40 CFR Part 372 Subpart E -- Forms and Instructions § 372.85 Toxic chemical release reporting form and instructions. (a) Availability of reporting form and instructions. The most current version of EPA Form R (EPA Form 9350-1 and subsequent revisions) and the instructions for completing this form may be obtained by writing to the Section 313 Document Distribution Center, P.O. Box 12505, Cincinnati, OH 45212. EPA also encourages facilities subject to this part to submit the required information to EPA by using magnetic media (computer disk or tape) in lieu of Form R. Instructions for submitting and using magnetic media may also be obtained from the address given in this paragraph. (b) Form elements. Information elements reportable on EPA Form R or equivalent magnetic media format include the following: (1) An indication of whether the report: (i) Claims chemical identity as trade secret. (ii) Covers the entire facility or part of a facility. (2) Signature of a senior management official certifying the following: "I hereby certify that I have reviewed the attached documents and, to the best of my knowledge and belief, the submitted information is true and complete and that amounts and values in this report are accurate based upon reasonable estimates using data available to the preparer of the report." (3) Facility name and address including the toxic chemical release inventory facility identification number if known. (4) Name and telephone number for both a technical contact and a public contact. (5) The four-digit SIC code(s) for the facility or establishments in the facility. (6) Latitude and longitude coordinates for the facility. (7) The following facility identifiers: (i) Dun and Bradstreet identification number. (ii) EPA identification number (RCRA I.D. Number). (iii) NPDES permit number. (iv) Underground Injection Well Code (UIC) identification number. The name(s) of receiving stream(s) or water body to which the chemical is released. Name of the facility's parent company and its Dun and Bradstreet identification number. (10) Name and CAS number (if applicable) of the chemical reported. (11) If the chemical identity is claimed trade secret, a generic name for the chemical. (12) A mixture component identity if the chemical identity is not known. (13) An indication of the activities and uses of the chemical at the facility. (14) An indication of the maximum amount of the chemical on site at any point in time during the reporting year. (15) Information on releases of the chemical to the environment as follows: (i) An estimate of total releases in pounds per year (releases of less than 1,000 pounds per year may be indicated in ranges (from the facility plus an indication f the basis of estimate for the following: (A) Fugitive or non-point air emissions. (B) Stack or point air emissions. (C) Discharges to receiving streams or water bodies including an indication of the percent of releases due to stormwater. (D) Underground injection on site. (E) Releases to land on site. (ii) [Reserved] (16) Information on transfers of the chemical in wastes to off-site locations as follows: (i) For transfers to Publicly Owned Treatment Works (POTW): (A) The name and address (including county) of each POTW to which the chemical is transferred. (B) An estimate of the amount of the chemical transferred in pounds per year (transfers of less than 1,000 pounds per year may be indicated as a range) and an indication of the basis of the estimate. (ii) For transfers to other off-site locations: (A) The name, address (including county), and EPA identification number (RCRA I.D. Number) of each off-site location, including an indication of whether the location is owned or controlled by the reporting facility or its parent company. (B) An estimate of the amount of the chemical in waste transferred in pounds per year (transfers of less than 1,000 pounds may be indicated in ranges) to each off-sit location, and an indication of the basis for the estimate and an indication of the type of treatment or disposal used. (17) The following information relative to waste treatment: (i) An indication of the general type of wastestream containing the reported chemical. (ii) The treatment method applied to the wastestream. (iii) An indication of the concentration of the chemical in the wastestream prior to treatment. (iv) An estimate in percent of the efficiency of the treatment plus an indication of whether the estimate is based upon operating data. (v) An indication (use is optional) of whether treatments listed are part of a treatment sequence. (18) Pollution prevention data (reporting is optional) which includes the type of pollution prevention modification, quantity of the chemical in the wastes prior to treatment and disposal (for both the current and prior reporting year), a production index, and the reason for the pollution prevention action. This optional reporting expires after the 1990 reporting year. [53 FR 4525, February 16, 1988, as amended at 56 FR 29183, June 26, 1991] § 372.95 Alternate threshold certification and instructions. (a) Availability of the alternate threshold certification statement and instructions. Availability of the alternate threshold certification statement and instructions is the same as provided in § 372.85(a) for availability of the reporting form and instructions. (b) Alternate threshold certification statement elements. The following information must be reported on an alternate threshold certification statement pursuant to § 372.27(b): (1) Reporting year. (2) An indication of whether the chemical identified is being claimed as trade secret. (3) Chemical name and CAS number (if applicable) of the chemical, or the category name. (4) Signature of a senior management official certifying the following: pursuant to 40 CFR 372.27, "I hereby certify that to the best of my knowledge and belief for the toxic chemical listed in this statement, the annual reportable amount, as defined in 40 CFR 372.27(a), did not exceed 500 pounds for this reporting year and that the chemical was manufactured, or processed, or otherwise used in an amount not exceeding 1 million pounds during this reporting year." (5) Date signed. (6) Facility name and address. (7) Mailing address of the facility if different than paragraph (b)(6) of this section. (8) Toxic chemical release inventory facility identification number if known. (9) Name and telephone number of a technical contact. (10) The four-digit SIC codes for the facility or establishments in the facility. (11) Latitude and longitude coordinates for the facility. (12) Dun and Bradstreet Number of the facility. (13) EPA Identification Number(s) (RCRA) I.D. Number(s) of the facility. (14) Facility NPDES Permit Number(s). (15) Underground Injection Well Code (UIC) I.D. Number(s) of the facility. (16) Name of the facility's parent company. (17) Parent company's Dun and Bradstreet Number. [59 FR 61488, Nov. 30, 1994]