United States

ENVIRONMENTAL PROTECTION AGENCY

Washington, DC 20460	AGENCY USE ONLYOMB Control No.: 2060-0226

Expires: 6/30/2014

SNAP INFORMATION NOTICE

For Significant New Alternatives	Date of Receipt:

Date 90 Day Review Begins:

Date Review Completed:

CBI Status:



When completed send this form to:

Via US Postal Service:                                                  
                                 Via Overnight Delivery Service:

SNAP DOCUMENT CONTROL OFFICER                       SNAP DOCUMENT
CONTROL OFFICER

OFFICE OF AIR AND RADIATION, 6205 J                      U.S. EPA

U.S. EPA                                                                
         1310 L STREET NW

1200 PENNSYLVANIA AVE NW                                     10th FLOOR
(MC 6205J)

WASHINGTON, DC 20460                                     WASHINGTON, DC
20005



	Enter the total number of pages in your SNAP information Notice:
Document Control Number



INTRODUCTION

GENERAL INSTRUCTIONS

This form may be used to submit information under the Significant New
Alternatives Policy (SNAP) program for the review of alternatives to
class I and class II ozone-depleting substances (ODS) under section 612
of the Clean Air Act.  Submitters are required to provide this
information on new substitutes to assist the Agency in assessing the
acceptability of chemicals or processes that are considered alternatives
for ODSs.  A separate notice must be filed for each alternative you are
submitting.

PAPER SUBMISSIONS: All paper submissions must be provided in three
complete copies.  If information is to be claimed as confidential, all
confidential information must be excised from one of the copies, which
will be placed in the public docket; the other two copies must include
the confidential material.  If no claims of confidentiality are made for
the submission, all copies must be identical.

CD-ROM SUBMISSIONS: The SNAP program also accepts submissions via
CD-ROM.  If information is to be claimed as confidential, all
confidential information must be excised from one of the files on the
CD-ROM, which will be placed in the public docket; the other file must
include the confidential material.  The file with the confidential
material must include “contains CBI” in the file name.

STEP-BY-STEP INSTRUCTIONS: The Instructions for the SNAP Information
Notice and TSCA/SNAP Addendum (“Instructions”) are designed to
assist applicants in completing this form.  The Instructions provide
step-by-step guidance on submitting a SNAP notice, asserting
confidentiality claims, completing the notice form, sector-specific data
requirements, and submitting test data and supplemental information.

To facilitate Agency review of alternatives, this form must be filled
out as completely as possible.  Please provide all information requested
to the extent that it is known or reasonably ascertainable.  Make
reasonable estimates if actual data is unavailable.

TYPE OF NOTICE (Check only one box)

Select the appropriate box identifying the type of notice submitted:

Manufacturer Submission:  New alternative, Substance, or
Formulation___________________________________________

Petition: New alternative, Substance, or
Formulation__________________________________________________________

Petition: Revision of the Existing SNAP
list__________________________________________________________________


Petition: Request to Grandfather Use of An Unacceptable
Substitute_____________________________________________





Part I - GENERAL INFORMATION

You must provide the identity of the alternative chemical or processes
and the identity and percentages of all components in a blend and/or
process, even if you claim the identity as confidential.  You may
authorize another person to submit the identity for you, but your
submission will not be complete and review cannot begin until EPA
receives this information.

Part II - ALTERNATIVE-SPECIFIC INFORMATION

                                                       

Please indicate the sector(s) for which you are submitting information
on the substitute by checking the appropriate boxes:

Refrigeration and Air Conditioning 	           

Foam Blowing    			      

Solvent Cleaning      	  	        

Fire Extinguishing 

		and Explosion Prevention    	      

Sterilization       	 		      

Aerosols 				      

Adhesives, Coatings, and Inks 	       

Tobacco Expansion 		      

Pesticides 			       

You may need additional copies of Part II if there are several
manufacturing, processing, or use operations that you will describe in
this notice.  Please reproduce these sections as needed.

If your substitute is also subject to review under FIFRA, provide the
FIFRA Registration Number:

 _____________________________

	Part III - RELEASE AND EXPOSURE DATA

Please reproduce additional copies of Part III as necessary.

