5900-472 ODS Petition to Import CDX Reporting Form

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

Petition to Import Form_.4.2020.VER2

OMB: 2060-0170

Document [pdf]
Download: pdf | pdf
OMB Control #:2060-0170
Expiration Date :4/16/2023

ODS Petition to Import
CDX Reporting Form

EPA Form # 5900-472

Paperwork Reduction Act:
This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 4301 et seq. (OMB Control No.
2010-0042.) Responses to this collection of information are mandatory (40 CFR 82). 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 be to 18 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 including through the use of automated collection techniques to the Director, Regulatory
Support Division, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., N.W. Washington D.C. 20460. Include the
OMB control number in any correspondence. Do not send the completed form to this address.

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ICFGOLLA ICF INTERNATIONAL (Log ool)

Petition to Import for Use: ► RPET1_XXXX_05923
Step 1

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Importer and Exporter Information

Facilities

Equipment and Installation Information

Import Summary

Optional Uploads

Importer and Exporter Information
Please enter all required information below. Fields with red asterisk are requi"ed The 'Company Name' has been pre-populated from your CDX profile and cannot be edited. Click the 'Copy From CDX' link lo populate the fields with your COX profile information.
Importer Information
Copy From COX
- Company Name

ICF INTERNATIONAL

- Contact First Name

• Importer Number

Vessel Name

- Contact Last Name

- Expected Year of Import

Expected Month of Import

- Email

• Phone

- Intended Port Of Entry

[ Select an Opu0t1

• Street Address 1

Street Address 2

- City

- State

• Counuy

Postal Code

Please enter all required information below
Exporter lnformalion
• Company Name

• Contact Name

• Email

• Phone

• Street Address 1

StreetAddrns2

• City

Postal Code

• Counuy

Was this ODS owned by another party after recovery?

Yes

'1 No

Other Owners

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Nexf PaJe Fae

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✓ Vahdate

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File Typeapplication/pdf
File TitleImports for Destruction Form Screenshots
AuthorJette, Gabrielle
File Modified2020-04-16
File Created2020-01-23

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