5900-510 HFC Process Agent Annual Report

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Overview

Instructions
Section 1
Section 2
Section 3
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
	HFC Process Agent Annual 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 3 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 # 5900-510

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Sheet 2: Section 1

	U.S. Environmental Protection Agency
	HFC Process Agent Annual Report
	Date Prepared:
	Section 1: Report Identification Information
	Complete all fields below. No fields may be left blank.
	Company Name:
	Facility Name:
	Facility Address:
	Process Agent Use:
	Submission Type:
	Reporting Year:
		x

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Sheet 3: Section 2

U.S. Environmental Protection Agency

HFC Process Agent Annual Report

Company Name:

Reporting Period:

Section 2: Process Agent Data

In the table below, enter the quantity of each regulated substance that was used as a process agent during the reporting period, along with the amount of products and byproducts manufacutred and the quantity of stack point source emissions.

If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions.

Name of Regulated Substance Used as a Process Agent

Amount Used as a Process Agent (§84.31(g)(2)(ii))

Stack Point Source Emissions (§84.31(g)(2)(iv))

Product or Byproduct (1)

Product or Byproduct (2)

Product or Byproduct (3)

Name of Product or Byproduct Manufactured

Amount Manufactured (§84.31(g)(2)(iii))

Amount Eventually Destroyed (§84.31(g)(2)(iii))

Amount Eventually Used as Feedstock (§84.31(g)(2)(iii))

Name of Product or Byproduct Manufactured

Amount Manufactured (§84.31(g)(2)(iii))

Amount Eventually Destroyed (§84.31(g)(2)(iii))

Amount Eventually Used as Feedstock (§84.31(g)(2)(iii))

Name of Product or Byproduct Manufactured

Amount Manufactured (§84.31(g)(2)(iii))

Amount Eventually Destroyed (§84.31(g)(2)(iii))

Amount Eventually Used as Feedstock (§84.31(g)(2)(iii))

Selection

kg

kg

Text

kg

kg

kg

Text

kg

kg

kg

Text

kg

kg

kg

x

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Sheet 4: Section 3

	U.S. Environmental Protection Agency
	HFC Process Agent Annual Report
	Company Name:
	Reporting Period:
	Section 3: HFC Emission Reduction Plans
	Please provide a description of any HFC emission reduction actions planned or currently under investigation.
	HFC Emission Reduction Actions
	Text
	x

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Sheet 5: Reference List

	U.S. Environmental Protection Agency
	HFC Process Agent Annual 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 Section 2 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