Attachment A: Nanoscale Materials Stewardship Program Data Form

Notice to Participants:

Participation in and submission of data to the Program is voluntary

EPA is requesting you provide data to the extent it is known or reasonably ascertainable

Use of this form by Program participants is also voluntary

You do not have to fill out the entire form – you may leave portions blank when data is not known or reasonably ascertainable

In some instances EPA is requesting that you explain why data is not available

EPA encourages participants to provide as much data as possible including why data is not available

You may use the form as a guide to determine which data to report to EPA

Participation in and submission of data to the Program does not imply an intent to manufacture or import for a commercial purpose

Completion and submission of this form to the Program does not satisfy any requirement under 40 CFR part 720 to submit a PMN or under 40 CFR part 721 to submit a Significant New Use Notification

07-09-07 Version. Form Not Approved.

U.S. ENVIRONMENTAL PROTECTION AGENCY

AGENCY USE ONLY:	Document control number	EPA case number	Date of receipt

When completed

send this form to

U.S. E.P.A.

DOCUMENT CONTROL OFFICER (7407M)

1200 PENNSYLVANIA AVE. NW

WASHINGTON, D.C. 20460

ATTN: NANOSCALE MATERIALS STEWARDSHIP PROGRAM

	This form has been developed for the U.S. EPA’s Nanoscale Materials Stewardship Program.  To ease the burden of reporting, the form is based on the standard Premanufacture Notice (PMN) form (EPA FORM 7710-25, Rev. 5-95); many of the pages in this form are adapted from those in the PMN form; irrelevant sections have been removed.  Additional pages seeking nanoscale materials-specific information are inserted in the most relevant places.

GENERAL INSTRUCTIONS

As much of this form is adapted from the PMN form, it may be instructive to read “Instruction Manual for Reporting Under the TSCA §5 New Chemicals Program” (available from the Toxic Substances Control Act (TSCA) Information Service,<PHONE_NUMBER>, or<PHONE_NUMBER>(fax) or at http://www.epa.gov/opptintr/newchems/pubs/pmnforms.htm).

Just as in a standard PMN, provide all information requested in this form to the extent it is known or reasonably ascertainable.  Particularly as related to the health and environmental effects of the manufacture, processing, distribution in commerce, use, or disposal of the substance, all test data in your possession or control and a description of all other known data should be provided.  Reasonable estimates or modeling data may be given in the absence of actual data.  Standard literature citations may be submitted for data in the open scientific literature.  Complete test data report (written in English), not summary data, should be submitted, if they do not appear in the open literature.  Clearly identify whether test data is on the substance, on an analog, or from models.

Any answer may be left blank or filled with “N/A,” if the information is not available, or the question is not applicable (e.g., characterization data for tests that were not run, production volume for materials that are not at the production stage, CAS name and number for materials not registered with CAS, etc.).  IT IS NOT NECESSARY TO DO ADDITIONAL TESTING IN ORDER TO COMPLETE THIS FORM.

Attach additional sheets as needed.  Label each continuation sheet with the corresponding section heading.  List all attachments including data and optional information on page 15.

Only one substance should be submitted per form.

Any information may be claimed as confidential.  To assert a claim on the form, mark (X) the confidential box next to the information claimed as confidential.  To assert a claim in an attachment, circle or bracket the information claimed as confidential.  If information is claimed as confidential, a sanitized version (including attachments) should be provided.  For additional instructions on claiming information as confidential, read the Instructions Manual.  Submission of confidential information on this form constitutes consent for disclosure of the information to EPA contractors under the security procedures used in handling information submitted under TSCA.

NOTICES

Participation in and submission of data to the Program is voluntary.

Use of this form by Program participants is also voluntary.

Participation in and submission of data to the Program does not imply an intent to manufacture or import for a commercial purpose.

Completion and submission of this form to the Program does not satisfy any requirement under 40 CFR part 720 to submit a PMN or under 40 CFR part 721 to submit a Significant New Use Notice. For information on PMN submissions, see   HYPERLINK "http://www.epa.gov/opptintr/newchems/index.htm"  http://www.epa.gov/opptintr/newchems/index.htm

TEST DATA  Hazard and exposure test data would be most useful if the physical/chemical properties of the nanoscale material relevant to assessing test results are obtained at the initiation of testing.  Additional relevant information on preparation of the nanoscale material for administration and storage history of the material between production and administration will assist in interpretation. When possible, interpret data in the context of accompanying positive and negative nanoscale substance control data from the same test system. Indicate which of the following data are included in this submission:

  FORMCHECKBOX   Physical / Chemical properties

  FORMCHECKBOX   Structure / activity relationships	  FORMCHECKBOX   Health effects

  FORMCHECKBOX   Exposure ERiskEassessments	  FORMCHECKBOX   Environmental effects

  FORMCHECKBOX   Environmental fate	  FORMCHECKBOX

  FORMCHECKBOX  	Test data not in the possession or control of the submitter

Other

  FORMCHECKBOX  	Mark (x) if any information is claimed as confidential.

TIME REQUIRED TO COMPLETE THE FORM

EPA estimates that it will take ???? hours to complete this form, including time to review instructions, search existing data sources, gather and maintain the data needed, and complete and review the collection of information. Please provide an estimate of the amount of time in work hours it took to complete this form.	Hours:

COMMENTS

Please provide feedback concerning the Nanoscale Materials Stewardship Program Data Submission Form.

  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

CHECK LIST

Please verify that the questions in the following general areas were answered by marking (X) in the boxes.  (Answers may include, for example, “N/A,” “none,” “not known”).

	  FORMCHECKBOX   Physical and chemical characterization

	  FORMCHECKBOX   Risk management information

STATEMENT

All information provided in this form is accurate as of the date of submission.

I understand that this is not an actual PMN, and as such, does not satisfy any requirement under 40 CFR part 720 to submit a PMN.

