5900-201 Request for Additional Class 2 Consumption Allowances

Production, Import, Export, Recycling, Destruction, Transhipment, and Feedstock Use of Ozone-Depleting Substances (Renewal)

Copy of Class II RACA_v5.0.xlsm

Reporting of the Production, Import, Export, Recycling, Destruction, Transhipment, and Feedstock Use of Ozone-Depleting Substances

OMB: 2060-0170

Document [xlsx]
Download: xlsx | pdf

Overview

Instructions
Section 1
Section 2
Summary
Reference List


Sheet 1: Instructions





OMB Control Number: 2060-0170

Expiration Date: 4/16/2023

U.S. Environmental Protection Agency

Stratospheric Ozone Protection Program




Request for Additional Class II Consumption Allowances (Sec 82.20)

Version 5.0

Last Updated: April 2020




Instructions

Complete this form by filling in the data fields that are highlighted in blue. Guidance on how to complete individual data fields are provided in comment bubbles. Use the arrows to navigate between the tabs. Once completed, use the 'prepare submission' button on the Summary tab to generate your CSV file.

Copying and Pasting Data: If data are pasted into this reporting form from another spreadsheet, the formatting of specific cells must be consistent with the requirements of the form in order to be

accepted into EPA’s ODS Tracking System. Refer to the Reference List to identify the valid naming scheme for specific data fields. Additionally, select "Paste As Values" when pasting data into the form.

Report Submission: This Excel file, the generated CSV file, and all supporting attachments should be submitted to EPA through the Central Data Exchange (CDX). Refer to EPA's website for additional information on form submission:

https://www.epa.gov/ods-phaseout/ods-recordkeeping-and-reporting.




All information submitted to EPA will be treated as confidential in accordance with 40 CFR Part 2, Subpart B, and will only be disclosed by the means set forth in the subpart.

This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-0170). Responses to this collection of information are mandatory (40 CFR 82.20). 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 number and expiration date are displayed in the upper right corner of the form. The public reporting and recordkeeping burden for this collection of information is estimated to be 4 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 #5900-201





Sheet 2: Section 1










U.S. Environmental Protection Agency






Request for Additional Class II Consumption Allowances












Date Prepared:













Section 1: Report Identification Information






Complete all fields below. No fields may be left blank.





The company name must match the organization name under which this report is submitted to EPA through CDX. Company Name:

1



Submission Type:

1



Reporting Year:

1



Enter your company's Employer Identification Number (EIN). Employer Identification Number (EIN):

1












Original Submission






Re-Submittal






Sheet 3: Section 2



























U.S. Environmental Protection Agency





















Request for Additional Class II Consumption Allowances










































Company Name:


















Reporting Period:









































Section 2: Export Transaction Data




















In the table below, enter export transaction data for each class II controlled substance for which additional consumption allowances are being requested. For all export transactions, all fields are required unless otherwise indicated. As a reminder, if the material was produced or imported by a company other than the exporter,a written statement from the producer or importer stating that the material was produced or imported with expended allowances must be provided to EPA along with the submission of this report. Additionally, for each export transaction, a copy of the invoice and bill of lading documenting the sale and indicating the net quantity shipped must be provided to EPA.





If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions.






The transaction number is autopopulated. Transaction Number Enter the date for when the shipment exited the United States. Date of Export Enter the name of the company that received or purchased material. Recipient Company Enter the street address of the recipient company. Recipient Company Street Address Enter the city of the recipient company. Recipient Company City Select the country to which the shipment was exported. If copying and pasting data into the table, please refer to the Reference List for the valid list of countries. Recipient Company Country Enter the postal code of the recipient company. Recipient Company Postal Code Enter the name of the contact for the recipient company. If this information is not available, enter "Not Available." Recipient Company Contact Name Enter the phone number of the contact from the recipient company. If this information is not available, enter "Not Available." Recipient Company Phone Number Select the name of the class II chemical exported. If copying and pasting data into the table, please refer to the Reference List for the valid list of chemical names. Name of the Class II Chemical Exported Enter the total quantity (kg) of the class II chemical exported. Quantity of the Class II Chemical Exported Enter the 10-digit commodity code of the chemical exported as it appears on Customs documentation. Refer to the Reference List for a list of commonly used commodity codes for class II chemicals. Commodity Code Enter the name of the port where the shipment exited the United States. Port of Exit from the United States Enter the Employer Identification Number (EIN) shown on the Shipper's Export Declaration Form. This number may or may not refer to the exporter as defined by EPA. If a shipping agent is acting on behalf of the exporter as defined by the regulation, the EIN of the agent shown on the U.S. Customs Form 7525 should be reported here. Your company's EIN as entered in Section 1 of this report will automatically populate for each transaction entered. Revise the number if the EIN for the shipment is different from your company's EIN. The number entered should have no dashes. Shipment EIN Complete this field if the material was produced in the United States. If Produced in the U.S. Complete these columns if the material was imported into the United States. If Imported into the U.S. Enter the date of when the chemical was purchased from the producer or importer, if the company that exported the material is not the same company that produced or imported the material. Date Purchased





