9600-032 Section 8(d) Health and Safety Data Reporting

CBI SUBMISSION
OMB Control No. 2070-0224

United States Environmental Protection Agency
Washington, DC 20460
Section 8(d) Health & Safety Data Reporting
This is an original submission:

This is an amendment:

✔
CERTIFICATION

Official Title:

Contact Person:

Email Address:

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Signature:

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I hereby certify to the best of my knowledge and belief that (1) all information entered on this form is
complete and accurate; and (2) any confidentiality claims are true and correct as to that information
for which they have been asserted. Any knowing and willful misinterpretation is subject to criminal
penalty pursuant to 18 USC 1001.

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Date Signed:

Contact Information

Submission
Information

Submission Type:

Submitter
Information

CBI:

Yes:

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PART 1

No:

✔

Address:

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Company Name:

Christest

123 Main Street
City, WA, 12345
United States

Contact Person:

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Phone Number:

Email Address:

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2025640710

Technical Contact
Information

Date Submitted:

[email protected]

CBI:

Yes: ✔ No:
Company Name:

Address:

test

test
test
test, AL, 12345
United States

Contact Person:

test test
Phone Number:

Email Address:

1234567890

[email protected]

EPA Form 9600-032

Page 1

Paperwork Reduction Act: This collection of information is approved by OMB under the Paperwork Reduction Act,
44 U.S.C. 3501 et seq. (OMB Control No. 2070-0224). Responses to this collection of information are mandatory for
certain persons, as specified at 15 U.S.C. 2607. 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 50 hours per initial Section 8(a)
PAIR submission; 68 hours for Chemical Specific Section 8(a) Rules, 11 hours for Health and Safety Section 8(d);
and .97 hours for Section 8(c). 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 to the Regulatory Support
Division Director, 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.

Section 8(d) Health & Safety Data Reporting Page 2
CBI SUBMISSION

PART 2

Study Information

Full Study Report

Document Upload:

CBI:

Yes:

Blank ESA.pdf
Effects:

✔

Endpoints:

Health Effects

Acute Toxicity: dermal

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Initiated Studies
Ongoing Studies
Robust Summary
Studies Which are
Known but without
Possession of
Copies
Studies Previously
Sent to Federal
Agencies without
Confidentiality
Claims

Substantiation Opt-Out and Documents
Yes:

No:

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Substantiation Opt-Out:

✔

N

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PART 3
Substantiation
Opt-Out and
Documents

No:

Page 2

Section 8(d) Health & Safety Data Reporting Page 3
CBI SUBMISSION

Claim: Technical Contact Information
Applicable Only to General CBI Claims

Yes

No

CBI

io
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A person may assert a claim of confidentiality for the specific chemical identity of a chemical substance as described in § 711.15(b)(3)
of this part only if the identity of that chemical substance is treated as confidential in the Master Inventory File as of the time the report
is submitted for that chemical substance. Generic chemical identities and accession numbers may not be claimed as confidential. To
assert a claim of confidentiality for the identity of a reportable chemical substance, you must submit with the report detailed written
answers to the questions from subsection (b) and to the following questions.
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1. Please specifically explain what harm to the competitive position of your business would be likely to result from
the release of the information claimed as confidential. How would that harm be substantial? Why is the substantial
harm to your competitive position likely (i.e., probable) to be caused by release of the information rather than just
possible? If you claimed multiple types of information to be confidential (e.g. site information, exposure information,
environmental release information, etc.), explain how disclosure of each type of information would be likely to cause
substantial harm to the competitive position of your business.
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X

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2. Has your business taken precautions to protect the confidentiality of the disclosed information? If yes, please
explain and identify the specific measures, including but not limited to internal controls, that your business has
taken to protect the information claimed as confidential. If the same or similar information was previously reported to
EPA as non-confidential (such as in an earlier version of this submission), please explain the circumstances of that
prior submission and reasons for believing the information is nonetheless still confidential.
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3A. Is any of the information claimed as confidential required to be publicly disclosed under any other Federal
law? If yes, please explain. test

X

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3B. Does any of the information claimed as confidential otherwise appear in any public documents, including
(but not limited to) safety data sheets; advertising or promotional material; professional or trade publications;
state, local, or Federal agency files; or any other media or publications available to the general public? If yes,
please explain why the information should be treated as confidential.
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X

N

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3C. Has a patent been published for the chemical identity you claim confidential? What chemical identity
information is not revealed by the patent? How is release of that specific information likely to cause substantial
competitive harm? And failure to explain this harm may lead to denial of your confidentiality claim.
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4. Is the claim of confidentiality intended to last less than 10 years (see TSCA section 14(e)(1)(B))? If yes, please
indicate the number of years (between 1-10 years) or the specific date after which the claim is withdrawn.
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5. Has EPA, another federal agency, or court made any confidentiality determination regarding information
associated with this chemical substance? If yes, please provide the circumstances associated with the prior
determination, whether the information was found to be entitled to confidential treatment, the entity that made the
decision, and the date of the determination.
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Page 3

X

X

X