| OMB Control Number: 2060-XXXX | ||||
| Expiration Date: X/XX/202X | ||||
| American Innovation and Manufacturing Act - HFC Sale or Conveyance Report | ||||
| Worksheet Instructions: | ||||
| Version: | ||||
| r0.1 | ||||
| Updated: | ||||
| 9/23/2021 | ||||
| External Links: | ||||
| Reporting Form Navigation: | ||||
| Section 1 - Application-Specific Seller Identification | ||||
| Section 2 - Application-Specific Purchaser Information | ||||
| Section 3 - Transaction Information | ||||
| Section 1 - Application-Specific Seller Identification | ||||
| Instructions: Complete the following company information. | ||||
| Company Name: | ||||
| AIMRS Company ID: | ||||
| Reporting Year: | ||||
| Section 2 - Application-Specific Purchaser Identification | ||||
| Instructions: Complete the following company information. | ||||
| Purchaser Company Name: | ||||
| AIMRS Purchaser Company ID: | ||||
| Section 3 - Transaction Information | ||||
| Instructions: Provide the following information for each HFC produced or imported using application-specific allowances that is being sold or conveyed. In addition, provide a certification that the regulated substances will be used only for the same application for which the application-specific allowance under which the substances were produced or imported was allocated. §84.21(a)(2)(vi) | ||||
| Transaction Data | ||||
| 1 | 2 | 3 | 4 | |
| HFC | Quantity Sold or Conveyed (kg) §84.21(a)(2)(iii) |
Total Cost of the Regulated Substance being Sold or Conveyed (USD) §84.21(a)(2)(iv) |
Application for Which Allowances Were Allocated §84.21(a)(2)(v) |
|
| 1 | ||||
| 2 | ||||
| 3 | ||||
| Provide the specific products that the application-specific purchaser plans to produce with the HFCs. §84.21(a)(2)(v) | ||||
| 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 84.21). 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 6 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 # 5900-538 | ||||
| Chemical Name | [Common Name] | [Application-Specific Allowance] | [Year] | ||
| CHF3 | HFC-23 | Propellants in Metered-dose Inhalers | 2022 | ||
| CH2F2 | HFC-32 | Defense Spray | 2023 | ||
| CH3F | HFC-41 | Structural Composite Preformed Polyurethane Foam (Marine and Trailer Use) | 2024 | ||
| CF3CHFCHFCF2CF3 | HFC-43-10mee | Etching of Semiconductor Material or Wafers and the Cleaning of Chemical Vapor Desposition (CVD) Chambers within the Semiconductor Manufafturing Sector | 2025 | ||
| CHF2CF3 | HFC-125 | On-board Aerospace Fire Suppression | 2026 | ||
| CHF2CHF2 | HFC-134 | 2027 | |||
| CH2FCF3 | HFC-134a | 2028 | |||
| CH2FCHF2 | HFC-143 | 2029 | |||
| CH3CF3 | HFC-143a | 2030 | |||
| CH2FCH2F | HFC-152 | ||||
| CH3CHF2 | HFC-152a | ||||
| CF3CHFCF3 | HFC-227ea | ||||
| CH2FCF2CF3 | HFC-236cb | ||||
| CHF2CHFCF3 | HFC-236ea | ||||
| CF3CH2CF3 | HFC-236fa | ||||
| CH2FCF2CHF2 | HFC-245ca | ||||
| CF3CH2CF3 | HFC-245fa | ||||
| CF3CH2CF2CH3 | HFC-365mfc |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |