributed that were produced by your establishment,
regardless of when the product was produced.
o Do not include amounts that are custom blended, placed directly into application
equipment, or applied to a crop, commodity or site by your staff.
o Foreign producers should enter only the amount of product or number of devices exported to
the United States.
o Round all quantities to the nearest whole number.

•

Item 52—Amount Sold or Distributed in 2018 to Foreign Markets (Exported) (Required
field):
o Enter the quantity exported from the United States in 2018, regardless of when the product
was produced.
o Round all quantities to the nearest whole number.
o Foreign establishments enter “0” in Item 52.
•

Item 53—Amount (Estimated) to be Produced in 2019 (Required field):
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o Enter an estimate of the quantity to be produced in 2019.
o Round all quantities to the nearest whole number.
Signature Certification: (Items 36 through 41)
•

Items 36 and 37—Name and Title of Company Official or Authorized Agent (Required
field): Please enter the name and title of the person who is responsible for your
establishment’s compliance with the requirements of FIFRA §7. Note: If you are the
authorized agent submitting this report, please enter your name and title.

•

Items 38 and 39—Signature of Company Official or Authorized Agent and Date
(Required field): The company official and/or authorized agent listed in Item 36 must sign
and date the report in order for it to be complete.

•

Items 40 and 41— Telephone Number of Company Official or Authorized and Email
Agent (Required field): The company official and/or authorized agent listed in Item 36 must
provide email address and telephone number in order for it to be complete.

Confidentiality. Under FIFRA §7(d) (7 USC §136e), information reported in Items 50, 51, 52 and
53 of EPA Form 3540-16 will be treated as business confidential, subject to the provisions of FIFRA
§10 (7 USC §136h). You are not required to assert a claim of confidentiality for this information.
If you wish to assert a claim of confidentiality for other information you have provided on this form,
you must identify by the box number(s) information for which you are asserting a claim of
confidentiality. Information so designated will be disclosed by the EPA only to the extent allowed
by, and by means of, the procedures set forth in 40 CFR Part 2. If you do not claim the information
as confidential upon submission of the report, it may be made available to the public without further
notice to you.
Public Reporting Burden. The time required to complete this report is estimated to average one
hour and 26 minutes, per response, including reviewing instructions, searching data sources,
gathering and maintaining data needed, and completing review and collection of information. Send
comments regarding this burden estimate or other aspects related to this information collection,
including suggestions for reducing this burden, to: Director, Collection Strategies Division, U.S.
Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, DC 20460.
Include the OMB control number in any correspondence. Do not send the completed 3540-16 form
to the above address.

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Where to Submit Reports
DOMESTIC PRODUCERS:
EPA Regional Offices

Submit reports to the following EPA Regional Office where your company
headquarters is located.
States/Terr.
EPA Regional Offices
Covered

States/Terr.
Covered

U.S. EPA Region 1
Kan Tham (3540-16)
Toxics and Pesticides Unit (OES 05-4)
5 Post Office Square, Suite 100
Boston, MA 02109-3912
Telephone: 617-918-1872

CT, MA
ME, NH
RI, VT

U.S. EPA Region 6
Chuck Ruple (3540-16)
Pesticides Section (6MM-XP)
1445 Ross Avenue
Dallas, TX 75202-2733
Telephone: 214-665-6534

AR, LA
NM, OK
TX

U.S. EPA Region 2
Kristen Ridarick (3540-16)
Pesticides Team (MS-500)
2890 Woodbridge Avenue
Edison, NJ 08837-3679
Telephone: 732-321-4459

NJ, NY
PR, VI

U.S. EPA Region 7
Brandon Boatman (3540-16)
Pesticides Section
(WWPD/TOPE/PEST)
11201 Renner Boulevard
Lenexa, KS 66219
Telephone: 913-551-7993

IA, KS
MO, NE

U.S. EPA Region 3
Christine Convery (3540-16)
Pesticides and Asbestos Programs Branch (3LC42)
1650 Arch Street
Philadelphia, PA 19103-2029
Telephone: 215-814-2249

DC, DE
MD, PA
VA, WV

U.S. EPA Region 8
Carol Ann Ross (3540-16)
FIFRA Division (8ENF-AT-TP)
1595 Wynkoop
Denver, CO 80202
Telephone: 303-312-6018

CO, MT
ND, SD
UT, WY

U.S. EPA Region 4
Pesticide Reports Contact (3540-16)
Pesticides Section
Sam Nunn Atlanta Federal Center, 12th Floor
61 Forsyth Street, SW
Atlanta, GA 30303
Telephone: 404-562-9090

AL, FL
GA, KY
MS, NC
SC, TN

U.S. EPA Region 9
Scott McWhorter (3540-16)
FIFRA Section (ENF 3-3)
75 Hawthorne Street
San Francisco, CA 94105-3901
Telephone: 415-972-3584

AZ, CA
GU, HI
MP, NV

U.S. EPA Region 5
Pesticide Reports Contact (3540-16)
Pesticides & Toxics Compliance Section (LC-17J)
77 West Jackson Boulevard
Chicago, IL 60604
Telephone: 312-886-0270

IL, IN
MI, MN
OH, WI

U.S. EPA Region 10
Andrew Landry (3540-16)
Pesticides and Toxics Unit (OCE-101)
1200 Sixth Avenue, Suite 900
Seattle, WA 98101-1128
Telephone: 206-553-1504

AK, ID
OR, WA

FOREIGN PRODUCERS:

Submit reports to the following EPA Washington, DC address:

U.S. Postal Service Mail Address

Courier Delivery Address

Foreign Pesticide Reports Contact (3540-16)
U.S. Environmental Protection Agency
Pesticides, Waste & Toxics Branch (2227A)
1200 Pennsylvania Avenue, NW
Washington, DC 20460-0001 USA
Telephone: 202-564-2084

Foreign Pesticide Reports Contact (3540-16)
U.S. Environmental Protection Agency
Pesticides, Waste & Toxics Branch
William J. Clinton Building—South (Room 7119B)
1200 Pennsylvania Avenue, DC 20004 USA
Telephone: 202-564-2084

NOTE: The Agency does not notify you when your paper report is received. To ensure
the Agency receives the report, you may wish to send it by certified or registered mail,
return receipt requested.
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