	Confidential

Signature and title of Authorized Official (Original Signature Required)

 	Date

Signature of agent  - (if applicable)

	Date

Part I -- GENERAL INFORMATION

Section A -- SUBMITTER IDENTIFICATION	Confi-

Mark () the “Confidential” box next to any subsection you claim as confidential	dential

1a.	Person Submitting

       (in U.S.)	Name of authorized official

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	Company

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Mailing address (number and street)

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City, State, ZIP Code

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 b.	Agent (if applicable)	Name of authorized official

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	Company

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Mailing address (number and street)

c.	If you are submitting this as part of a joint submission, mark (X) this box.

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	Joint Submitter (if applicable)	Name of authorized official

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	Company

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Mailing address (number and street)

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City, State, ZIP Code	Telephone	Area Code	Number

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	2.	Technical Contact (in U.S.)	Name of authorized official

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Mailing address (number and street)

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City, State, ZIP Code	Telephone	Area Code	Number

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Part I -- GENERAL INFORMATION -- Continued

	Section B -- CHEMICAL IDENTITY INFORMATION: **

	Mark (X) the “Confidential” box next to any item you claim as confidential

	Complete either item 1 (Class 1 or 2 substances) or 2 (Polymers) as appropriate.  Complete all other items.

	If another person will submit chemical identity information for you (for either Item 1 or 2), mark (X) the box at the right.

	Identify the name, company, and address of that person in a continuation sheet.	  FORMCHECKBOX  	Confi-

dential

1.	Class 1 or 2 chemical substances (for definitions of class 1 and class 2 substances, see the Instructions Manual) **

	a.	Class of substance - Mark (X)	1	  FORMCHECKBOX  	Class 1	or	2	  FORMCHECKBOX  	Class  2

		b.	Chemical name (Currently correct Chemical Abstracts (CA) Name that is consistent with TSCA Inventory listings for similar substances.  **

		c.	Please identify which method you used to develop or obtain the specified chemical identity information: (check one).

		  FORMCHECKBOX  	Method 1 (CAS Inventory Expert Service 	  FORMCHECKBOX  	Method 2 (Other Source)

		d.	Molecular formula and CAS Registry Number (if a number already exists for the substance)  **

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		e.	For a class 1 substance, provide a complete and correct chemical structure diagram.  For a class 2 substance - (1) List the immediate precursor substances with their respective CAS Registry Numbers.  (2) Describe the nature of the reaction or process.  (3) Indicate the range of composition and the typical composition (where appropriate).  (4) Provide a correct representative or partial chemical structure diagram, as complete as can be known, if one can be reasonably ascertained.  **

  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

Part I -- GENERAL INFORMATION -- Continued

Section B -- CHEMICAL IDENTITY INFORMATION -- Continued

2.	Polymers (For a definition of polymer, see the Instructions Manual.) Confi-

dential

	a.	Indicate the number-average weight of the lowest molecular weight composition of the polymer you intend to manufacture.

		Indicate maximum weight percent of low molecular weight species (not including residual monomers, reactants, or solvents) below 500 and below 1,000 absolute molecular weight of that composition.

		Describe the methods of measurement or the basis for your estimates: GPC	  FORMCHECKBOX  		Other      FORMCHECKBOX  :	(Specify)		  FORMTEXT

		i)	lowest number average molecular weight:		  FORMTEXT

		ii)	maximum weight % below 500 molecular weight:		  FORMTEXT

		iii)	maximum weight % below 1000 molecular weight:		  FORMTEXT

  FORMCHECKBOX  		Mark (X) this box if you attach a continuation sheet.

	b.	Make separate confidentiality claims for monomer or other reactant identity, composition information, and residual information.  Mark (X) the “Confidential” box next to any item you claim as confidential

		(1)	-	Provide the specific chemical name and CAS Registry Number (if a number exists) of each monomer or other reactant used in the manufacture of the polymer.

		(2)	-	Mark (X) this column if entry in column (1) is confidential.

		(3)	-	Indicate the typical weight percent of each monomer or other reactant in the polymer.

		(4)	-	Mark (X) the identity column if you want a monomer or other reactant used at two weight percent or less to be listed as part of the polymer description on the TSCA Chemical Substance Inventory.

		(5)	-	Mark (X) this column if entries in columns (3) and (4) are confidential.

		(6)	-	Indicate the maximum weight percent of each monomer or other reactant that may be present as a residual in the polymer as manufactured for commercial purposes.

		(7)	-	Mark (X) this column if entry in column (6) is confidential.

Monomer or other reactant and CAS Registry Number

(1)	Confi-

dential

(2)	Typical

composition

(3)	Identity

Mark (X) (4)	Confi-

dential

(5)	Maximum

residual

(6)	Confi-dential

(7)

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		c.	Please identify which method you used to develop or obtain the specified chemical identity information (check one).

	  FORMCHECKBOX  	Method 1	(CAS Inventory Expert Service)	  FORMCHECKBOX  	Method 2 (other source)

		d.	The currently correct Chemical Abstracts (CA) name for the polymer that is consistent with TSCA Inventory listings for similar polymers. **

Part I -- GENERAL INFORMATION -- Continued

Section B -- CHEMICAL IDENTITY INFORMATION -- Continued

3.	Impurities

	(a)	-	Identify each impurity that may be reasonably anticipated to be present in the chemical substance as manufactured for commercial purpose.  Provide the CAS Registry Number if available.  If  there are unidentified impurities, enter “unidentified.”

	(b)	-	Estimate the maximum weight % of each impurity.  If there are unidentified impurities, estimate their total weight %.

Impurity and CAS Registry Number

(a)	Maximum

percent

(b)	Confi-

dential

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	  FORMCHECKBOX  		Mark  (X) this box if you attach a continuation sheet.

	4.	Synonyms - Enter any chemical synonyms for the chemical identified in subsection 1 or 2.	Confi-

dential

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	  FORMCHECKBOX  		Mark  (X) this box if you attach a continuation sheet.

