5900-543 HFC Reclaimer One-Time Reporting Form

Initial Reporting of the Hydrofluorocarbon Allowance Allocation and Trading Program

HFC Reclaimer One-Time Reporting Form r0.2.xlsx

Initial Reporting of the Hydrofluorocarbon Allowance Allocation and Trading Program

OMB: 2060-0735

Document [xlsx]
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Overview

Reclamation Information
Lists


Sheet 1: Reclamation Information






OMB Control Number: 2060-XXXX






Expiration Date: X/XX/202X










American Innovation and Manufacturing Act - HFC Reclaimer One-Time Reporting Form














Worksheet Instructions:







Version:


r0.2






Updated:


9/21/2021






External Links:










Reporting Form Navigation:


Section 1 - Company Identification






Section 2 - 2021 End of Year Inventory






Section 3 - Laboratory Batch Testing Information














EPA may request additional information or ask follow up questions to verify the accuracy of this submission and supporting documentation, including pursuant to CAA section 114 as authorized under the AIM Act.














Section 1 - Company Identification






Instructions: Complete the following company information.






Company Name:






AIMRS Company ID:














Section 2 - 2021 End-of-Year Inventory






Instructions: Provide the quantity of each HFC held in inventory on December 31, 2021.






End-of-Year Inventory


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HFC Quantity Recovered
(kg)
§84.31(i)(1)(i)
Quantity Reclaimed
(kg)
§84.31(i)(1)(i)
Quantity of Virgin Material
(kg)
§84.31(i)(1)(i)
Total Quantity of Inventory
(kg)
§84.31(i)(1)(i)








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Section 3 - Laboratory Batch Testing Information






Instructions: Provide the following information on laboratory batch testing conducted during the prior year. For each laboratory identified, provide a signed statement from the laboratory confirming there is an ongoing business relationship with your company. Provide additional supporting documentation, as needed, to respond to these reporting requirements.











Batch Testing




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Laboratory Name
§84.31(i)(1)(ii)
Number of Batches Tested in Prior Year
§84.31(i)(1)(iii)
Number of Batches that Did Not Meet the Specifications in Appendix A to 40 CFR part 82, Subpart F in the Prior Year
§84.31(i)(1)(iv)
























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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 40 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 # 5900-543






Sheet 2: Lists

Chemical Name

[Common_Name_1]
CHF3 HFC-23 2 HFC-23
CH2F2 HFC-32 3 HFC-32
CH3F HFC-41 4 HFC-41
CF3CHFCHFCF2CF3 HFC-43-10mee 5 HFC-43-10mee
CHF2CF3 HFC-125 6 HFC-125
CHF2CHF2 HFC-134 7 HFC-134
CH2FCF3 HFC-134a 8 HFC-134a
CH2FCHF2 HFC-143 9 HFC-143
CH3CF3 HFC-143a 10 HFC-143a
CH2FCH2F HFC-152 11 HFC-152
CH3CHF2 HFC-152a 12 HFC-152a
CF3CHFCF3 HFC-227ea 13 HFC-227ea
CH2FCF2CF3 HFC-236cb 14 HFC-236cb
CHF2CHFCF3 HFC-236ea 15 HFC-236ea
CF3CH2CF3 HFC-236fa 16 HFC-236fa
CH2FCF2CHF2 HFC-245ca 17 HFC-245ca
CF3CH2CF3 HFC-245fa 18 HFC-245fa
CF3CH2CF2CH3 HFC-365mfc 19 HFC-365mfc
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