Part IV - LIST OF ATTACHMENTS

Please attach additional sheets if you do not have enough space on the
form to fully answer a question.  Label each continuation sheet with the
corresponding section heading and the question.  In part IV, list these
attachments and any test data, other data, or any optional information
that you include in this notice.

TEST DATA AND OTHER DATA

You are required to submit all test data in your possession or control
and to provide a description of all other data known to you if these
data are related to the health and environmental effects of the
manufacture, processing, distribution in commerce, use, or disposal of
the alternative.  Standard literature citations may be submitted if they
do not appear in the open scientific literature.  Complete test data (in
English), not summaries of data, must be submitted if they do not appear
in the open literature.  The following are test data and other data that
might be submitted (see the Instructions for a more complete list of
data to be submitted.)  Please indicate test data to be included in your
submission notice by checking the appropriate boxes:

 Yes    No

Flammability Data		 Yes    No

Environmental Effects 

	Data			 Yes    No

Environmental Fate 

	Data			 Yes    No

Risk Assessments		 Yes    No

Test Data Not in the Possession/

	Control of the Submitter	 Yes    No

Other Data 			 Yes    No





CONFIDENTIALITY CLAIMS

Anyone submitting information must assert a claim of confidentiality at
the time of submission for any data which are to be treated as
Confidential Business Information (CBI).  Substantiation of this claim
must also be provided at this time.  All information claimed as CBI will
be treated in a manner consistent with 40 CFR Part 2, Subpart B. 
Failure to assert a claim of confidentiality at the time of submission
may result in disclosure of information by the Agency without further
notice.

To assert a claim on this form, circle or bracket the information you
claim as confidential and mark the confidential box at the bottom of the
page.  Then provide substantiation of this claim on an attachment to the
notice.  If any information is claimed as confidential, you must provide
a “sanitized” version of this notice, including attachments, to EPA
with your submission.  For additional information on claiming
information as confidential, please see the Instructions Manual.

Information submitted as CBI may be accessed by companies designated as
Authorized Representatives of the United States Environmental Protection
Agency (EPA) under an EPA contract for the purpose of assisting EPA in
the development and implementation of national regulations for the
protection of stratospheric ozone, including the development of the SNAP
program.  These Authorized Representatives may have access to any
information received by the Stratospheric Protection Division within the
EPA Office of the Atmospheric Programs for use in reviewing the need for
possible control of any substance, practice, process or activity that
may reasonably be anticipated to affect stratospheric ozone.  Access to
such information is necessary to ensure that these companies can
complete the work required by the contract.

Authorized Representatives of the Administrator are subject to the
provisions of 42 U.S.C. 7414(c) respecting confidential business
information as implemented by 40 CFR 2.301(h).





Part I - GENERAL INFORMATION 

Section A - SUBMITTER IDENTIFICATION



1. (a) Person Submitting Notice (in U.S.)

________________________________________________________________________
_____________________________________

Name of Authorized Official                                             
                                                                 Title

________________________________________________________________________
____________________________________

Company/Organization

________________________________________________________________________
____________________________________

Mailing Address                                                         
                                                                        
Telephone & Fax Numbers 

________________________________________________________________________
____________________________________

E-mail Address

(b) Agent (if applicable)

________________________________________________________________________
____________________________________

Name of Authorized Official                                             
                                                                 Title

________________________________________________________________________
____________________________________

Company/Organization

________________________________________________________________________
____________________________________

Mailing Address                                                         
                                                                        
Telephone & Fax Numbers 

________________________________________________________________________
____________________________________

E-mail Address

(c) Joint Submitter (if applicable)

________________________________________________________________________
____________________________________

Name of Authorized Official                                             
                                                                 Title

________________________________________________________________________
____________________________________

Company/Organization

________________________________________________________________________
____________________________________

Mailing Address                                                         
                                                                        
Telephone & Fax Numbers 

________________________________________________________________________
____________________________________

E-mail Address

2. Technical Contact (in U.S.)

________________________________________________________________________
__________________________________

Name of Authorized Official                                             
                                                                 Title

