5900-150 Class 1 Importer Quarterly Report

Production, Import, Export, Recycling, Destruction, Transhipment, and Feedstock Use of Ozone-Depleting Substances (Final Rule)

Copy of Class I Importer_v5.0.xlsm

Reporting for the Production, Import, Export, Destruction, Transhipment, and Feedstock Use of Ozone-Depleting Substances

OMB: 2060-0170

Document [xlsx]
Download: xlsx | pdf

Overview

Instructions
Section 1
Section 2
Section 3
Summary
Reference List


Sheet 1: Instructions





OMB Control #: 2060-0170

Expiration Date: 4/16/2023

U.S. Environmental Protection Agency

Stratospheric Ozone Protection Program




Class I Importer Quarterly Report (Sec 82.13)

Version 5.0

Last Updated: April 2020




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.

This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-0170). Responses to this collection of information are mandatory (40 CFR 82.13). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The number and expiration date are displayed in the upper right corner of the form. The public reporting and recordkeeping burden for this collection of information is 4 hours per response. Send comments on the Agency’s need this formation, 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, Regulatory Support Division, U.S. Environmental Protection Agency (2821T), 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.




EPA Form #5900-150





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






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











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





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
















































































































































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



























































































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