	5.	Trade identification - List trade names for the chemical substance identified in subsection 1 or 2.

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	  FORMCHECKBOX  		Mark  (X) this box if you attach a continuation sheet.

	6.	Generic chemical name -	If you claim chemical identify as confidential, provide a generic name for your substance that reveals the specific chemical identity of the chemical substance to the maximum extent possible.  Refer to the TSCA Chemical Substance Inventory, 1985 Edition, Appendix B for guidance on developing generic names.

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  FORMCHECKBOX  		Mark  (X) this box if you attach a continuation sheet.

7.	Byproducts -	Describe any byproducts resulting from the manufacture, processing, use, or disposal of the chemical substance.  Provide the CAS Registry Number if available.

Byproduct

(1)	CAS Registry Number

(2)	Confi-

Part I -- GENERAL INFORMATION -- Continued

Section C -- PRODUCTION, IMPORT, AND USE INFORMATION:

			Mark (X) the “Confidential” box next to any item you claim as confidential.

1.	Production volume -- Estimate the maximum production volume during the first 12 months of production.  Also estimate the maximum production volume for any consecutive 12-month period during the first three years of production.  Estimates should be on 100% chemical substance basis.

Maximum first 12-month production (kg/yr)

(100% chemical substance basis)	Maximum 12-month production (kg/yr)

(100% chemical substance basis)	Confi-dential

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	2.	Use Information -- Make separate confidentiality claims for the description of the category of use, the percent of production volume devoted to each category, the formulation of  the substance, and other use information.  Mark (X) the “Confidential” Box next to any item you claim as confidential.

	a.	(1) --	Describe each intended category of use of the chemical substance by function and application..

		(2) --	Mark (X) this column if entry column (1) is confidential business information (CBI).

		(3) --	Estimate the percent of total production for the first three years devoted to each category of use.

		(4) --	Mark (X) this column if entry in column (4) is confidential business information (CBI).

		(5) --	Estimate the percent of the substance as formulated in mixtures, suspensions, emulsions, solutions, or gels as manufactured for commercial purposes at sites under your control associated with each category of use.

		(6) --	Mark (X) this column if entry in column (6) is confidential business information (CBI).

		(7) --	Indicate % of product volume expected for the listed “use” sectors.  Mark more than one box if appropriate.

		(8) --	Mark (X) this column if entry(ies) in column (8) is (are) confidential business information (CBI).

Category of use (1)	CBI

Produc-tion %	CBI	% in

Form-	CBI	% of substance expected per use

(7)	CBI

(by function and application i.e. a dispersive dye for finishing polyester fibers)

(2)

(3)

(4)	ulation

(5)

(6)	Site-

limited	Con-*

sumer	Indus-trial	Com-mercial

(8)

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*	If you have identified a “consumer” use, please provide on a continuation sheet a detailed description of the use(s) of this chemical substance in consumer products.  In addition include estimates of the concentration of the chemical substance as expected in consumer products and describe the chemical reactions by which this substance loses its identity in the consumer product.

  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

	b.	Generic

		use description	If you claim any category of use description in subsection 2a as confidential, enter a generic description of that category.  Read the Instructions Manual for examples of generic use descriptions.

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	  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

3.	Hazard Information -- Include a copy of reasonable facsimile 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 to this substance regarding protective equipment or practices for the safe handing, transport, use, or disposal of the substance.  List in part III hazard information you include.

Part I -- GENERAL INFORMATION – Continued

Section C –-Continued

Mark (X) the “CBI” box next to any item you claim as confidential. CBI

4. State of manufacture or importation

Please specify:

	a. Substance is at what stage of manufacture (importation)?

	  FORMCHECKBOX   currently manufactured 	  FORMCHECKBOX   will be manufactured	  FORMCHECKBOX   no plan to manufacture				  FORMCHECKBOX   not known	  FORMCHECKBOX

	b. First/planned date of manufacture/import:

	  FORMCHECKBOX

5. State of commercial availability

Please specify:

	a. Substance is at what stage of commercial availability?

	  FORMCHECKBOX   currently available   	  FORMCHECKBOX   will be made available    	  FORMCHECKBOX   no plan to make commercially available	  FORMCHECKBOX   not known	  FORMCHECKBOX

	b. First/planned date of commercial availability:

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6. Nanoscale properties.  Briefly describe any unique or enhanced properties that arise from the nanoscale features of the material, particularly in contrast to any non-nanoscale varieties that exist. 	  FORMCHECKBOX

  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

7. Briefly explain why this material is designed and/or produced to be a nanoscale material.	  FORMCHECKBOX

  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

Part II-- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE

Section A – INDUSTRIAL SITES CONTROLLED BY THE SUBMITTER	Mark (X) the “Confidential” box next to any item you claim as confidential

Complete section A for each type of manufacture, processing, or use operation involving the chemical substance at industrial sites you control.  See instructions manual

	1.	Operation description

		a.	Identity -- Enter the identity of the site at which the operation will occur.	Confi-

dential

	Name

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	Site address (number and street)

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City, County, State, ZIP code

	If the same operation will occur at more than one site, enter the number of sites.  Identify the additional sites on a continuation sheet, and if any of the sites have significantly different production rates or operations, include all the information requested in this section for those sites as attachments.

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		  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

			b.	Type --

			Mark (X)

  FORMCHECKBOX  	Manufacturing

  FORMCHECKBOX  	Processing

  FORMCHECKBOX  	Use

		c.	Amount and Duration -- Complete 1 or 2 as appropriate

1.	Batch	Maximum kg/batch (100%  chemical substance)

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2.	Continuous	Maximum kg/day (100%  chemical substance)

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	d.	Process description

	(1)	Diagram the major unit operation steps and chemical conversions.  Include interim storage and transport containers (specify- e.g. 5 gallon pails, 55 gallon drum, rail car, tank truck, etc.).