________________________________________________________________________
_________________________________

Company/Organization

________________________________________________________________________
__________________________________

Mailing Address                                                         
                                                                        
Telephone & Fax Numbers 

________________________________________________________________________
__________________________________

E-mail Address

3. If you have had a prior communication with EPA concerning this
notice, note the date and type of communication (letter, phone, etc.)
and the EPA staff person’s name:

Mark (X) if None ________________

Mark (X) this box if this page contains CBI __________



Part I - GENERAL INFORMATION (continued)

Section B - ALTERNATIVE IDENTIFICATION

1. Commercial/Trade name (s) of alternative:



2. (a) Name of chemical(s) (preferably IUPAC nomenclature) and/or
process name.  For blends, provide the percent composition of each
constituent.  For powdered aerosols used in fire suppression, see page
11 of the Instructions for additional necessary composition information.

    (b) Chemical Abstracts Service (CAS) registry number and molecular
formula.

    (c) For alternative processes and technologies describe the
technology and and provide a diagram of the system.  Also provide the
information on any chemical constituents.

    (d) If you have applied for or hold a patent on the substitute,
provide the patent name, number (if available), and information on the
topics covered in the patent. 



3. Generic name: 

If the name of the substitute is declared Confidential Business
Information, provide a generic name.



4. Specific End-Use

   (a) Describe each end-use that may be reasonably anticipated for the
alternative.  Be sure to provide a broad description (e.g.,
terpene-based semi-aqueous solvent cleaner for electronic parts, or HFC
substitute refrigerant for centrifugal chillers).  For a list of end
uses, see Appendix A to the Instructions, beginning on p. 23.  If the
alternative is a refrigerant, indicate whether it is a candidate for use
in retrofits of existing equipment, for use in new equipment only, or
both.

   (b) Identify the ODS and the quantity of substitute needed to replace
it for each end use in pounds (i.e., the replacement ratio).





Part I - GENERAL INFORMATION (continued)

Section B - ALTERNATIVE IDENTIFICATION (Continued)

5. Impurities

    (a) Identify each impurity that may reasonably be anticipated to be
present in the chemical alternative as manufactured for commercial
purposes.  If there are unidentified impurities, enter
“unidentified.”

    (b) Provide the CAS Registry Number for each impurity if available.

    (c) Estimate the maximum weight percentage of each impurity.  If
there are unidentified impurities, estimate their total weight   
percentages.



6. Byproducts:

    (a) Describe any byproducts or degradation products resulting from
the manufacturer, processing, use or disposal of the chemical
alternative or chemicals used in the new alternative.  If there are
unidentified byproducts/ degradation products enter “unidentified.” 

    (b) Provide the CAS Registry Number for each byproduct or
degradation product if available.







10.  Vapor pressure @ 20º C                                    psi

(Also provide vapor pressure-temperature curve for refrigerants.)	11. 
Critical temperature                                                    
   ºC	12.  Critical Pressure                                          
psi

13.  Are spectra attached?	14.  Disassociation constant

15.  Particle size distribution	16.  Volatilization from soil

17.  Volatilization from water	18.  Viscosity @ 20 ºC

19.  pH@concentration	20.  Thermal conductivity (for foam blowing
agents)



21.  Adsorption coefficient	22.  Flammability limits (LFL, UFL)         
            % vol

23.  Flash point	24.  Heat of combustion

25.  Maximum pressure rise	26.  Maximum rate of pressure rise

27.  Other (specify)

	28. Flammability: Provide any information on flammability concerns. 
For example, if any abatement techniques are being used to minimize the
risks associated with flammable substances or mixtures, detail those
techniques below.  If a substitute is flammable, an assessment of
overall risk in each end-use may be required.  For flammable
refrigerants, provide a fault tree analysis for each end use.  For
flammable foam blowing agents used in spray foam, provide a training
program that addresses flammability concerns specific to this
substitute. (See Appendix B to Instructions for sector-specific data
requirements for flammable substances).