Enter the name of the company that produced the chemical, if applicable. Company that Produced the Class II Chemical Enter the name of the company that imported the chemical into the United States, if applicable. Company that Imported the Class II Chemical Select the country from which the material was imported into the United States, if applicable. Source Country





Autopopulated Date Text Text Text Selection Text Text Text Selection kg Text Text Number Text Text Selection Date





1 1/15/2018 Company A 1 Main Street Melbourne Australia 3000 John Smith 011 46 8 508 280 00 HCFC-124 1,000.00 2903.71.0000 Miami, FL 12345678900
Company B New Zealand 3/7/2018











































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0





























x


x





x











Afghanistan


#NAME?





Afghanistan











Albania


HCFC-123





Albania











Algeria


HCFC-124





Algeria











Andorra


#NAME?





Andorra











Angola


#NAME?





Angola











Antigua and Barbuda


#NAME?





Antigua and Barbuda











Argentina









Argentina











Armenia









Armenia











Australia









Australia











Austria









Austria











Azerbaijan









Azerbaijan











Bahamas









Bahamas











Bahrain









Bahrain











Bangladesh









Bangladesh











Barbados









Barbados











Belarus









Belarus











Belgium









Belgium











Belize









Belize











Benin









Benin











Bermuda









Bermuda











Bhutan









Bhutan











Bolivia (Plurinational State of)









Bolivia (Plurinational State of)











Bosnia and Herzegovina









Bosnia and Herzegovina











Botswana









Botswana











Brazil









Brazil











Brunei Darussalam









Brunei Darussalam











British Virgin Islands









British Virgin Islands











Bulgaria









Bulgaria











Burkina Faso









Burkina Faso











Burundi









Burundi











Cambodia









Cambodia











Cameroon









Cameroon











Canada









Canada











Cape Verde









Cape Verde











Central African Republic









Central African Republic











Chad









Chad











Chile









Chile











China









China











Colombia









Colombia











Comoros









Comoros











Congo









Congo











Cook Islands









Cook Islands











Costa Rica









Costa Rica











Cote d'Ivoire









Cote d'Ivoire











Croatia









Croatia











Cuba









Cuba











Cyprus









Cyprus











Czech Republic









Czech Republic











Democratic Republic of the Congo









Democratic Republic of the Congo











Denmark









Denmark











Djibouti









Djibouti











Dominica









Dominica











Dominican Republic









Dominican Republic











Ecuador









Ecuador











Egypt









Egypt











El Salvador









El Salvador











Equatorial Guinea









Equatorial Guinea











Eritrea









Eritrea











Estonia









Estonia











Ethiopia









Ethiopia











European Union









European Union











Fiji









Fiji











Finland









Finland











France









France











Gabon









Gabon











Gambia









Gambia











Georgia









Georgia











Germany









Germany











Ghana









Ghana











Greece









Greece











Grenada









Grenada











Guatemala









Guatemala











Guinea









Guinea











Guinea-Bissau









Guinea-Bissau











Guyana









Guyana











Haiti









Haiti











Holy See









Holy See











Honduras









Honduras











Hong Kong









Hong Kong











Hungary









Hungary











Iceland









Iceland











India









India











Indonesia









Indonesia











Iran (Islamic Republic of)









Iran (Islamic Republic of)