	(2)	Provide the identity, the approximate weight (by kg/day or kg/batch on a 100%  chemical substance basis), and entry point of all starting materials and feedstocks (including reactants, solvents, catalysts, etc.), and of all products, recycle streams, and wastes.  Include cleaning chemicals (note frequency if not used daily or per batch.).

	(3)	Identify by number the points of release, including small or intermittent releases, to the environment of the chemical substance.  If releasing to two media at the same step, assign a second release number for the second medium.

Part II-- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE -- Continued

Section A – INDUSTRIAL SITES CONTROLLED BY THE SUBMITTER – Continued

2.	Occupational Exposure -- Make separate confidentiality claims for  the description of worker activity, physical form of the chemical substance, number of workers exposed, and duration of activity.  Mark (X) the “Confidential” box next to any item you claim as confidential.

	(1) --	Describe the activities (i.e. bag dumping, tote filling, unloading drums, sampling, cleaning, etc.) in which workers may be exposed to the substance.

	(2) --	Mark (X) this column if entry in column (1) is confidential business information (CBI).

	(3) --	Describe any protective equipment and engineering controls used to protect workers.

	(4) --	Indicate the physical form(s) of the chemical substance (e.g., solid: crystal, granule, powder, or dust) and %  chemical substance (if part of a mixture) at the time of exposure.

	(5) --	Mark (X) this column if entry in column (4) is confidential business information (CBI).

	(6) --	Estimate the maximum number of workers involved in each activity for all sites combined.

	(7) --	Mark (X) this column if entry in column (6) is confidential business information (CBI).

	(8) 	and (9) -- Estimate the maximum duration of the activity  for any worker in hours per day and days per year.

	(10)	-- Mark (X) this column if entries in columns (8) and (9) are confidential business information (CBI).

Worker activity	CBI	Protective Equipment/

Physical forms(s)

CBI	# of	CBI	Maximum	duration	CBI

(i.e., bag dumping, filling drums)

(1)

(2)	Engineering Controls

(3)

and %  substance

(4)

(5)	Workers Exposed

(6)

(7)	Hrs/day

(8)	Days/yr

(9)

(10)

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  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

3.	Environmental Release and Disposal -- Make separate confidentiality claims for the release number and the amount of the chemical substance released and other release and disposal information.  Mark (X) the “Confidential” box next to each item you claim as confidential.

	(1) --	Enter the number of each release point identified in the process description, part II, section A, subsection 1d(3).

	(2) --	Estimate the amount of the substance released (a) directly to the environment or (b) into control technology (in kg/day or kg/batch).

	(3) --	Mark (X) this column if entries in columns (1) and (2) are confidential business information (CBI).

	(4) --	Identify the media (stack air, fugitive air (optional-see Instruction Manual), surface water, on-site or off-site land or incineration, POTW, or other (specify)) to which the substance will be released from that release point.

	(5) --	a.  Describe control technology, if any, and control efficiency that will be used to limit the release of the substance to the environment.  For releases disposed of on land, characterize the disposal method and state whether it is approved for disposal of RCRA hazardous waste.  On a continuation sheet, for each site describe any additional disposal methods that will be used and whether the waste is subject to secondary or tertiary on-site treatment.  b. Estimate the amount released to the environment after control technology (in kg/day).

	(6) --	Mark (X) this column if entries in columns (4) and (5) are confidential business information (CBI).

	(7) --	Identify the destination(s) of releases to water.  Please supply NPDES (National Pollutant Discharge Elimination System) numbers for direct discharges or NPDES numbers of the POTW (Publicly Owned Treatment Works).  Mark (X) if the POTW name or NPDES # is confidential business information (CBI).

Release

Number	Amount of substance released	CBI	Media of

release	Control technology and efficiency (you may wish to optionally attach efficiency data)	CBI

(1)	(2a)	(2b)

(3)	e.g. stack air

(4)

(5a)

(5b)

destination(s) of releases to water.

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  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

Part II-- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE -- Continued

Section B – INDUSTRIAL SITES CONTROLLED BY OTHERS

Complete section B for typical processing or use operations involving the chemical substance at sites you do not control.  See the Instructions Manual. Complete a separate section B for each type of processing, or use operation involving the chemical substance.  If the same operation is performed at more than one site describe the typical operation common to these sites.  Identify additional sites on a continuation sheet.

1.	Operation Description -- To claim information in this section as confidential, circle or bracket the specific information that you claim as confidential.

	(1) -- Diagram the major unit operation steps and chemical conversions, including interim storage and transport containers (specify - e.g. 5 gallon pails, 55 gallon drums, rail cars, tank trucks, etc).  On the diagram, identify by letter and briefly describe each worker activity.  (2) -- Provide the identity, the approximate weight (by kg/day or kg/batch, on a 100%  chemical substance basis), and entry point of all feedstocks (including reactants, solvents and catalysts, etc) and all products, recycle streams, and wastes.  Include cleaning chemicals (note frequency if not used daily or per batch).  (3) -- Identify by number the points of release, including small or intermittent releases, to the environment of the chemical substance.  (4) Please enter the # of sites (remember to identify the locations of these sites on a continuation sheet):

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# of sites

  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

2.	Worker Exposure/Environmental Release

	(1) --	From the diagram above, provide the letter for each worker activity.  Complete 2-8 for each worker activity described.

	(2) --	Estimate the number of workers exposed for all sites combined.

	(4) --	Estimate the typical duration of exposure per worker in (a) hours per day and (b) days per year.

	(6) --	Describe physical form of exposure and %  chemical substance (if in mixture), and any protective equipment and engineering controls, if any, used to protect workers.

	(7) --	Estimate the percent of the substance as formulated when packaged or used as a final product.

	(9) --	From the process diagram above, enter the number of each release point.  Complete 9-13 for each release point identified.

