5900-546 American Innovation and Manufacturing Act - HFC Producer

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Overview

Quarterly Information
Shipment and Sales
Production Summary
End-of-Year Reporting
HFC-23 Emissions

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Sheet 1: Quarterly Information

						OMB Control Number: 2060-0734
						Expiration Date: XX/XX/202X
	American Innovation and Manufacturing Act - HFC Producer Quarterly Report
	Worksheet Instructions:
	Complete and submit an HFC Producer Quarterly Report if your facility produces HFCs. Section 1 must be completed prior to submission. Section 2 must be completed if your facility produced HFCs during the reporting quarter; if no HFCs were produced during the quarter, Section 2 may be left blank. Section 3 must be completed if your facility sold or shipped produced HFCs off-site during the quarter for second party transformation, second party destruction, or process agent use. Section 4 must be completed if orders were placed or material was produced for application-specific allowance holders. Section 5 is automatically populated based on data entered in Section 2. Sections 6 through 8 must be completed if your facility is reporting quarter 4 activity.
	Version:
	TBD
	Updated:
	TBD
	External Links:
	HFC Allocation Rule Reporting HelpDesk	AIM Act Paperwork Reduction Act Burden
	Reporting Form Navigation:
	Section 1 - Facility Identification	Section 5 - Quarterly Production Summary
	Section 2 - Quarterly Production Information	Section 6 - End-of-Year Inventory
	Section 3 - Recipient Facility Information	Section 7 - Annual Emissions
	Section 4 - Application-Specific Allowance Holder Information	Section 8 - HFC-23 Emissions
	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 - Facility Identification
	Instructions: Complete the following facility information.
	Facility Name:
	Facility ID:
	Reporting Year:
	Reporting Quarter:
	Were HFCs produced during the reporting period?
	Were any produced HFCs shipped off-site during the reporting period to another facility or a second party for transformation, destruction, or process agent use?
	Did the facility produce HFC-23 during the reporting year?
	Were any orders placed from application-specific allowance holders or were HFCs produced for application-specific end-uses?
	Section 2 - Production Data
	Instructions: Enter the quantity of each HFC that was produced during the quarter. If no HFCs were produced, the table may be left blank. If HFCs were produced for second party transformation or second party destruction, a copy of the transformation and/or destruction verification from each facility for whom HFCs were produced must be provided along with this report. Additionally provide records required under §84.31(b)(4)(xiv) documenting proof that allowances were expended.
	HFC Production Data
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	HFC Produced	Date of Production / Date Allowances were Expended §84.31(b)(2)(x)	Gross Production (kg) §84.31(b)(2)(iv)	In-House Transformation (kg) §84.31(b)(2)(i)		Second Party Transformation (kg) §84.31(b)(2)(i)	In-House Destruction (kg) §84.31(b)(2)(ii)		Second Party Destruction (kg) §84.31(b)(2)(ii)	In-House Process Agent Use (kg) §84.31(b)(2)(iii)		Second Party Process Agent Use (kg) §84.31(b)(2)(iii)	Produced with Application-Specific Allowances (kg) §84.31(b)(2)(ix)						Net Production (kg) §84.31(b)(2)(iv)	Amount of Production/Consumption Allowances Expended (MTEVe) §84.31(b)(2)(iv)	Amount of Application-Specific Allowances Expended (MTEVe) §84.31(b)(2)(iv)
													Metered Dose Inhalers	Defense Sprays	Structural Composite Foam	Semiconductors	Onboard Aerospace Fire Suppression	Military End-Uses
				On-site	Off-site		On-site	Off-site		On-site	Off-site
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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. 2060-0734). 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 38 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., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.
	EPA Form # 5900-546

