5900-149 Class 1 Exporter Annual Report

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

Copy of Class I Exporter_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
Summary
Reference List

Sheet 1: Instructions




OMB Control Number: 2060-0170

Expiration Date: 4/16/2023

U.S. Environmental Protection Agency

Stratospheric Ozone Protection Program







Class I Exporter Annual 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 estimated to be 2 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 #5900-149




Sheet 2: Section 1









U.S. Environmental Protection Agency






Class I Exporter Annual 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



Enter your company's Employer Identification Number (EIN). Employer Identification Number (EIN):

1












Original Submission






Re-Submittal





Sheet 3: Section 2
























U.S. Environmental Protection Agency


















Class I Exporter Annual Report




































Company Name:

















Reporting Period:





































Section 2: Export Transaction Data


















In the table below, enter data for each export transaction containing a class I controlled substance that took place during the reporting period. If no class I controlled substances were exported, the table may be left blank. For all controlled substances that are exported, all fields are required.





















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 exited the United States. Date of Export Enter the name of the company that received or purchased material during the reporting period. Recipient Company Enter the street address of the recipient company. Recipient Company Street Address Enter the city of the recipient company. Recipient Company City Select the country to which the shipment was exported. If copying and pasting data into the table, please refer to the Reference List for the valid list of countries. Recipient Company Country Enter the postal code of the recipient company. Recipient Company Postal Code Enter the name of the contact for the recipient company. If this information is not available, enter "Not Available." Recipient Company Contact Name Enter the phone number of the contact from the recipient company. If this information is not available, enter "Not Available." Recipient Company Phone Number Select the name of the chemical exported. 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 Exported Enter the total quantity (kg) of the chemical exported. Quantity of the Class I Chemical Exported Enter the 10-digit commodity code of the chemical exported 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 exited the United States. Port of Exit from the United States Enter the Employer Identification Number (EIN) shown on the Shipper's Export Declaration Form. This number may or may not refer to the exporter as defined by EPA. If a shipping agent is acting on behalf of the exporter as defined by the regulation, the EIN of the agent shown on the U.S. Customs Form 7525 should be reported here. Your company's EIN as entered in Section 1 of this report will automatically populate for each transaction entered. Revise the number if the EIN for the shipment is different from your company's EIN. The number entered should have no dashes. Shipment EIN Select the transaction type of the material. The transaction type can be New or Used. 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 Q must be selected prior to completing this field. - If the material is New, the intended use can be Global Lab, Other Essential Use (EU), Transformation, or Destruction. - If the material is Used, the intended use can be Transformation, Destruction, Aircraft Halon Bottles, or Other. If copying and pasting data into the table, please refer to the Reference List for the valid list of intended uses. Intended Use





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





1 1/15/2018 Company A 1 Main Street Melbourne Australia 3000 John Smith 011 46 8 508 280 00 CFC-13 1,000.00 2903.77.0020 Miami, FL 12345678900 New Global Lab



1st
















































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































1



























x


x



x x










Afghanistan


CBM



New Global Lab










Albania


CCL4



Used Other EU










Algeria


CFC-11




Transformation










Andorra


CFC-12




Destruction










Angola


CFC-13




Aircraft Halon Bottles










Antigua and Barbuda


CFC-111




Other










Argentina


CFC-112
















Armenia


CFC-113
















Australia


CFC-114
















Austria


CFC-115
















Azerbaijan


CFC-211
















Bahamas


CFC-212
















Bahrain


CFC-213
















Bangladesh


CFC-214
















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: Summary









0


U.S. Environmental Protection Agency







Class I Exporter Annual Report














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.






Chemical Name Country Total Exported (kg)























































































































































































































Sheet 5: Reference List











U.S. Environmental Protection Agency







Class I Exporter Annual 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 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


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


Belize Israel Saudi Arabia

Other EU In-house 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

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.
Botswana Kenya Slovakia


Brazil Kiribati Slovenia


Brunei Darussalam Kuwait Solomon Islands






British Virgin Islands Kyrgyzstan Somalia (Federal Republic of)

Class I Commodity Codes/Description
Bulgaria Lao People's Democratic Republic South Africa

2903.77.0010 Trichlorofluoromethane (CFC-11)
Burkina Faso Latvia South Korea (Republic of Korea)

2903.77.0020 Trichlorotrifluoroethanes (CFC-113)
Burundi Lebanon South Sudan

2903.77.0030 Dichlorotetrafluoroethane (CFC-114)
Cambodia Lesotho Spain

2903.77.0040 Monochloropentafluoroethane (CFC-115)
Cameroon Liberia Sri Lanka

2903.77.0050 Dichlorodifluoromethane (CFC-12)
Canada Libya Sudan

2903.77.0080 Other CFCs
Cape Verde Liechtenstein Suriname

2903.14.0000 Carbon tetrachloride
Central African Republic Lithuania Swaziland

2903.76.0010 Bromotrifluoromethane (Halon 1301)
Chad Luxembourg Sweden

2903.76.0050 Bromochlorodifluoromethane (Halon 1211) and dibromotetrafluoroethanes (Halon 2402)
Chile Madagascar Switzerland



China Malawi Syrian Arab Republic

2903.79.1000 Bromochloromethane (CBM)
Colombia Malaysia Tahiti

2903.19.6010 Methylchloroform (1,1,1-Trichloroethane)
Comoros Maldives Taiwan

3824.71.0100 Mixtures containing chlorofluorocarbons (CFCs)
Congo Mali Tajikistan

3824.72.0000 Mixtures containing bromochlorodifluoromethane (Halon 1211),
bromotrifluoromethane (Halon 1301), or dibromotetrafluoroethanes (Halon 2402)
Cook Islands Malta Thailand



Costa Rica Marshall Islands The Former Yugoslav Republic of Macedonia



Cote d'Ivoire Mauritania

3824.73.0000 Mixtures containing hydrobromofluorocarbons (HBFCs)
Croatia Mauritius Timor-Leste

3824.75.0000 Mixtures containing carbon tetrachloride
Cuba Mexico Togo

3824.76.0000 Mixtures containing 1,1,1-trichloroethane (methyl chloroform)


Cyprus Micronesia (Federated States of) Tonga






Czech Republic Monaco Trinidad and Tobago






Democratic Republic of the Congo Mongolia Tunisia






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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