Mark (X) this box if this page contains CBI __________



Part II - ALTERNATIVE-SPECIFIC INFORMATION (Continued)

Section B - ATMOSPHERIC INFORMATION

1.  Ozone-depletion potential (ODP):

     (a) Provide the 100 year ODP of the alternative relative to CFC-11,
if known.  If the substitute is a blend, provide the ODPs of the
individual constituents.  Reference the source for each ODP.

     (b) Provide any additional data on the ODP of the alternative (e.g.
atmospheric lifetime, chlorine or bromine loading potentials). 
Reference the source of this information and attach any supporting
documentation.



2.  Global Warming Characteristics:

    (a) Provide the alternative’s atmospheric lifetime and global
warming potential (GWP) relative to carbon dioxide over 100-year time
horizon, and 20-year or 500-year time horizon, if known.  Reference the
most recent assessment report of the Intergovernmental Panel on Climate
Change (IPCC AR4).  Alternate sources may include the 2010 World
Meteorological Organization (WMO) Scientific Assessment of Ozone
Depletion or the peer-reviewed literature.  If the substitute is a
blend, provide the GWPs of the individual constituents and an estimate
of the blend at its nominal composition.

    (b) If known, provide the alternative’s expected impact on energy
efficiency relative to the substance it is replacing (e.g. +/- X%) and
results of  any testing or modeling done (both theoretical and actual
testing).  Energy efficiency information is particularly useful for
refrigerants and foams.

    (c) For GWP values that do not come from AR4 or WMO 2010, provide
any available additional data on the atmospheric lifetime and GWP of the
alternative, including infrared absorption spectrum and infrared
absorption capacity.  Reference the source of this information.  



Mark (X) this box if this page contains CBI __________

Part II - ALTERNATIVE-SPECIFIC INFORMATION (continued)

Section C - OTHER STATUTES AND STANDARDS

1.  Describe whether and how the manufacture, use, and disposal of the
alternative is regulated under other environmental regulatory statutes
such as those listed below.  List any concentration-based or other
numerical standards to which the alternative is subject under the
standards and regulations.

Titles of the Clean Air Act (CAA) other than Title VI
_____________________________________________________

the Clean Water Act (CWA)
________________________________________________________________________
_

the Safe Drinking Water Act (SDWA)
_________________________________________________________________

the Resource Conservation and Recovery Act (RCRA)
____________________________________________________

the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA)
____________________________________________

the Toxic Substances Control Act (TSCA)
______________________________________________________________

the Comprehensive Environmental Response, Compensation and Liability Act
(CERCLA) ________________________

the Emergency Planning and Community Right to Know Act (EPCRA or SARA
Title III) ________________________

State and local laws
________________________________________________________________________
_________

Other applicable environmental federal, state, and local laws not
mentioned above _______________________________

 

2.  Describe whether and how occupational, consumer, or general
population exposure to the alternative is regulated under health and
safety related statutory authorities, such as those implemented by the
Food and Drug Administration (FDA), the Occupational Safety and Health
Administration (OSHA), the Department of Transportation (DOT), and state
and local laws.  List any concentration-based or other numerical
standards to which the alternative is subject under the above statutes
and regulations.  Also list any other standard-setting organizations
such as the National Fire Prevention Association (NFPA)  the American
Society of Heating, Refrigerating, and Air Conditioning Engineers
(ASHRAE), or Underwriters Laboratories (UL) that will evaluate the
substitute from a health and safety perspective. 





Part II - ALTERNATIVE-SPECIFIC INFORMATION (continued)

Section D - COST AND AVAILABILITY OF THE ALTERNATIVE

1.  Estimate the cost per pound for the substitute chemical.  For
alternative processes and technologies, describe installation costs
associated with the alternative.  Please describe the information used
as the basis for this cost estimate.



2.  Provide information on production of the substitute.  Include
estimates on:

    (a) Year substitute will be available if not currently produced.

    (b) Total pounds production per year (current figure).

    (c) Years to maximum market penetration.

    (d) Maximum total production per year at market saturation.

    (e) Estimated percentage of market at market saturation.



3.  Describe any new equipment and use profiles that will be necessary
in order to use the substitute.  If retrofitting of existing equipment
is required, detail changes in technologies needed to use the
alternative and address any materials compatibility issues.  Provide
information on each end-use and capital costs associated with the
substitute or alternative process.  Include cost of equipment and/or any
new materials, equipment lifetime, changes in labor and energy costs.