Iraq









Iraq











Ireland









Ireland











Israel









Israel











Italy









Italy











Jamaica









Jamaica











Japan









Japan











Jordan









Jordan











Kazakhstan









Kazakhstan











Kenya









Kenya











Kiribati









Kiribati











Kuwait









Kuwait











Kyrgyzstan









Kyrgyzstan











Lao People's Democratic Republic









Lao People's Democratic Republic











Latvia









Latvia











Lebanon









Lebanon











Lesotho









Lesotho











Liberia









Liberia











Libya









Libya











Liechtenstein









Liechtenstein











Lithuania









Lithuania











Luxembourg









Luxembourg











Madagascar









Madagascar











Malawi









Malawi











Malaysia









Malaysia











Maldives









Maldives











Mali









Mali











Malta









Malta











Marshall Islands









Marshall Islands











Mauritania









Mauritania











Mauritius









Mauritius











Mexico









Mexico











Micronesia (Federated States of)









Micronesia (Federated States of)











Monaco









Monaco











Mongolia









Mongolia











Montenegro









Montenegro











Morocco









Morocco











Mozambique









Mozambique











Myanmar









Myanmar











Namibia









Namibia











Nauru









Nauru











Nepal









Nepal











Netherlands









Netherlands











New Zealand









New Zealand











Nicaragua









Nicaragua











Niger









Niger











Nigeria









Nigeria











Niue









Niue











North Korea (Democratic People's Republic of Korea)









North Korea (Democratic People's Republic of Korea)











Norway









Norway











Oman









Oman











Pakistan









Pakistan











Palau









Palau











Panama









Panama











Papua New Guinea









Papua New Guinea











Paraguay









Paraguay











Peru









Peru











Philippines









Philippines











Poland









Poland











Portugal









Portugal











Qatar









Qatar











Republic of Moldova









Republic of Moldova











Romania









Romania











Russian Federation









Russian Federation











Rwanda









Rwanda











Saint Kitts and Nevis









Saint Kitts and Nevis











Saint Lucia









Saint Lucia











Saint Vincent and the Grenadines









Saint Vincent and the Grenadines











Samoa









Samoa











San Marino









San Marino











Sao Tome and Principe









Sao Tome and Principe











Saudi Arabia









Saudi Arabia











Senegal









Senegal











Serbia









Serbia











Seychelles









Seychelles











Sierra Leone









Sierra Leone











Singapore









Singapore











Slovakia









Slovakia











Slovenia









Slovenia











Solomon Islands









Solomon Islands











Somalia (Federal Republic of)









Somalia (Federal Republic of)











South Africa









South Africa











South Korea (Republic of Korea)









South Korea (Republic of Korea)











South Sudan









South Sudan











Spain









Spain











Sri Lanka









Sri Lanka











Sudan









Sudan











Suriname









Suriname











Swaziland









Swaziland











Sweden









Sweden











Switzerland









Switzerland











Syrian Arab Republic









Syrian Arab Republic











Tahiti









Tahiti











Taiwan









Taiwan











Tajikistan









Tajikistan











Thailand









Thailand











The Former Yugoslav Republic of Macedonia









The Former Yugoslav Republic of Macedonia











Timor-Leste









Timor-Leste











Togo









Togo











Tonga









Tonga











Trinidad and Tobago









Trinidad and Tobago











Tunisia









Tunisia











Turkey









Turkey











Turkmenistan









Turkmenistan











Tuvalu









Tuvalu











Uganda









Uganda











Ukraine









Ukraine











United Arab Emirates









United Arab Emirates











United Kingdom of Great Britain and Northern Ireland









United Kingdom of Great Britain and Northern Ireland











United Republic of Tanzania









United Republic of Tanzania











#NAME?









#NAME?











#NAME?









#NAME?











Uruguay









Uruguay











Uzbekistan









Uzbekistan











Vanuatu









Vanuatu











Venezuela (Bolivarian Republic of)









Venezuela (Bolivarian Republic of)





Sheet 4: Summary








U.S. Environmental Protection Agency



Request for Additional Class II Consumption Allowances








Company Name:



Reporting Period:








Summary



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.