	(10) 	--     Estimate the amount of the substance released (a) directly to the environment or (b) into control technology to the environment (in kg/day or kg/batch).

	(12)	--     Describe media of release i.e. stack air, fugitive air (optional-see Instructions Manual), surface water, on-site or off-site land or incineration, POTW, or other (specify) and control technology, if any, that will be used to limit the release of the substance to the environment.

	(14)	--     Identify byproducts which may result from the operation.

	(3), (5), (8), (11), (13) and (15) -- Mark (X) this column if any of the proceeding entries are confidential business information (CBI).

Letter

of

Act-ivity	# of

Workers

Exposed	CBI	Duration

of

Exposure	CBI	Protective Equip. /

Engineering Controls/

Physical Form and %

substance	% in

Form-

ulation	CBI	Release

Number	Amount of

Substance

Released	CBI	Media of Release

& Control

Technology	CBI

(1)	(2)	(3)	(4a)	(4b)	(5)	(6)	(7)	(8)	(9)	(10a)	(10b)	(11)	(12)	(13)

  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT

  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT

  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT

  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT   	  FORMTEXT

(14) -- Byproducts:

  FORMTEXT   	(15)

Part II-- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE -- Continued

Section A / B, Subsection 2. Occupational Exposure – Continued.  b. Details of protective equipment / engineering controls.

(Use this form both for sites controlled by submitter and by others.  Make copies as necessary.)

Please provide the following information:

	(1) –The worker activities listed in Section A.2 or B.1 for which protective equipment/engineering controls are in use.

	(2) – A brief description of the rationale for selecting the protective equipment/engineering controls, including internal exposure

               control limits, data and the methods used to generate the data that informed the decision.

	(3) – A brief description of the cleaning, reuse, and/or disposal of the protective equipment

	(4) – A brief description of any data (personal and/or area), units (e.g., mass conc., surface area, or particle number conc.) and

               any exposure monitoring methods used.

Mark (X) in the “CBI” column next to any item you claim as confidential.	CBI

(1) Worker activity / Protective equipment / Engineering Control	  FORMCHECKBOX

	 (2) Rationale for selecting equipment / controls, associated internal exposure control limit / data / methods

	  FORMCHECKBOX

	  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

(3) Cleaning, reuse, and/or disposal of protective equipment

	  FORMCHECKBOX

	  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

(4) Exposure monitoring data (personal and/ or area), units (e.g., mass conc., surface area, or particle number conc.), and methods used

	  FORMCHECKBOX

	  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

	  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

Section A.3 / Section B, subsection 2. Environmental Release and Disposal – Continued.  Details of control technology.

(Use this form both for sites controlled by submitter and by others. Make copies as necessary)

To assist EPA in gaining a better understanding of the need for and the types of control technology used at the release points in the manufacture and handling of engineered nanoscale materials, please provide the following information for each release point for which control technology is used:

	(1) – The Release Number, as identified in the process description, part II, section A, subsection 1d(3) (page 8).

	(2) – A brief description of the rationale for selecting the control technology.

	(3) – Data and measurement methods of waste treatment efficiency studies.

Release

Number (1)	Mark (X) in the “CBI” column next to any item you claim as confidential.	CBI

	(2) Rationale for selecting control technology

	  FORMCHECKBOX

	  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

(3) Data and measurement methods of waste treatment or purification studies

	  FORMCHECKBOX

	  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

	  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

Part II-- HUMAN EXPOSURE AND ENVIRONMENTAL RELEASE -- Continued

Section C – Lifecycle

Mark (X) the “CBI” box next to any item you claim as confidential. CBI

1. In addition to the information already given, provide a brief overview of the lifecycle of the material, including all workplaces that manufacture, process, or use the material, methods of packaging and transporting the material, all expected general population, environmental, and consumer uses, and the expected manufacturing and processing methods of the material or any consumer products 	  FORMCHECKBOX

containing the material. If not included in Sections A or B above, include a description of the end of life disposal or disposition of products containing the nanoscale material.

  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

Section D – Misc. Health, Exposure, Hazard Information

Mark (X) the “CBI” box next to any item you claim as confidential. CBI

1. Describe any training, hazard communication (e.g. MSDS), etc. specific to the nanoscale material that is provided to workers.	  FORMCHECKBOX

  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

2. Estimate the total number of individuals—other than previously described workers—(e.g. general public, consumers) who may be exposed to the material and the duration of the exposure.	  FORMCHECKBOX

  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

3. Describe any other procedure, equipment, etc. being used to mitigate exposure to the material.	  FORMCHECKBOX

  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

4. Describe product labeling and any customer training specific to the nanoscale material.	  FORMCHECKBOX

  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

5. Describe other risk management practices specific to the nanoscale material.	  FORMCHECKBOX

  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

OPTIONAL POLLUTION PREVENTION INFORMATION

To claim information in this section as confidential circle or bracket the specific information that you claim as confidential.

In this section you may provide information not reported elsewhere in this form regarding your efforts to reduce or minimize potential risks associated with activities surrounding manufacturing, processing, use and disposal of the substance.  Please include new information pertinent to pollution prevention, including source reduction, recycling activities and safer processes or products available due to the chemical substance.  Source reduction includes the reduction in the amount or toxicity of chemical wastes by technological modification, process and procedure modification, product reformulation, raw materials substitution, and/or inventory control.  Recycling refers to the reclamation of useful chemical components from wastes that would otherwise be treated or released as air emissions or water discharges, or land disposal.  Descriptions of pollution prevention, source reduction and recycling should emphasize potential risk reduction subsequent to compliance with existing regulatory requirements and can be either quantitative or qualitative.  EPA is interested in the information to assess overall net reductions in toxicity or environmental releases and exposures, not the shifting of risks to other environmental media or non-environmental areas (e.g., occupational or consumer exposure).  In addition, information on the relative cost or performance characteristics of the substance to potential alternatives may be provided.

