Form 5900-495 Application-Specific HFC Allowances End User Reporting T

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Overview

Question 1
Questions 2-3
Questions 4-6
Questions 7-9
Questions 10-15

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Sheet 1: Question 1

DRAFT		Control Number 2060-XXXX
		Expiration Date: XX-XX-XXXX
Company Name
Company Address
Contact Name
Contact Email
Contact Phone Number
1. Please use the drop-down menu below to indicate which application your company uses that is consistent with the list in the AIM Act at (e)(4)(B)(iv). Please describe the application and how the HFC is used in that application.
Application
Description
	This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-XXXX). Responses to this collection of information are voluntary. 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 public reporting and recordkeeping burden for this collection of information is estimated to be 8 to 38 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 to the Regulatory Support Division Director, 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 # 5900-495

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Sheet 2: Questions 2-3

DRAFT
HFC/HFC Blend	2. What quantity (in kilograms) of each HFC did your company use in each of the years from 2018 through 2020 for the application?			3. If your company uses recovered, recycled, or reclaimed HFCs for your application, what quantity (in kilograms) did you use in each of the years from 2018 through 2020?
	2018	2019	2020	2018	2019	2020
HFC–134
HFC–134a
HFC–143
HFC–245fa
HFC–365mfc
HFC–227ea
HFC–236cb
HFC–236ea
HFC–236fa
HFC–245ca
HFC–43–10mee
HFC–32
HFC–125
HFC–143a
HFC–41
HFC–152
HFC–152a
HFC–23

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Sheet 3: Questions 4-6

DRAFT
4. What company/companies are you purchasing each HFC from?		5. How much (in kilograms) of each HFC was purchased from each of those sources each year?			6. Did you purchase each HFC from a domestic supplier or import the material directly?
Company Name	HFC	2018	2019	2020

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Sheet 4: Questions 7-9

DRAFT
7. Please specify what your company does with the excess supply of each HFC (e.g., destroyed; put into inventory; sent off-site for destruction, recycling, or reclamation; emitted; returned to HFC suppliers (e.g., as container heels))?
HFC/HFC Blend	8. How much inventory (in kilograms) of each HFC was in your company’s possession or held under contract by another company for your use on December 31, 2020?	9. How much (in kilograms) of each HFC did you send off-site for destruction in each of the years from 2018 through 2020?
		2018	2019	2020
HFC–134
HFC–134a
HFC–143
HFC–245fa
HFC–365mfc
HFC–227ea
HFC–236cb
HFC–236ea
HFC–236fa
HFC–245ca
HFC–43–10mee
HFC–32
HFC–125
HFC–143a
HFC–41
HFC–152
HFC–152a
HFC–23

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Sheet 5: Questions 10-15

10. Is 2020 a representative year for your use, or are there reasons why 2020 is higher or lower than past years?
11. Are there quality issues with the HFC that you use, such as minimum purity specifications, that limit where your company can acquire HFCs from?
12. Could your company use recovered, recycled or reclaimed HFCs for any of the HFCs you currently use? If no, why? How much of each HFC that you use do you expect could be met with recovered, recycled or reclaimed HFCs?
13. What other chemicals have you historically used in this application other than HFCs? If available, when did you transition and why?
14. Is there any limitation on which HFC your company could use in this application? If so, why?
15. Has your company considered a transition plan to lower-GWP HFCs and/or HFC alternatives? If yes, have you assessed whether there are low-GWP alternatives to the HFCs that you currently use, including other HFCs? Have you done any testing to determine if the alternatives can work in your application?