HFC Reclaimer Quarterly Reporting Form

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American Innovation and Manufacturing Act - HFC Reclaimer Quarterly Reporting F
Worksheet Instructions:
Version:
r0.1
Updated:
8/12/2026
External Links:
Reporting Form Navigation:
Section 1 - Company Identification
Section 2 - Quarterly Reclamation Information
Section 3 - End-of-Year Inventory

Section 1 - Company Identification
Instructions: Complete the following company information.
Company Name:
AIMRS Company ID:
Reporting Year:
Reporting Quarter:

Section 2 - Quarterly Reclamation Information
Instructions: Enter the quantity of eor each regulated substance that was received for reclamation during the quarter.
HFC Reclamation
1
2
3
HFC

Quantity of Material Received for
Reclamation
(kg)
§84.31(i)(2)

Quantity of Regulated Substance
Reclaimed
(kg)
§84.31(j)(2)

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2
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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.
Responses to this collection of information are mandatory (40 CFR 84.31). An agency may not conduct or sponsor, and a person
respond to, a collection of information unless it displays a currently valid OMB control number. The public reporting and recordkee
this collection of information is estimated to be 19.4 hours per response. Send comments on the Agency’s need this formation, th
provided burden estimates and any suggested methods for minimizing respondent burden including through the use of automated
techniques to the Director, Regulatory Support Division, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave.
D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No.
Responses to this collection of information are mandatory (40 CFR 84.31). An agency may not conduct or sponsor, and a person
respond to, a collection of information unless it displays a currently valid OMB control number. The public reporting and recordkee
this collection of information is estimated to be 19.4 hours per response. Send comments on the Agency’s need this formation, th
provided burden estimates and any suggested methods for minimizing respondent burden including through the use of automated
techniques to the Director, Regulatory Support Division, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave.
D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

EPA Form # 5900-549

OMB Control Number: 2060-XXXX
Expiration Date: X/XX/202X

uarterly Reporting Form

ation during the quarter.
4
Quantity of Waste Products
(kg)
§84.31(j)(2)

501 et seq. (OMB Control No. 2060-XXXX).
duct or sponsor, and a person is not required to
public reporting and recordkeeping burden for
ency’s need this formation, the accuracy of the
through the use of automated collection
21T), 1200 Pennsylvania Ave., NW, Washington,
rm to this address.

American Innovation and Manufacturing Act - HFC Reclaimer Quarterly Reporting Fo
Worksheet Instructions:
Version:
r0.1
Updated:
9/23/2021
External Links:
Reporting Form Navigation:
Section 1 - Company Identification
Section 2 - Quarterly Reclamation Information
Section 3 - End-of-Year Inventory

Section 3 - End-of-Year Inventory

Instructions: Provide the following information for each HFC held in inventory as of December 31. Data should only be rep
HFC End-of-Year Inventory
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2
3
Quantity Reclaimed
Quantity Recovered
HFC
(kg)
(kg)§84.31(i)(3)
§84.31(i)(3)
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OMB Control Number: 2060-XXXX
Expiration Date: X/XX/202X

mer Quarterly Reporting Form

ecember 31. Data should only be reported in the fourth quarter report.
Inventory
4
5
Quantity of Virgin Material
Total Quantity of Inventory
(kg)
(kg)
§84.31(i)(3)
§84.31(i)(3)

Chemical Name
CHF3
CH2F2
CH3F
CF3CHFCHFCF2CF3
CHF2CF3
CHF2CHF2
CH2FCF3
CH2FCHF2
CH3CF3
CH2FCH2F
CH3CHF2
CF3CHFCF3
CH2FCF2CF3
CHF2CHFCF3
CF3CH2CF3
CH2FCF2CHF2
CF3CH2CF3
CF3CH2CF2CH3

[Common Name]
HFC-23
HFC-32
HFC-41
HFC-43-10mee
HFC-125
HFC-134
HFC-134a
HFC-143
HFC-143a
HFC-152
HFC-152a
HFC-227ea
HFC-236cb
HFC-236ea
HFC-236fa
HFC-245ca
HFC-245fa
HFC-365mfc

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[Common_Name_1]
HFC-23
HFC-32
HFC-41
HFC-43-10mee
HFC-125
HFC-134
HFC-134a
HFC-143
HFC-143a
HFC-152
HFC-152a
HFC-227ea
HFC-236cb
HFC-236ea
HFC-236fa
HFC-245ca
HFC-245fa
HFC-365mfc

[Quarter]
1
2
3
4

[Year]
2022
2023
2024
2025
2026
2027
2028
2029
2030