                                                                        
                                                                        
                                                	

     U.S. Environmental Protection Agency

          stratospheric ozone protection program	class i controlled
substance 

methyl bromide producer quarterly report 

      	1.2    FORMCHECKBOX  Original Submittal    FORMCHECKBOX
  Re-submittal

1.3 Quarter and Year to Which This Report Applies 	  FORMCHECKBOX   1st	
 FORMCHECKBOX   2nd	  FORMCHECKBOX   3rd	  FORMCHECKBOX   4th	Year  
FORMTEXT        

1.4 Producing Company

Company Name    FORMTEXT        

Street Address   FORMTEXT        

                        

City    FORMTEXT        	State    FORMTEXT        
Zip Code    FORMTEXT        

1.5 Company Contact Identification

Reporting Company Contact Person

  FORMTEXT        

	Phone Number    FORMTEXT        	Fax Number    FORMTEXT 
      

E-mail Address   FORMTEXT        

1.6 Importer Information	Is your company an Importer of methyl bromide?

If yes, is the Importer Quarterly Report attached?	  FORMCHECKBOX    Yes

  FORMCHECKBOX    Yes	  FORMCHECKBOX    No

  FORMCHECKBOX    No

1.7 Exporter Information	Is your company an Exporter of methyl bromide?

If yes, is the Exporter Quarterly Report attached?	  FORMCHECKBOX    Yes

  FORMCHECKBOX    Yes	  FORMCHECKBOX    No

  FORMCHECKBOX    No

1.8 Sales to Critical Users Information	Did your company make sales
directly to critical users?

If yes, is the Sales of Critical Methyl Bromide to End Users Report
attached?	  FORMCHECKBOX    Yes

  FORMCHECKBOX    Yes	  FORMCHECKBOX    No

  FORMCHECKBOX    No

1.9 Critical Stock Allowances Information	Did your company own
pre-phaseout stocks of methyl bromide, receive critical stock allowances
(CSAs) allocations, or purchase CSAs? 

If yes, is the Pre-2005 Methyl Bromide Stocks Report attached?	 
FORMCHECKBOX    Yes

  FORMCHECKBOX    Yes	  FORMCHECKBOX    No

      

Title    FORMTEXT        

Signature     FORMTEXT        	Date      FORMTEXT 
      



SEND COMPLETED FORMS TO:	For U.S. Postal Service:

Tracking System Program Manager

Stratospheric Protection Division

U.S. EPA (6205J)

1200 Pennsylvania Avenue, NW

Washington, DC  20460	For Private Courier:

Tracking System Program Manager

Stratospheric Protection Division

U.S. EPA (6205J)

1310 L Street, NW;  10th Floor

Washington, DC  20005



Information in reports submitted in compliance with the final rule may
be claimed as confidential.  A company may assert a claim of
confidentiality for information submitted by clearly marking that
information as confidential.  Such information shall be treated in
accordance with EPA’s procedures for information claimed as
confidential at 40 CFR Part 2, Subpart B, and will only be disclosed by
the means set forth in the subpart.  If no claim of confidentiality
accompanies the report when it is received by EPA, it may be made public
without further notice to the company (40 CFR 2.203).

The public reporting and recordkeeping burden for this collection of
information is estimated to average 18 hours per response.  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 Director, Collection Strategies Division, U.S.
Environmental Protection Agency (2822T), 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.        
                                                                       
                                                                        
                                               	

     U.S. Environmental Protection Agency

             stratospheric ozone protection program



class i controlled substance 

methyl bromide producer quarterly report 

      

 2.2 Company Production Totals

A	B	C	D	E	F	G	H	I	J	K

In-House Transformation (kg)	Second-Party Transformation (kg)	In-House
Destruction (kg)	Second-Party Destruction (kg)	Quarantine and
Preshipment (QPS) (kg)	

Critical Use Exemption (CUE) (kg)	Emergency Use Exemption (kg)	Article 5
Production (kg)	Lab Use (kg)	Gross Production of Methyl Bromide (kg)

(A+B+C+D+E+F1+F2+F3+G+H+I=J)	Critical Stock Allowances (CSA) (kg)





	F1	F2	F3











Pre-plant	Post-Harvest	For Export





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  U.S. Environmental Protection Agency

stratospheric ozone protection program

class i controlled substance 

methyl bromide producer quarterly report 

      

3.2  Allowance Balance Summary





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B2	Total post-harvest critical use allowances for year to date (as of
end of the quarter) that were:	  FORMTEXT        

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C	Total critical stock allowances (CSAs) for year to date (as of end of
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                                                                 	OMB
Control Number: 2060-0482

                                                                        
                                                                        
                                  	 Expiration Date: 8/31/11

EPA Form # 5900-141, Revised 6/08  

                                                                        
                                                                 			 OMB
Control Number: 2060-0482

                                                                        
                                                                        
                  				 Expiration Date: 8/31/11

EPA Form # 5900-141, Revised 6/08  

                                                                        
                                                                 	   
OMB Control Number: 2060-0482

	   Expiration Date: 8/31/11

