5900-514 Request for Additional HFC Consumption Allowances

Phasedown of Hydrofluorocarbons: Establishing the Allowance Allocation and TradingProgram under the American Innovation and Manufacturing Act (Proposed Rule)

HFC RACA Reporting Form.xlsx

OMB: 2060-0734

Document [xlsx]
Download: xlsx | pdf

Overview

Instructions
Section 1
Section 2
Summary
Reference List


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




Request for Additional HFC Consumption Allowances (Sec 84.17)

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 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 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 # 5900-514





Sheet 2: Section 1








U.S. Environmental Protection Agency




Request for Additional HFC Consumption Allowances








Date Prepared:









Section 1: Report Identification Information




Complete all fields below. No fields may be left blank.



Company Name:




Submission Type:




Reporting Year:




Employer Identification Number (EIN):





x




Sheet 3: Section 2




















U.S. Environmental Protection Agency














Request for Additional HFC Consumption Allowances





























Company Name:













Reporting Period:






























Section 2: Export Transaction Data














In the table below, enter data for each export transaction containing a regulated substance that took place during the reporting period. As a reminder, a written statement from the producer that the regulated substances were produced with expended allowances or a written statement from the importer that the regulated substances were imported with expended allowances must be provided to EPA along with the submission of this report (§84.17(a)(1)(x)). In addition, for each transaction provide a copy of the bill of lading and the invoice indicating the net quantity (in kilograms) of regulated substances shipped and documenting the sale of the regulated substances to the purchaser (§84.17(a)(1)(viii)).

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

Transaction Number Date of Export
(§84.17(a)(1)(vi))
Recipient Company
(§84.17(a)(1)(i))
Recipient Company Street Address
(§84.17(a)(1)(i))
Recipient Company City
(§84.17(a)(1)(i))
Recipient Company Country
(§84.17(a)(1)(vii))
Recipient Company Contact Name
(§84.17(a)(1)(iii))
Recipient Company Contact Telephone Number
(§84.17(a)(1)(iii))
Recipient Company Contact Email Address
(§84.17(a)(1)(iii))
Name of the Substance Exported (§84.17(a)(1)(iv)) Quantity of the Substance Exported (§84.17(a)(1)(iv)) Commodity Code
(§84.17(a)(1)(ix))
Port of Exit from the United States
(§84.17(a)(1)(vi))
Shipment EIN
(§84.17(a)(1)(ii))
Source of Regulated Substance
(§84.17(a)(1)(v))
Date of Purchase of Regulated Substance
(§84.17(a)(1)(v))




Number Date Text Text Text Selection Text Text Text kg kg Text Text Text Text Date

















































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































x
















Sheet 4: Summary






U.S. Environmental Protection Agency


Request for Additional HFC Consumption Allowances






Company Name:

Reporting Period:



Export 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.

HFC Name Total Consumption Allowances Requested (kg)













































Sheet 5: Reference List









U.S. Environmental Protection Agency





Request for Additional HFC Consumption Allowances





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






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