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Sheet 2: Shipment and Sales

				OMB Control Number: 2060-0734
				Expiration Date: XX/XX/202X
	American Innovation and Manufacturing Act - HFC Producer Quarterly Report
	Worksheet Instructions:
	Complete and submit an HFC Producer Quarterly Report if your facility produces HFCs. Section 1 must be completed prior to submission. Section 2 must be completed if your facility produced HFCs during the reporting quarter; if no HFCs were produced during the quarter, Section 2 may be left blank. Section 3 must be completed if your facility sold or shipped produced HFCs off-site during the quarter for transformation, second party destruction, or process agent use. Section 4 must be completed if orders were placed or material was produced for application-specific allowance holders. Section 5 is automatically populated based on data entered in Section 2. Sections 6 through 8 must be completed if your facility is reporting quarter 4 activity.
	Version:
	TBD
	Updated:
	TBD
	External Links:
	HFC Allocation Rule Reporting HelpDesk	AIM Act Paperwork Reduction Act Burden
	Reporting Form Navigation:
	Section 1 - Facility Identification	Section 5 - Quarterly Production Summary
	Section 2 - Quarterly Production Information	Section 6 - End-of-Year Inventory
	Section 3 - Recipient Facility Information	Section 7 - Annual Emissions
	Section 4 - Application-Specific Allowance Holder Information	Section 8 - HFC-23 Emissions
	Section 3 - Recipient Facility Information
	Instructions: Provide the quantity of regulated substances sold or transferred during the quarter to a facility other than the production facility for use in processes resulting in their transformation, destruction, or use as a process agent. Provide a copy of the transformation verification from each second party transformer showing their intent to transform those substances or a copy of the destruction verification from each second party destroyer confirming it destroyed the same regulated substance.
	Second Party Transformation, Destruction, or Process Agent Information
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	HFC	Recipient Facility Name §84.31(b)(2)(vii/viii)	Quantity (kg) §84.31(b)(2)(v)	Purpose
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	Section 4 - Application-Specific Allowance Holder Information
	Instructions: Identify the application-specific allowance holders from whom orders were placed, and the quantity of specific HFCs produced for those listed applications.
	Application-Specific Allowance Holder Information
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	HFC	Application-Specific Allowance Holder From Whom Orders Were Placed §84.31(b)(2)(ix)	Quantity Produced (kg) §84.31(b)(2)(ix)
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Sheet 3: Production Summary

OMB Control Number: 2060-0734

Expiration Date: XX/XX/202X

American Innovation and Manufacturing Act - HFC Producer Quarterly Report

Worksheet Instructions:

Complete and submit an HFC Producer Quarterly Report if your facility produces HFCs. Section 1 must be completed prior to submission. Section 2 must be completed if your facility produced HFCs during the reporting quarter; if no HFCs were produced during the quarter, Section 2 may be left blank. Section 3 must be completed if your facility sold or shipped produced HFCs off-site during the quarter for transformation, second party destruction, or process agent use. Section 4 must be completed if orders were placed or material was produced for application-specific allowance holders. Section 5 is automatically populated based on data entered in Section 2. Sections 6 through 8 must be completed if your facility is reporting quarter 4 activity.

Version:

TBD

Updated:

TBD

External Links:

HFC Allocation Rule Reporting HelpDesk

AIM Act Paperwork Reduction Act Burden

Reporting Form Navigation:

Section 1 - Facility Identification

Section 5 - Quarterly Production Summary

Section 2 - Quarterly Production Information

Section 6 - End-of-Year Inventory

Section 3 - Recipient Facility Information

Section 7 - Annual Emissions

Section 4 - Application-Specific Allowance Holder Information

Section 8 - HFC-23 Emissions

Section 5 - Quarterly Production Summary

Instructions: The values in the table below are calculated based on data entered in Section 2. If the totals appear to be incorrect, please return to Section 2 to review your data.

Quarterly Production Summary

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HFC Produced

Gross Production (kg)

In-House Transformation (kg)

Second-Party Transformation (kg)

In-House Destruction (kg)

Second-Party Destruction (kg)

In-House Process Agent Use (kg)

Second Party Process Agent Use (kg)

Application-Specific End-Uses (kg)

Net Production (kg)

Amount of Production/Consumption Allowances Expended (MTEVe)

Amount of Application-Specific Allowances Expended (MTEVe)

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HFC-23

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HFC-32

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HFC-41

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HFC-43-10mee

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HFC-125

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HFC-134

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HFC-134a

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HFC-143

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HFC-143a

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HFC-152

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HFC-152a

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HFC-227ea

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HFC-236cb

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HFC-236ea

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HFC-236fa

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HFC-245ca

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HFC-245fa

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HFC-365mfc

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Sheet 4: End-of-Year Reporting