Mark (X) this box if this page contains CBI __________



Part III - RELEASE AND EXPOSURE DATA

Section A - TOXICITY AND HAZARD INFORMATION

For chemical alternatives and for chemicals used with alternative
processes, summarize below (and attach supporting information on) the
acute and chronic toxicity of the substitute and of its constituent
chemicals on any organism (e.g. human and/or other mammals, fish,
wildlife, and plants), if available.  Include any data on impurities and
degradation products if known.  Also include information on any
permissible exposure limits (PELs), occupational exposure limits (OELs),
or Acceptable Exposure Limits (AELs) that have been set for the
substitute for use in the workplace.  In addition, please attach a copy
of any hazard warning statement, label, material safety data sheet, or
other information which will be provided to any person who is reasonably
likely to be exposed.  (See Pgs. 16-17 of the Instructions for
sector-specific  requirements for toxicity testing).



Section B - ENVIRONMENTAL RELEASE AND DISPOSAL AT MANUFACTURE

For each manufacturing site (for manufacturing of substitutes and/or
products containing substitutes):

     (a) Identify all site locations (i.e., name and address) for each
chemical manufacturing process.

     (b) Identify all site locations for manufacturing of products using
substitutes (e.g., refrigerators containing the substitutes).

     (c) Identify the points of release and/or exposure during the
manufacture of: (i) the substitute and/or (ii) products containing the
substitutes.

     (d) Provide information on the magnitude of release if available,
along with the media to which the substitute is released (e.g., indoor
air, outdoor air, water, land).



Mark (X) this box if this page contains CBI __________

Part III - RELEASE AND EXPOSURE DATA

Section C- OCCUPATIONAL EXPOSURE AT MANUFACTURE

For each manufacturing site (manufacturing of substitutes and/or
products containing substitutes):

     (a) Describe the activities in which workers may be exposed to
chemicals at the manufacturing facility.  Answer items (b) through (g)
for each activity.

     (b) Describe any protective equipment and engineering controls used
to protect workers (e.g., goggles, gloves, chemical hoods).

     (c) Indicate the physical form of chemicals at the time of
handling/exposure (e.g., solid, liquid, gas).

     (d) Estimate average and maximum numbers of workers involved in
each activity.

     (e) Estimate average and maximum duration of activity for any
worker, in terms of (1) hours/day and (2) days/year.

     (f) Enter the contact pathway (e.g., ingestion, inhalation,
dermal).

     (g) Estimate the average and high-end exposure concentrations
(separated by a /), being sure to provide units of measure.



Section D - ENVIRONMENTAL RELEASE AND DISPOSAL IN END-USE

For each end-use of a substitute (end-uses using the substitute in
products and/or processes):

     (a) Provide the estimated amount (in kg/day) of each chemical
released to the environment (e.g., as a solid waste or wastewater
effluent) at the point of, or subsequent to, the end-use at a site using
the substitute (e.g., in products containing the substitute and
processes using the substitute).

     (b) Identify the media (indoor air, outdoor air, land, water) to
which the chemical will be released from that release point.

     (c) Describe the control technology used to limit release; estimate
the amount released to the environment with the control technology in
place to limit release.  If the substitute is to be disposed of,
indicate the method and location of disposal.

     (d) Are releases covered under RCRA?  If so, identify the RCRA
hazardous waste codes.

     (e) Identify the approximate number of sites expected to use the
substitute.





Part III - RELEASE AND EXPOSURE DATA (continued)

Section E - OCCUPATIONAL EXPOSURE AT END-USE

For all end-use scenarios of the substitute (end-uses utilizing the
substitute in products and/or processes):

     (a) Describe the activities in which workers may be exposed to
chemicals at the end-use (i.e., during installation, maintenance,
inspection, servicing, or use).  Answer items (b) through (g) for each
activity.

     (b) Describe any protective equipment or engineering controls used
to protect workers (e.g., goggles, gloves, chemical hoods).

     (c) Indicate the physical form of chemicals at the time of
handling/exposure (e.g., solid, liquid, gas).

