United States

 ENVIRONMENTAL PROTECTION AGENCY

Washington, DC 20460	AGENCY USE ONLY

OMB Control No.: 2060-0226

Expires:   06/30/2014 

TSCA/SNAP ADDENDUM

for Significant New Alternatives	Date of Receipt:

When completed send this form via U.S. mail to:          Or via
overnight delivery to:

SNAP Document Control Officer                   SNAP Document Control
Officer

Office of Air and Radiation, 6205 J                U.S. EPA

U.S. EPA                                                       1310 L
St, NW 

1200 Pennsylvania Ave, NW                         10th Floor (MC 6205J)

Washington, DC 20460                            Washington, DC 20005

	Date 90 Day Review Begins:

Date Review Completed:

PMN Document Control Number 



Enter the total number of pages in your SNAP information Notice:	SNAP
Document Control No.



INTRODUCTION

GENERAL INSTRUCTIONS

This form may be used in conjunction with the Premanufacture Notice
(PMN) for new chemical substances (EPA Form 7710-25 (Rev. 1-19)) to
submit chemicals for review under the Significant New Alternatives
Policy program as alternatives to Class I and II ozone-depleting
substances.  In addition to the information provided in the
Premanufacture Notice, the Agency is requesting submitters provide
information on the following topics.  This information will assist EPA
in assessing the acceptability of the chemical as an alternative to
ozone-depleting substances as required by Section 612 of the Clean Air
Act.  Please see the Instructions for the SNAP Information Notice and
TSCA/SNAP Addendum (“Instructions”) for additional information on
the relationship between the SNAP and TSCA PMN programs and for guidance
on completing this form.

To facilitate Agency review of alternatives, both this form and the
complete PMN form (including the physical and chemical properties
worksheet) 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 are
unavailable.

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 file; 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.  Please
provide a CD-ROM copy of your PMN submission along with your SNAP
submission.

CONFIDENTIALITY CLAIMS: Anyone submitting information must assert a
claim of confidentiality at the time of submission for any data which is
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 the information by
the Agency without further notice.

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 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.  In
general, this information will pertain to the feasibility, costs, and
environmental and health impacts of using substitutes for Class I and
Class II substances.  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
provision of 42 U.S.C. 7414(c) regarding 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 

________________________________________________________________________
______________________________

Email Address                                                           
                                                                      

(b) Agent (if applicable)

________________________________________________________________________
______________________________

Name of Authorized Official                                             
                                                                 Title

________________________________________________________________________
______________________________

Company/Organization

________________________________________________________________________
______________________________

Mailing Address                                                         
                                                                        
Telephone & Fax Numbers 

________________________________________________________________________
______________________________

Email Address 

(c) Joint Submitter (if applicable)

________________________________________________________________________
______________________________

Name of Authorized Official                                             
                                                                 Title

________________________________________________________________________
______________________________

Company/Organization

________________________________________________________________________
______________________________

Mailing Address                                                         
                                                                        
Telephone & Fax Numbers 

________________________________________________________________________
______________________________

Email Address 

2. Technical Contact (in U.S.)

________________________________________________________________________
______________________________

Name of Authorized Official                                             
                                                                 Title

________________________________________________________________________
______________________________

Company/Organization

________________________________________________________________________
______________________________

Mailing Address                                                         
                                                                        
Telephone & Fax Numbers 

________________________________________________________________________
______________________________

Email 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 II - ALTERNATIVE-SPECIFIC INFORMATION

1.  Name of chemical (preferably IUPAC nomenclature) and molecular
formula.



2.  Generic name (if chemical name of substitute is declared
Confidential Business Information)

   



3.  End-uses and ozone-depleting substances (ODSs) being replaced:

     (a) Describe each industrial sector and end-use that may be
reasonably anticipated for the alternative.  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 (i.e., the replacement ratio).



4.  Ozone-depletion Potential (ODP):

     (a) Provide the alternative’s 100-year ODP of the alternative
relative to CFC-11, if known.  Reference the source of the 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.



			

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

Part II - ALTERNATIVE-SPECIFIC INFORMATION (Continued)

5.  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.  



6.  Flammability Concerns:

     (a) Provide the alternative’s flash point, the upper and lower
flammability limits (UFL & LFL) in percent by volume, the heat of
combustion (kJ/kg), maximum pressure (PSI), and maximum rate of pressure
rise.

     (b) Provide any additional 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.

     (c) 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.



7.  Cost and Availability of Alternative:

     (a) Estimate the cost per pound for the alternative chemical. 
Please describe the information used as the basis for this cost
estimate.

     (b) 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 any new materials, equipment lifetime, changes in labor,
and energy costs.

      (c)  Provide information on when the substitute is expected to be
available, including:

- Year substitute is expected to be available

- Years to maximum market penetration - Maximum total production per
year at maximum market penetration, providing units of measure and
estimated percentage of market.



							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



	

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ࠀot required to respond to, a collection of information unless it
displays a currently valid OMB control number.

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, including through the use of automated
collection techniques to the U.S. Environmental Protection Agency, Attn:
Director, Collection Strategies Division, Office of Information
Collection, 1200 Pennsylvania Avenue, NW, Mail Code 2822T, Washington
DC, 20460.  Please include the EPA Docket ID Number OAR-2004-0077 and
OMB Control Number 2060-0226 in any correspondence.  Do not send the
completed form to this address.



  PAGE   1 

EPA Form 1265-07 (Revised 04/2011)			

Previous editions are obsolete