			OMB Control Number: 2060-0734
			Expiration Date: XX/XX/202X
	American Innovation and Manufacturing Act - HFC Producer Quarterly Report
	Worksheet Instructions:
	Complete and submit an HFC Producer Quarterly Report if your facility produces HFCs. Section 1 must be completed prior to submission. Section 2 must be completed if your facility produced HFCs during the reporting quarter; if no HFCs were produced during the quarter, Section 2 may be left blank. Section 3 must be completed if your facility sold or shipped produced HFCs off-site during the quarter for transformation, second party destruction, or process agent use. Section 4 must be completed if orders were placed or material was produced for application-specific allowance holders. Section 5 is automatically populated based on data entered in Section 2. Sections 6 through 8 must be completed if your facility is reporting quarter 4 activity.
	Version:
	TBD
	Updated:
	TBD
	External Links:
	HFC Allocation Rule Reporting HelpDesk	AIM Act Paperwork Reduction Act Burden
	Reporting Form Navigation:
	Section 1 - Facility Identification	Section 5 - Quarterly Production Summary
	Section 2 - Quarterly Production Information	Section 6 - End-of-Year Inventory
	Section 3 - Recipient Facility Information	Section 7 - Annual Emissions
	Section 4 - Application-Specific Allowance Holder Information	Section 8 - HFC-23 Emissions
	Section 6 - End-of-Year Inventory
	Instructions: Provide the quantity of each regulated substance held in inventory on December 31. Data should only be reported in the fourth quarter report.
	End-of-Year Inventory
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	HFC	Quantity of Inventory (kg) §84.31(b)(2)(x)
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	Section 7 - Annual Emissions
	Instructions: Provide the quantity of each HAP, HFC, and ODS emitted during the calendar year. Data should only be reported in the fourth quarter report.
	Annual Emissions
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	Substance Type	Substance	Production Line	Unit	Quantity of Emissions (lbs) §84.31(b)(3)
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Sheet 5: HFC-23 Emissions

			OMB Control Number: 2060-0734
			Expiration Date: XX/XX/202X
American Innovation and Manufacturing Act - HFC Producer Quarterly Report
Worksheet Instructions:
Complete and submit an HFC Producer Quarterly Report if your facility produces HFCs. Section 1 must be completed prior to submission. Section 2 must be completed if your facility produced HFCs during the reporting quarter; if no HFCs were produced during the quarter, Section 2 may be left blank. Section 3 must be completed if your facility sold or shipped produced HFCs off-site during the quarter for transformation, second party destruction, or process agent use. Section 4 must be completed if orders were placed or material was produced for application-specific allowance holders. Section 5 is automatically populated based on data entered in Section 2. Sections 6 through 8 must be completed if your facility is reporting quarter 4 activity.
Version:
TBD
Updated:
TBD
External Links:
HFC Allocation Rule Reporting HelpDesk	AIM Act Paperwork Reduction Act Burden
Reporting Form Navigation:
Section 1 - Facility Identification	Section 5 - Quarterly Production Summary
Section 2 - Quarterly Production Information	Section 6 - End-of-Year Inventory
Section 3 - Recipient Facility Information	Section 7 - Annual Emissions
Section 4 - Application-Specific Allowance Holder Information	Section 8 - HFC-23 Emissions
Section 8 - HFC-23 Emissions
Instructions: Provide annual facility-level data on HFC-23 emissions. Data should only be reported in the fourth quarter report.
HFC-23 Emissions
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HFC-23 Generated (metric ton) §84.31(b)(4)(ii)(A)	HFC-23 Emitted (metric ton) §84.31(b)(4)(ii)(A)	HFC-23 Generated and Captured for Any Purpose (metric ton) §84.31(b)(4)(ii)(A)	HFC-23 Generated and Captured for Consumptive Use (metric ton) §84.31(b)(4)(ii)(A)	HFC-23 Generated and Captured for Feedstock Use in the U.S. (metric ton) §84.31(b)(4)(ii)(A)	HFC-23 Generated and Captured for Destruction (metric ton) §84.31(b)(4)(ii)(A)	HFC-23 Used for Feedstock without Prior Capture (metric ton) §84.31(b)(4)(ii)(A)	HFC-23 Destroyed without Prior Capture (metric ton) §84.31(b)(4)(ii)(A)