   U.S. Environmental Protection Agency

	

             stratospheric ozone protection program	class i controlled
substance

notification of methyl bromide transfers 

      	1.2    FORMCHECKBOX  Original Submittal    FORMCHECKBOX
  Re-submittal

1.3 Number of     Transactions Reported	  FORMTEXT        	1.4
Number of Pages   

      Submitted	  FORMTEXT        

1.5 Company Information

	Company Name    FORMTEXT        



Street Address    FORMTEXT        



City    FORMTEXT        

	State    FORMTEXT        	Zip Code    FORMTEXT 
      

1.6 Company Contact Identification

Reporting Company Contact Person 

   FORMTEXT        

      

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 

notification of methyl bromide transfers 

(Sec 82.12)

SECTION 2    TRANSACTION RECORD

                               (Reproduce additional sheets as needed)



	TRANSACTION #	  FORMTEXT        			

2.1 Transferee Identification	

Transferee Company Name

  FORMTEXT        	Transferee Contact Person

  FORMTEXT        

Street Address   FORMTEXT        

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  Pre-Plant CUA	  FORMCHECKBOX   Post-Harvest CUA	  FORMCHECKBOX  
Article 5 Allowances	  FORMCHECKBOX   Critical Stock Allowance (CSA)

2.2 Type of Allowances Transferred (check only one)	  FORMCHECKBOX  
Current Year Allowances	  FORMCHECKBOX   Baseline Year Allowances

2.3  Number of Allowances Being Transferred (kg) 	  FORMTEXT 
      

2.4  Amount of Offset (kg)

For Pre-Plant and Post-Harvest CUAs, 0.001 x Section 2.3; 

For Article 5 Allowances, 0.01 x Section 2.3;

For CSAs no offset is applied, proceed to Section 2.5 	  FORMTEXT 
      

2.4  Number of Allowances Subtracted from Transferor’s Balance of
Chemical Being Transferred (Section 2.3 + Section 2.4) (kg)	  FORMTEXT 
      

2.5  Number of Allowances Being Received (kg)	  FORMTEXT 
      



  U.S. Environmental Protection Agency

        stratospheric ozone protection program

class i controlled substance 

notification of methyl bromide transfers

 (Sec 82.12)

SECTION 3    UNEXPENDED BALANCE SUMMARY



3.1  Balance of Unexpended Methyl Bromide Allowances Prior to Trades
Reported

A	B	C	D

Balance of Unexpended  Pre-Plant Critical Use Allowances 	Balance of
Unexpended Post-Harvest Critical Use  Allowances	Balance of Unexpended
Article 5 Allowances	Balance of Unexpended Critical Stock Allowances

  FORMTEXT        

	  FORMTEXT        

	  FORMTEXT        	  FORMTEXT        



                                                                        
                                                                 OMB
Control Number: 2060-0482

                                                                        
                                                                        
                                                      Expiration Date:
8/31/11

EPA Form 5900-146, Revised 6/08  

