5900-656 One Time ODS Process Agent Report_Class I

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

5900-656_One Time ODS Process Agent Report_Class I .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
Section 3
Reference List
Lists


Sheet 1: Instructions





OMB Control Number: xxxx-xxxx

Expiration Date: xx/xx/xxxx

U.S. Environmental Protection Agency

Stratospheric Ozone Protection Program




Class I Process Agent One-Time Report (Sec 82.13)

Version 1.0

Last Updated: September 2024




Instructions

Complete and submit a Class I ODS Process Agent One-Time Report if your company uses regulated Class I ODS as process agents. 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 82.13). 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 #5900-656





Sheet 2: Section 1










U.S. Environmental Protection Agency



Class I Process Agent One-Time 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:


Facility Start Up Date:


Plants Name(s):


Plant Address(es):


Plant Start Up Date(s):










Sheet 3: Section 2















U.S. Environmental Protection Agency










Class I Process Agent One-Time Report




















Faclity Name:









Reporting Period:





















Section 2: Class I Substance Use Information




















Complete all fields below for each process agent use of a Class I controlled substance. No fields may be left blank.




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





Name Purpose Final Product Manufactured Amount Used Total Air Emissions (kg) Fugitive Air Emissions (kg) Stack Point Air Emissions (kg)




ODS Substance (1)











ODS Substance (2)











ODS Substance (3)






































Name Amount Used Final Product Manufactured (1) Amount of Final Product (1) Produced Final Product Manufactured (2) Amount of Final Product (2) Produced Name of Byproduct (1) Amount of Byproduct (1) Produced Name of Byproduct (2) Amount of Byproduct (2) Produced

ODS Substance (1)











ODS Substance (2)











ODS Substance (3)
























Sheet 4: Section 3








U.S. Environmental Protection Agency


Class I Process Agent One-Time Report




Facility Name:

Reporting Period:






Section 3: Substance Use Mitigation




Complete all fields below for each process agent use of a Class I controlled substance.

Description of technologies used or actions taken to minimized use or emissions of Class I controlled substances, including estimated emissions reductions:










Description of Class I substance lifecycle (including percentages used as process agent and (1) retained within the process agent application, (2) consumed in the process agent application, (3) recovered after the process agent application, (4) emitted, and (5) entrained in the final product):




x

x

Sheet 5: Reference List









U.S. Environmental Protection Agency





Class II Process Agent One Time 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 and Section 3 of this form.








Chemical Name

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












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


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