5900-715 One Time ODS Emissions Report

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Overview

Instructions
Section 1
Section 2
Section 3
Reference List
Lists

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Sheet 1: Instructions

	OMB Control Number: xxxx-xxxx
	Expiration Date: xx/xx/xxxx
	U.S. Environmental Protection Agency
	Stratospheric Ozone Protection Program
	ODS One-Time Emissions Report (Sec 82.25)
	Version 1.0
	Last Updated: September 2024
	Instructions
	Complete and submit an ODS One-Time Emissions Report if your company performs an activity listed under 40 CFR 82.25(a) and destroys regulated ODS. Please provide information for only one facility per reporting form.
	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 in Section 3 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
	This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. XXXX-XXXX). Responses to this collection of information are mandatory (40 CFR 82.25). 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 X 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 #xxxx-xxx

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Sheet 2: Section 1

	U.S. Environmental Protection Agency
	ODS One-Time Emissions Report
	Date Prepared:	7/17/2025
	Section 1: Report Identification Information
	Complete all fields below for each facility in which the process agent was used. No fields may be left blank.
	Company Name:
	Submission Type:
	Reporting Year:
	Facility Name:
	Facility Address:

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Sheet 3: Section 2

	U.S. Environmental Protection Agency
	ODS One-Time Emissions Report
	Facility Name:
	Reporting Period:
	Section 2: Destruction Unit Testing
	Complete all fields below for each destruction unit. No fields may be left blank.
	If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions.
		Controlled Substance (1) Used in Destruction Efficiency Performance Test 82.25(e)(4)(i)	Controlled Substance (2) Used in Destruction Efficiency Performance Test 82.25(e)(4)(i)	Surrogate Used in Destruction Efficiency Performance Test, if applicable 82.25(e)(4)(i)	Date of Most Recent Destruction Unit Test 82.25(e)(4)(ii)
	Destruction Unit (1)
	Destruction Unit (2)
	Destruction Unit (3)
	If surrogates were used in the performance test conducted to determine destruction efficiency, provide information on why the surrogate is sufficient to demonstrate the destruction efficiency for each controlled substance, consistent with requirements in 82.25(d)(6)(i). 82.25(e)(4)(i)
	Provide the names of all applicable Federal or State regulations that may apply to the destruction process. 82.25(e)(4)(iii)

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Sheet 4: Section 3

U.S. Environmental Protection Agency

ODS One-Time Emissions Report

Facility Name:

Reporting Period:

Section 3: Products of Incomplete Combustion of Controlled Substances

Complete all fields below for each controlled substance product of incomplete combustion (PIC). No fields may be left blank. As part of your submission, please also provide the methods and results of any measurement or modeling studies, including the PICs for which the exhaust stream was analyzed, as well as copies of relevant scientific papers, if available, or citations of the papers, if they are not.

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

Controlled Substance Destroyed

Controlled Substance PIC

Describe any measurements, research, or analysis performed or obtained that relate to the formation of products of incomplete combustion that are controlled substances during the destruction of controlled substances. 82.25(e)(6)

PIC (1)

PIC (2)

PIC (3)

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Sheet 5: Reference List

	U.S. Environmental Protection Agency
	ODS One-Time Emissions Report
	Reference List
	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. When copying and pasting data into the form, please ensure consistency with the formatting of the list below.
	Chemical Name List: The table below lists the valid chemical names that may be used when entering data into Section 2, Section 3, and Section 4 of this form.
	Chemical Name
	Class I ODS
	CFC-12	CFC-114	CFC-214	Halon 1211	CH3CCL3
	CFC-13	CFC-115	CFC-215	Halon 1301	HBFCs
	CFC-111	CFC-211	CFC-216	Halon 2402
	CFC-112	CFC-212	CFC-217	CBM
	CFC-113	CFC-213	Halon 1202	CCL4
	Class II ODS
	HCFC-21	HCFC-124a	HCFC-142b	HCFC-231	HCFC-251
	HCFC-22	HCFC-131	HCFC-151	HCFC-232	HCFC-252
	HCFC-31	HCFC-132b	HCFC-221	HCFC-233	HCFC-253
	HCFC-121	HCFC-133a	HCFC-222	HCFC-234	HCFC-261
	HCFC-122	HCFC-141	HCFC-223	HCFC-235	HCFC-262
	HCFC-123	HCFC-141a	HCFC-224	HCFC-241	HCFC-271
	HCFC-123a	HCFC-141b	HCFC-225ca	HCFC-242
	HCFC-123b	HCFC-142	HCFC-225cb	HCFC-243
	HCFC-124	HCFC-142a	HCFC-226	HCFC-244

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Sheet 6: Lists

Chemical Name	Submission Type	Reporting Year	Current Year
CFC-12	Original Submission	2024	2025
CFC-13	Re-Submittal	2025
CFC-111		2026
CFC-112		2027
CFC-113		2028
CFC-114		2029
CFC-115		2030
CFC-211		2031
CFC-212		2032
CFC-213		2033
CFC-214		2034
CFC-215		2035
CFC-216
CFC-217
Halon 1202
Halon 1211
Halon 1301
Halon 2402
CBM
CCL4
CH3CCL3
HBFCs
HCFC-21
HCFC-22
HCFC-31
HCFC-121
HCFC-122
HCFC-123
HCFC-123a
HCFC-123b
HCFC-124
HCFC-124a
HCFC-131
HCFC-132b
HCFC-133a
HCFC-141
HCFC-141a
HCFC-141b
HCFC-142
HCFC-142a
HCFC-142b
HCFC-151
HCFC-221
HCFC-222
HCFC-223
HCFC-224
HCFC-225ca
HCFC-225cb
HCFC-226
HCFC-231
HCFC-232
HCFC-233
HCFC-234
HCFC-235
HCFC-241
HCFC-242
HCFC-243
HCFC-244
HCFC-251
HCFC-252
HCFC-253
HCFC-261
HCFC-262
HCFC-271