  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

Part III -- LIST OF ATTACHMENTS

Attach continuation sheets for sections of the form and test data and other data (including physical/chemical properties and structure/activity information), and optional information after this page.  Clearly identify the attachment and the section of the form to which it relates, if appropriate.  Number consecutively the pages of the attachments.  In the column below, enter the inclusive page numbers of each attachment.

Mark (X) the “Confidential” box next to any attachment name you claim as confidential.  Read the Instructions Manual for guidance on how to claim any information in an attachment as confidential. Include with the sanitized copy of the form a sanitized version of any attachment in which you claim information as confidential.

	Attachment name	Attachment

page number(s)	Confi-dential

PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET **

To assist EPA’s review of physical and chemical properties data, please complete the following worksheet for data you provide and include it in the form.  Identify the property measured, the page of the form on which the property appears, the value of the property, the units in which the property is measured (as necessary), and whether or not the property is claimed as confidential.  The physical state of the neat substance should be provided.  These measured properties should be for the neat (100% pure) chemical substance.  Properties that are measured for mixtures or formulations should be so noted (% substance in __).

Property

(a)	Mark (X) if provided	Page number (b)	Value

(c)	Measured or Estimate

(M or E)	Confi-dential Mark (X)

(d)

	Physical state of neat substance

		 (s)		 (l)		 (g)

	Vapor pressure

		@ Temperature				°C

						Torr

	Density/relative density

						g/cm3

	Solubility

		@	Temperature 			°C

		Solvent

						g/L

	Solubility in water @ Temperature			°C

						g/L

	Melting temperature

						°C

	Boiling / sublimation temperature@		torr pressure

						°C

	Spectra

	Dissociation constant

	Octanol / water partition coefficient

	Henry’s Law constant

	Volatilization from water

	Volatilization from soil

	pH	@ concentration

	Flammability

	Explodability

	Adsorption / coefficient

PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET II

To assist EPA in understanding the types of characterization data typically available for engineered nanoscale materials and the cost of obtaining that data, for each of the physical and chemical properties submitted on page 16, provide: the approximate cost of obtaining data, the method used to obtain the data, and, if a particular piece of data was not collected, a brief reason why.  If non-standard methods were used in the collection of data, briefly describe them.

Property	Mark (X) if provided	Method used	Confi-dential Mark (X)	Approx. Cost	Confi-dential Mark (X)

	Physical state of neat substance

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Vapor pressure

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Density/relative density

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Solubility in solvent

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Solubility in water

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Melting temperature

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Boiling / sublimation temperature

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Spectra

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Dissociation constant

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET II – Continued

Property	Mark (X) if provided	Method used	Confi-dential Mark (X)	Approx. Cost	Confi-dential Mark (X)

	Octanol / water partition coefficient

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Henry’s Law constant

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Volatilization from water

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Volatilization from soil

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		pH

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Flammability

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Explodability

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Adsorption / coefficient

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET III – Nanoscale Materials Specific Data

Please provide the additional chemical and physical characterization data listed below.  Additional pages may be attached to provide more information.

Property	Mark (X)

if provided	Mark (X) if page attached	Value	Measured / Estimated

(M or E)	CBI

 Mark (X)

General Characteristics

	Crystal structure

		Agglomeration state

Particle Characteristics

Particle size distribution

	Provide graph with percentage of particles in each diameter class.  For elongated particles, provide length distribution graph showing the percentage of particles in each length class.

		Mean particle size (diameter and/or length)

	nm

			Standard deviation from mean

			Largest particle size (diameter and/or length)

	nm

		Smallest particle size (diameter and/or length)

	nm

		Aspect ratio

			Average aerodynamic diameter

	nm

	Average particle mass

	g

	Particle shape

	Surface Characteristics

	Surface area

	m2/g

	Average particle surface area

	m2

	Surface charge (Zeta potential)

	mV

	Porosity

		Surface chemical composition

		Surface / volume ratio

	Other

	Other

	  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET III cont– Nanoscale Materials Specific Data

Please provide the additional chemical and physical characterization data listed below.  Additional pages may be attached to provide more information.

Property	Mark (X)

if provided	Mark (X) if page attached	Value	Measured / Estimated

(M or E)	CBI

 Mark (X)

Fate and Transport

	Diffusion rate

		Gravitational settling rate

		Sorption rate

		Deposition rate

		Wet and dry transport

		Biodegradation rate

		Bioaccumulation

	Biotransformation

		Influence of redox/photochemical reaction

	Other

	Other

	  FORMCHECKBOX  	Mark (X) this box if you attach a continuation sheet.

		PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET IV

To assist EPA in understanding the types of characterization data typically available for engineered nanoscale materials and the cost of obtaining that data, for each of the physical and chemical properties submitted on page 19, provide: the approximate cost of obtaining data, the method used to obtain the data, and, if a particular piece of data was not collected, a brief reason why.  If non-standard methods were used in the collection of data, briefly describe them.

Property	Mark (X) if provided	Method used	Confi-dential Mark (X)	Approx. Cost	Confi-dential Mark (X)

	Crystal structure

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Agglomeration state

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Particle size distribution

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Mean particle size and standard deviation

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Largest particle size

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Smallest particle size

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Aspect ratio

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Average aerodynamic diameter

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Average particle mass

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET IV continued

Property	Mark (X) if provided	Method used	Confi-dential Mark (X)	Approx. Cost	Confi-dential Mark (X)

	Particle shape

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Surface area

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Average particle surface area

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Surface charge

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Porosity

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Surface chemical composition

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Surface / volume ratio

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Diffusion rate

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Gravitational settling rate

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		PHYSICAL AND CHEMICAL PROPERTIES WORKSHEET IV continued

Property	Mark (X) if provided	Method used	Confi-dential Mark (X)	Approx. Cost	Confi-dential Mark (X)

	Sorption rate

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Deposition rate

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Wet and dry transport

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Biodegradation rate

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Bioaccumulation

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Biotransformation

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Influence of redox / photochemical reaction

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Other

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

		Other

  FORMCHECKBOX   Mark (X) if description of method attached

			If not provided, why?: 	  FORMCHECKBOX   Not applicable      FORMCHECKBOX   Too expensive      FORMCHECKBOX   Too much test material required      FORMCHECKBOX   No known method

		  FORMCHECKBOX   Other (specify):

** Notes

Part I

Section B:  It is recognized that systematic nomenclature has not been fully developed for nanoscale materials, therefore it is not necessary to provide the “correct Chemical Abstract name” nor the “CAS Registry Number,” if it does not exist.  Please fill out these sections to the best of your ability in light of the limitations.