Chemical Name Total Consumption Allowances Requested (kg)












































Sheet 5: Reference List















































U.S. Environmental Protection Agency











































Request for Additional Class II Consumption Allowances










































Reference List























































































Copying and Pasting Data: If data is pasted into this reporting form from another spreadsheet, the formatting of specific cells must be consistent with the requirements of the form in order to be accepted into EPA’s ODS tracking system. When copying and pasting data into the form, please ensure consistency with the formatting of the lists provided below.





































Chemical Name List: The table below lists the valid chemical names that may be used when entering data into Section 2 of this form.
Country List: The table below lists the valid country names that may be used when entering data into Section 2 of this form.


















































































Class II Chemicals with Allowances

Source Country





































HCFC-123 HCFC-124

Afghanistan Greece Papua New Guinea









































Albania Grenada Paraguay









































Algeria Guatemala Peru





































Commodity Code List: The table below lists the commonly used class II commodity codes that may be used when entering data into Section 2 of this form. A complete list of commodity codes can be found in the Official Harmonized Tariff Schedule.
Andorra Guinea Philippines






































Angola Guinea-Bissau Poland






































Antigua and Barbuda Guyana Portugal






































Argentina Haiti Qatar









































Armenia Holy See Republic of Moldova





































Class II Commodity Codes/Description
Australia Honduras Romania





































2903.72.0020 Dichlorotrifluoroethane (HCFC-123)
Austria Hong Kong Russian Federation





































2903.79.9030 Monochlorotetrafluoroethane (HCFC-124)
Azerbaijan Hungary Rwanda





































3824.74.0000 Mixtures containing hydrochlorofluorocarbons (HCFCs) but not containing chlorofluorocarbons (CFCs)
Bahamas Iceland Saint Kitts and Nevis







































Bahrain India Saint Lucia









































Bangladesh Indonesia Saint Vincent and the Grenadines









































Barbados Iran (Islamic Republic of) Samoa









































Belarus Iraq San Marino









































Belgium Ireland Sao Tome and Principe









































Belize Israel Saudi Arabia









































Benin Italy Senegal









































Bermuda Jamaica Serbia









































Bhutan Japan Seychelles









































Bolivia (Plurinational State of) Jordan Sierra Leone









































Bosnia and Herzegovina Kazakhstan Singapore









































Botswana Kenya Slovakia









































Brazil Kiribati Slovenia









































Brunei Darussalam Kuwait Solomon Islands









































British Virgin Islands Kyrgyzstan Somalia (Federal Republic of)









































Bulgaria Lao People's Democratic Republic South Africa









































Burkina Faso Latvia South Korea (Republic of Korea)









































Burundi Lebanon South Sudan









































Cambodia Lesotho Spain









































Cameroon Liberia Sri Lanka









































Canada Libya Sudan









































Cape Verde Liechtenstein Suriname









































Central African Republic Lithuania Swaziland









































Chad Luxembourg Sweden









































Chile Madagascar Switzerland









































China Malawi Syrian Arab Republic









































Colombia Malaysia Tahiti









































Comoros Maldives Taiwan









































Congo Mali Tajikistan









































Cook Islands Malta Thailand









































Costa Rica Marshall Islands The Former Yugoslav Republic of Macedonia









































Cote d'Ivoire Mauritania









































Croatia Mauritius Timor-Leste









































Cuba Mexico Togo









































Cyprus Micronesia (Federated States of) Tonga









































Czech Republic Monaco Trinidad and Tobago









































Democratic Republic of the Congo Mongolia Tunisia









































Denmark Montenegro Turkey









































Djibouti Morocco Turkmenistan









































Dominica Mozambique Tuvalu









































Dominican Republic Myanmar Uganda









































Ecuador Namibia Ukraine









































Egypt Nauru United Arab Emirates









































El Salvador Nepal United Kingdom of Great Britain and Northern Ireland









































Equatorial Guinea Netherlands









































Eritrea New Zealand United Republic of Tanzania









































Estonia Nicaragua Uruguay









































Ethiopia Niger Uzbekistan









































European Union Nigeria Vanuatu









































Fiji Niue Venezuela (Bolivarian Republic of)









































Finland North Korea (Democratic People's Republic of Korea) Viet Nam









































France Yemen









































Gabon Norway Zambia









































Gambia Oman Zimbabwe









































Georgia Pakistan










































Germany Palau










































Ghana Panama


















































































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