     (d) Estimate average and maximum numbers of workers involved in
each activity.

     (e) Estimate average and maximum duration of activity for any
worker, in terms of (1) hours/day and (2) days/year.

     (f) Enter the contact pathway (e.g,. ingestion, inhalation,
dermal).

     (g) Estimate the average and high-end exposure concentrations
(separated by a /), being sure to provide units.  Personal monitoring
data may be required for some end uses (see pgs. 17-18 of Instructions).



Section F - CONSUMER EXPOSURE

For each end-use of a substitute (end-uses where a consumer might be
exposed):

     (a) Identify the potentially exposed consumer population (e.g,.
indoor residents).

     (b) Identify the exposure medium (e.g., air).

     (c) Enter the contact pathway (e.g,. ingestion, inhalation,
dermal).

     (d) Describe the exposure point of concentration.  Provide (1)
average and (2) high-end concentration estimates, including units of
measure.



Part III - RELEASE AND EXPOSURE DATA (continued)

Section G - GENERAL POPULATION EXPOSURE (optional)

For manufacturing of substitutes and products containing substitutes:

     (a) Identify and number potential general population exposure
points.

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(b) For each exposure point described in (a), identify the potentially
exposed population (e.g., residents at the fenceline to the
manufacturing facility).

     (c) Identify the contact pathway (e.g., ingestion, inhalation,
dermal).





Part IV - LIST OF ATTACHMENTS

List below any attachments that complete the responses to the questions
on this form or that provide additional information that may assist
EPA’s review of the alternative under Section 612 of the Clean Air
Act.  Also, provide citations for information already submitted to EPA
as part of past regulatory and information activities, as well as for
other information that could not be included with this submission.  If
you have attached continuation pages, describe the Part, Section and
question number being continued.  Attach additional pages if necessary. 
Mark (X) in the CBI box next to any attachment that contains information
you claim as confidential.

Attachment Name	Question #	Number of Pages	CBI



















































































































				

Mark (X) this box if this page contains CBI __________

Part V - CERTIFICATION

I certify to the best of my knowledge and belief that:

1.  All information provided in this notice is complete and truthful as
of the date of the submission.

2.  I am submitting with this notice all test data in my possession or
control and a description of all other data known to or reasonably
ascertainable by me.

3.  If this is a submission of a new alternative, the company named in
Part I, Question 1a of this notice:

     (a) intends to manufacture, formulate, import, market, or use a new
alternative to a Class I or Class II ozone-depleting substance which is
identified in Part I, Section B, Question 2.

     (b) seeks an acceptability determination on a new alternative(s) to
a Class I or Class II ozone-depleting substance, which is identified in
Part I, Section B, Question 2.

4.  The accuracy of the statements made in this notice reflects my best
prediction of the anticipated facts regarding the alternative described
herein.  Any knowing and willful misinterpretation is subject to
criminal penalty pursuant to section 113(c) of the Clean Air Act and 18
U.S.C.§1001.

Signature and Title of Authorized Official (Original Signature
Required):                                 Date

  

Signature of Agent (Where Applicable):                                  
                                                       Date





For persons filing a SNAP Information Notice, the reporting burden is
estimated to average 171 hours per year.  For persons filing a TSCA/SNAP
Addendum, the reporting burden is estimated to average 36 hours her
year.  Burden means that total time, or financial resources expended by
persons to generate, maintain, retain, or disclose or provide
information to or for a Federal agency.  This includes the time needed
to review instruction; develop, acquire, install, and utilize technology
and systems for the purposes of collecting, validating, and verifying
information; adjust the existing ways to comply with any previously
applicable instructions and requirements; train personnel to be able to
respond to a collection of information; search data sources; complete
and review the collection of information; and transmit or otherwise
disclose the information.  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.

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gies Division (2822T), U.S. Environmental Protection Agency,1200
Pennsylvania Ave NW,  Washington, DC 20460.  Include the OMB control
number in any correspondence.  Do not send the completed form to this
address.



 PAGE   

 PAGE   7 

Form 1265-07 (Revised 04/2011)			

Previous editions are obsolete

