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OMB Control Number: 2060-XXXX |
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Expiration Date: X/XX/202X |
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American Innovation and Manufacturing Act - HFC Producer One-Time Reporting Form |
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Worksheet Instructions: |
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Version: |
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r0.1 |
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Updated: |
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9/24/2021 |
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External Links: |
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Reporting Form Navigation: |
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Section 1 - Facility Identification |
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Section 2 - Production Facility Information |
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Section 3 - HFC-23 Production Information |
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Section 1 - Facility Identification |
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Instructions: Complete the following facility information. |
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Company Name: |
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Facility Name: |
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AIMRS Facility ID: |
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Section 2 - Production Facility Information |
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Instructions: Provide the following information on the production facility. Information on only one producing facility may be reported per reporting form. Provide supporting documentation, as needed, to respond to these reporting requirements. |
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Production Process Information |
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HFC |
Quantity of Fugitive Losses
§84.31(b)(1)(iv) |
Estimates Percent Efficiency of the Production Process
§84.31(b)(1)(vi) |
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Describe the method by which the producer in practice measures daily quantities of regulated substances produced. §84.31(b)(1)(i) |
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Provide the conversion factors by which the daily records as currently maintained can be converted into kilograms of regulated substances produced, including any constants or assumptions used in making those calculations (e.g., tank specifications, ambient temperature or pressure, density of the regulated substance). §84.31(b)(1)(ii) |
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Describe internal accounting procedures for determining plant-wide production. §84.31(b)(1)(iii) |
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Provide a list of any coproducts, byproducts, or emissions from the production line that are other regulated substances; ozone-depleting substances listed in 40 CFR part 82, subpart A; or hazardous air pollutants initially identified in Section 112 of the Clean Air Act, and as revised through rulemaking and codified in 40 CFR 63. §84.31(b)(1)(v) |
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Provide a description of any processes that use a regulated substance as a process agent. §84.31(b)(1)(vii) |
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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 200 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. |
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EPA Form # 5900-540 |
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OMB Control Number: 2060-XXXX |
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Expiration Date: X/XX/202X |
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| American Innovation and Manufacturing Act - HFC Producer One-Time Reporting Form |
| Worksheet Instructions: |
|
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| Version: |
| r0.1 |
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| Updated: |
| 9/24/2021 |
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| External Links: |
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| Reporting Form Navigation: |
| Section 1 - Facility Identification |
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| Section 2 - Production Facility Information |
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| Section 3 - HFC-23 Production Information |
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| Section 3 - HFC-23 Production Information |
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| Instructions: Provide the following information if a producer of HFC-23. Provide supporting documentation, as needed, to respond to these reporting requirements. |
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| Provide information on the capacity to produce the intended chemical on the line on which HFC-23 is produced. §84.31(b)(4)(i)(A) |
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| Provide a description of actions taken at the facility to control the generation of HFC-23 and its emissions. §84.31(b)(4)(i)(B) |
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Provide identification of approved destruction technology and its location intended for use for HFC-23 destruction. §84.31(b)(4)(i)(C)
In addition, provide a copy of the destruction removal efficiency report associated with the destruction technology. §84.31(b)(4)(i)(D) |
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