5900-658 One Time ODS Process Agent One-Time Report Class II

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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
	Class II Process Agent One-Time Report (Sec 82.24)
	Version 1.0
	Last Updated: September 2024
	Instructions
	Complete and submit a Class II ODS Process Agent One-Time Report if your company uses regulated Class II 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 82.24). 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 #5900-658

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Sheet 2: Section 1

	U.S. Environmental Protection Agency
	Class II 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):

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Sheet 3: Section 2

U.S. Environmental Protection Agency

Class II Process Agent One-Time Report

Facility Name:

Reporting Period:

Section 2: Class II Substance Use Information

Complete all fields below for each process agent use of a Class II 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)

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Sheet 4: Section 3

	U.S. Environmental Protection Agency
	Class II 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 II controlled substance.
	Description of technologies used or actions taken to minimized use or emissions of Class II controlled substances, including estimated emissions reductions:
	Description of Class II 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
	#REF!
	#REF!
	#REF!
	#REF!

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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
	HCFC-21	HCFC-123	HCFC-131	HCFC-141b	HCFC-221	HCFC-225cb	HCFC-234	HCFC-244	HCFC-262
	HCFC-22	HCFC-123a	HCFC-132b	HCFC-142	HCFC-222	HCFC-226	HCFC-235	HCFC-251	HCFC-271
	HCFC-31	HCFC-123b	HCFC-133a	HCFC-142a	HCFC-223	HCFC-231	HCFC-241	HCFC-252
	HCFC-121	HCFC-124	HCFC-141	HCFC-142b	HCFC-224	HCFC-232	HCFC-242	HCFC-253
	HCFC-122	HCFC-124a	HCFC-141a	HCFC-151	HCFC-225ca	HCFC-233	HCFC-243	HCFC-261

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Sheet 6: Lists

Chemical Name	Submission Type	Reporting Year	Current Year
HCFC-21	Original Submission	2024	2025
HCFC-22	Re-Submittal	2025
HCFC-31		2026
HCFC-121		2027
HCFC-122		2028
HCFC-123		2029
HCFC-123a		2030
HCFC-123b		2031
HCFC-124		2032
HCFC-124a		2033
HCFC-131		2034
HCFC-132b		2035
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