5900-150 Class I Importer Quarterly Report

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Overview

Instructions
Section 1
Section 2
Section 3
Summary
Reference List

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Sheet 1: Instructions

	U.S. Environmental Protection Agency
	Stratospheric Ozone Protection Program
	Class I Importer Quarterly Report (Sec 82.13)
	Version 3.1
	Last Updated: September 2019
	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: 2010-0170
	Expiration Date: 8/31/2021

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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

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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 and the intended use is not Aircraft Halon Bottles. Do not enter a date for Aircraft Halon Bottles. 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

Cote 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

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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, second party destruction, and global lab; however, it is expected that all material imported for second party transformation, second party destruction, and global lab 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

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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

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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)

Cote 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