5900-504 Application-Specific HFC Allowance Holder Biannual Repor

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Overview

Instructions
Section 1
Section 2
Section 3
Section 4
Section 5
Reference List

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Sheet 1: Instructions

	OMB Control Number: 2060-XXXX
	Expiration Date: X/XX/202X
	U.S. Environmental Protection Agency
	Allowance Allocation and Trading Program under the AIM Act
	Application-Specific HFC Allowance Holder Biannual Report (Sec 84.31)
	Version 1.0
	Last Updated:
	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 Section 5 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 HFC 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/climate-hfcs-reduction/collection-data-support-establishment-hfc-allowance-allocation-and-trading
	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 mandatory (40 CFR 84.31). 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 X 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 # 5900-504

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Sheet 2: Section 1

	U.S. Environmental Protection Agency
	Application-Specific HFC Allowance Holder Biannual Report
	Date Prepared:
	Section 1: Report Identification Information
	Complete all fields below. No fields may be left blank.
	Company Name:
	Application:
	Submission Type:
	Reporting Year:
	Reporting Period:
		x

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Sheet 3: Section 2

	U.S. Environmental Protection Agency
	Application-Specific HFC Allowance Holder Biannual Report
	Company Name:
	Reporting Period:
	Section 2: Application-Specific Use Data
	In the table below, enter the quantity of each regulated substance that was used in the application, along with the quantity acquired through conferring allowances that were imported or produced, the quantity purchased without expending application-specific allowances (i.e., from the open market), the quantity contained in exported products, and the quantity regulated or destroyed during the reporting period.
	If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions.
	Name of Regulated Substance Used in the Application	Quantity of Regulated Substance Used in the Application (§84.31(i)(1)(i))	Quantity of Regulated Substance Acquired through Conferring Allowances that Were Imported (§84.31(i)(1)(ii))	Quantity of Regulated Substance Acquired through Conferring Allowances that Were Produced Domestically (§84.31(i)(1)(iii))	Quantity of Regulated Substance Purchased without Expending Application-Specific Allowances (§84.31(i)(1)(v))	Quantity of Regulated Substance Contained in Exported Products (§84.31(i)(1)(vii))	Quantity of Regulated Substance Destroyed (§84.31(i)(1)(viii))	Quantity of Regulated Substance Recycled (§84.31(i)(1)(viii))
	Selection	kg	kg	kg	kg	kg	kg	kg
	x

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Sheet 4: Section 3

	U.S. Environmental Protection Agency
	Application-Specific HFC Allowance Holder Biannual Report
	Company Name:
	Reporting Period:
	Section 3: Inventory Data
	In the table below, provide the quantity of each regulated substance held by the reporting company or held under contract by another company for the reporting company’s use on the last day of the previous six-month period.
	If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions.
	Regulated Substance Name	Quantity of Regulated Substance Held in Inventory (§84.31(i)(1)(vi))
	Selection	kg
	x

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Sheet 5: Section 4

	U.S. Environmental Protection Agency
	Application-Specific HFC Allowance Holder Biannual Report
	Company Name:
	Reporting Period:
	Section 4: Allowance Conferral Data
	In the table below, please provide the names of the companies to which application-specific allowances were conferred.
	If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions.
	Regulated Substance Name	Company to which Allowances were Conferred (§84.31(i)(1)(iv))	Quantity of Allowances Conferred
	Selection	Text	kg
	x

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Sheet 6: Section 5

	U.S. Environmental Protection Agency
	Application-Specific HFC Allowance Holder Biannual Report
	Company Name:
	Reporting Period:
	Section 5: Request for Application-Specific Allowances for the Next Calendar Year (JAN-JUN REPORTING PERIOD ONLY)
	In the table below, provide the quantities of each regulated substance acquired and used in the previous three years.
	If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions.
	Regulated Substance Name	Quantity of Regulated Substance Acquired in Previous Three Years (§84.31(i)(2)(i))			Quantity of Regulated Substance Used in Previous Three Years (§84.31(i)(2)(i))
		Year 1	Year 2	Year 3	Year 1	Year 2	Year 3
	Selection	kg	kg	kg	kg	kg	kg
	In the table below, provide the requested information on suppliers for material acquired in the previous three years and quantities of each regulated substance held in inventory.
	If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions.
	Regulated Substance Name	Name of Regulated Substance Supplier (§84.31(i)(2)(ii))	Method of Regulated Substance Acquisition (§84.31(i)(2)(iii))	Were the HFCs acquired through Conferring Allowances or the General Market (§84.31(i)(2)(iv))	Quantity of Regulated Substance Held in Inventory (§84.31(i)(2)(iv))
	Selection	Test	Selection	Selection	kg
	In the table below, provide a description of plans to transition to regulated substances with a lower exchange value or alternatives to regulated substances.
	Transition Plans (§84.31(i)(2)(v))
	Text
	x

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Sheet 7: Reference List

	U.S. Environmental Protection Agency
	Application-Specific HFC Allowance Holder Biannual Report
	Reference List
	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 HFC tracking system. When copying and pasting data into the form, please ensure consistency with the formatting of the list below.
	Chemical Name List: The table below lists the valid chemical names that may be used when entering data into Section2, Section 3, Section 4, and Section 5 of this form.
	Chemical Name
	HFC-23	HFC-134	HFC-152	HFC-236ea	HFC-365mfc
	HFC-32	HFC-134a	HFC-152a	HFC-236fa	HFC-43-10mee
	HFC-41	HFC-143	HFC-227ea	HFC-245ca
	HFC-125	HFC-143a	HFC-236cb	HFC-245fa