B.1.a:  It is noted that a nanoscale material may or may not be accurately described as a Class 1 or Class 2 substance.  If the choice is not obvious, this section may be left blank.  In addition, a brief explanation may be given for why a particularly classification is or is not appropriate.

B.1.b / B.2.d:  If a Chemical Abstracts Name is not available, please use a name that is most in agreement with CA nomenclature.

B.1.d may be read as:

d. Molecular formula (including molecular shape / physical form) and CAS Registry Number (if a number already exists for the substance).

B.1.e:  For the nanoscale material, please provide the information requested for Class 2 substances, regardless of whether the material is Class 1 or Class 2 or cannot be determined.

B.2.e may be read as:

"Provide a correct representative or partial chemical structure diagram, as complete as can be known, if one can be reasonably ascertained.  Alternatively, if applicable, provide a correct representative structure for the polymer as part of a composite."

[Note: the components of a composite are separate chemical identities.  For example in a composite of starch molecules between layers of clay treated with surfactants, the starch, clay, and surfactants might be on the TSCA Inventory, but since the interactions between the components are weak electrical interactions, there is no chemical substance.]

Physical and Chemical Properties Worksheet

It is noted that, for nanoscale materials, protocols and methods may not exist or be standardized for measurement of the physical and chemical properties listed in this worksheet.

Based on EPA FORM 7710-25 (Rev. 5-95).  						Page   PAGE  1  of   NUMPAGES  25 					Draft version—NOT AN OFFICIAL FORM

ATTACHMENT

PAGE    PAGE  14

Based on EPA FORM 7710-25 (Rev. 5-95).  						Page   PAGE  25  of   NUMPAGES  25

ATTACHMENT

PAGE    PAGE  14

Based on PMN Form EPA 7710-25 (Rev. 5-95) Page 11

Based on PMN Form EPA 7710-25 (Rev. 5-95) Page 3

Based on PMN Form EPA 7710-25 (Rev. 5-95) Page 5

Based on PMN Form EPA 7710-25 (Rev. 5-95) Page 6

Based on PMN Form EPA 7710-25 (Rev. 5-95) Page 4

Identical to PMN Form EPA 7710-25 (Rev. 5-95) Page 3

Based on PMN Form EPA 7710-25 (Rev. 5-95) Page 8

Based on PMN Form EPA 7710-25 (Rev. 5-95) Page 9

Based on PMN Form EPA 7710-25 (Rev. 5-95) Page 7

Based on PMN Form EPA 7710-25 (Rev. 5-95) Page 10

Page 10-NMSP-2

Based on PMN Form EPA 7710-25 (Rev. 5-95) Page 13

Based on PMN Form EPA 7710-25 (Rev. 5-95) Page 12


[Federal Register Volume 79, Number 201 (Friday, October 17, 2014)]
[Notices]
[Pages 62507-62508]
[FR Doc No: 2014-24675]

=======================================================================
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DEPARTMENT OF TRANSPORTATION

Federal Aviation Administration

Aviation Rulemaking Advisory Committee Meeting on Transport
Airplane and Engine Issues

AGENCY: Federal Aviation Administration (FAA), DOT.

ACTION: Notice of public meeting.

-----------------------------------------------------------------------

SUMMARY: This notice announces a public meeting of the FAA's Aviation
Rulemaking Advisory Committee (ARAC) Transport Airplane and Engine
(TAE) Subcommittee to discuss TAE issues.

DATES: The meeting is scheduled for Thursday, November 13, 2014,
starting at 9:00 a.m. Eastern Daylight Time. The public must make
arrangements by November 3, 2014, to present oral statements at the
meeting.

ADDRESSES: 929 Long Bridge Drive, Arlington, VA 22202.

FOR FURTHER INFORMATION CONTACT: Ralen Gao, Office of Rulemaking, ARM-

209, FAA, 800 Independence Avenue SW., Washington, DC 20591, Telephone
(202) 267-3168, FAX<PHONE_NUMBER>, or email at<EMAIL_ADDRESS>
SUPPLEMENTARY INFORMATION: Pursuant to Section 10(a)(2) of the Federal
Advisory Committee Act (Pub. L. 92-463; 5 U.S.C. app. 2), notice is
given of an ARAC meeting to be held November 13, 2014.
    The agenda for the meeting is as follows:

 Opening Remarks, Review Agenda and Minutes
 FAA Report
 ARAC Report
 Transport Canada Report
 EASA Report
 Engine Harmonization Working Group Report--Engine Endurance
Testing
 Airworthiness Assurance Working Group Report
 Engine Harmonization Working Group Report--Bird Ingestion
 Flight Test Harmonization Working Group Report
 Any Other Business
 Action Items Review

    Attendance is open to the public, but will be limited to the
availability of meeting room space. Please confirm your attendance with
the person listed in the FOR FURTHER INFORMATION CONTACT section no
later than November 3, 2014. Please provide the following information:
Full legal name, country of citizenship, and name of your industry
association, or applicable affiliation. If you are attending as a
public citizen, please indicate so.
    The FAA will arrange for teleconference service for individuals
wishing to join in by teleconference if we receive notice by November
3, 2014. For persons participating by telephone, please contact the
person listed in FOR FURTHER INFORMATION CONTACT by email or phone for
the teleconference call-in number and passcode. Anyone calling from
outside the Arlington, VA, metropolitan area will be responsible for
paying long-distance charges.
    The public must make arrangements by November 3, 2014, to present
oral statements at the meeting. Written statements may be presented to
the Subcommittee at any time by providing 25 copies to the person
listed in the FOR FURTHER INFORMATION CONTACT section or by providing
copies at the meeting. Copies of the documents to be presented to the
Subcommittee may be made available by contacting the person listed in
the FOR FURTHER INFORMATION CONTACT section.
    If you need assistance or require a reasonable accommodation for
the meeting or meeting documents, please contact the person listed in
the FOR FURTHER INFORMATION CONTACT section. Sign and oral
interpretation, as well as a listening device, can be made available if
requested 10 calendar days before the meeting.

    Issued in Washington, DC, on October 9, 2014.
Lirio Liu,
Designated Federal Officer.
[FR Doc. 2014-24675 Filed 10-16-14; 8:45 am]
BILLING CODE 4910-13-P


[Federal Register Volume 77, Number 89 (Tuesday, May 8, 2012)]
[Notices]
[Page 27041]
[FR Doc No: 2012-10977]

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DEPARTMENT OF ENERGY

Federal Energy Regulatory Commission

Combined Notice of Filings  1

    Take notice that the Commission received the following electric
rate filings:

    Docket Numbers: ER10-2124-003; ER10-2125-003; ER10-2127-003; ER10-
2128-003; ER10-2129-003; ER10-2130-003; ER10-2131-004; ER10-2132-003;
ER10-2133-004; ER10-2134-003; ER10-2135-003; ER10-2136-003; ER10-2137-
004; ER10-2138-004; ER10-2139-004; ER10-2140-004; ER10-2141-004; ER10-
2764-003; ER11-3872-004; ER11-4044-003; ER11-4046-003; ER12-161-003;
ER12-164-002.
    Applicants: Forward Energy LLC, Sheldon Energy LLC, Invenergy
Cannon Falls LLC, Spindle Hill Energy LLC, Spring Canyon Energy LLC,
Grays Harbor Energy LLC, Grand Ridge Energy LLC, Willow Creek Energy
LLC, Hardee Power Partners Limited, Judith Gap Energy LLC, Invenergy TN
LLC, Wolverine Creek Energy LLC, Grand Ridge Energy II LLC, Grand Ridge
Energy III LLC, Grand Ridge Energy IV LLC, Grand Ridge Energy V LLC,
Vantage Wind Energy LLC, Beech Ridge Energy LLC, Gratiot County Wind
LLC, Stony Creek Energy LLC, Bishop Hill Energy III LLC, Gratiot County
Wind II LLC, Bishop Hill Energy LLC.
    Description: Notification of Change in Facts under Market-Based
Rate Authority of Spring Canyon Energy LLC, et al.
    Filed Date: 4/27/12.
    Accession Number: 20120427-5409.
    Comments Due: 5 p.m. ET 5/18/12.

    Docket Numbers: ER10-3083-001; ER10-3082-001.
    Applicants: Motiva Enterprises LLC, Shell Chemical LP.
    Description: Motiva Enterprises LLC et al., Supplement to Updated
Market Power Analysis for the Southeast Region.
    Filed Date: 4/27/12.
    Accession Number: 20120427-5209.
    Comments Due: 5 p.m. ET 5/18/12.

    Docket Numbers: ER12-1638-000.
    Applicants: PJM Interconnection, LLC.
    Description: Original Service Agreement No. 3278; Queue No. X2-083
to be effective 3/29/2012.
    Filed Date: 4/27/12.
    Accession Number: 20120427-5304.
    Comments Due: 5 p.m. ET 5/18/12.

    Docket Numbers: ER12-1639-000.
    Applicants: Pacific Gas and Electric Company.
    Description: Amendment to CDWR's Comprehensive Agreement, PG&E Rate
Schedule FERC No. 77 to be effective 4/30/2012.
    Filed Date: 4/27/12.
    Accession Number: 20120427-5329.
    Comments Due: 5 p.m. ET 5/18/12.

    Docket Numbers: ER12-1641-000.
    Applicants: Cleco Power LLC.
    Description: NOTICE OF CANCELLATION--SA 90--LAGEN to be effective
4/30/2012.
    Filed Date: 4/27/12.
    Accession Number: 20120427-5345
    Comments Due: 5 p.m. ET 5/18/12.

    Take notice that the Commission received the following land
acquisition reports:

    Docket Numbers: LA12-1-000.
    Applicants: Rockland Wind Farm LLC.
    Description: Rockland Wind Farm LLC Quarterly Land Acquisition
Report for 1st Quarter 2012.
    Filed Date: 4/27/12.
    Accession Number: 20120427-5360.
    Comments Due: 5 p.m. ET 5/18/12.

    The filings are accessible in the Commission's eLibrary system by
clicking on the links or querying the docket number.
    Any person desiring to intervene or protest in any of the above
proceedings must file in accordance with Rules 211 and 214 of the
Commission's Regulations (18 CFR 385.211 and 385.214) on or before 5:00
p.m. Eastern time on the specified comment date. Protests may be
considered, but intervention is necessary to become a party to the
proceeding.
    eFiling is encouraged. More detailed information relating to filing
requirements, interventions, protests, service, and qualifying
facilities filings can be found at: http://www.ferc.gov/docs-filing/efiling/filing-req.pdf. For other information, call<PHONE_NUMBER>
(toll free). For TTY, call<PHONE_NUMBER>.

    Dated: April 30, 2012.
Nathaniel J. Davis, Sr.,
Deputy Secretary.
[FR Doc. 2012-10977 Filed 5-7-12; 8:45 am]
BILLING CODE 6717-01-P