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U.S. Environmental Protection Agency |
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Class II Importer Quarterly Report |
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Company Name: |
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Reporting Period: |
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Section 2: Import Transaction Data |
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In the table below, enter data for each import transaction containing a class II controlled substance that took place during the reporting period. If no controlled substances were imported, the table may be left blank. For all controlled substances that are imported, all fields are required unless otherwise indicated. As a reminder, if material was imported for second party transformation or second party destruction, a copy of the transformation and/or destruction verification from each company for whom material was imported must be provided to EPA along with the submission of this report. |
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If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions. |
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If blends were imported, refer to the table of HCFC blends provided in the Blend Breakout tab, as needed. |
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The transaction number is autopopulated.
Transaction Number |
Enter the date for when the shipment entered the United States.
Date of Import |
Select the country from which the shipment was imported.
If copying and pasting data into the table, please refer to the Reference List for the valid list of countries.
Source Country |
Select the name of the chemical imported. If the chemical is a blend, select the name of the blend. A table of HCFC blends is provided in the 'Blends Breakout' tab for reference.
If the import is a blend and the name of the blend is not listed in the dropdown list, select 'Other' and manually enter the name and quantity of each class II chemical contained within the blend in columns I-N.
If copying and pasting data into the table, please refer to the Reference List for the valid list of chemical names.
Name of the Chemical Imported |
Enter the total quantity (kg) of the chemical imported. If the chemical is a blend, the quantity should equal the total quantity of the blend.
Quantity of Chemical Imported |
Enter the 10-digit commodity code of the chemical imported as it appears on Customs documentation.
Refer to the Reference List for a list of commonly used commodity codes for class II chemicals.
Commodity Code |
These fields will automatically populate unless the name of the chemical imported is identified as 'Other'.
Summary of Class II Controlled Substances Imported |
Enter the name of the port where the shipment entered the United States.
Port of Entry into the United States |
Enter the Customs Entry Summary Number for the shipment. This number identifies the specific shipment. The Customs Entry Summary Number is generally three (3) letters followed by nine (9) digits.
Customs Entry Summary Number |
Enter the Importer Number of the shipment. Your company's Importer Number as entered in Section 1 of this report will automatically populate for each transaction entered. Revise the number if the Importer Number of the shipment is different from your company's Importer Number.
The number entered should have no dashes.
Shipment Importer Number |
Select the transaction type of the material. The transaction type can be New, Used, or Heels.
Heels should only be reported at the end of the year (i.e., on Q4 reports).
If copying and pasting data into the table, please refer to the Reference List for the valid list of transaction types.
Transaction Type |
Select the intended use of the material. Note that the Transaction Type in Column R must be selected prior to completing this field.
- If the material is New, the intended use can be In-House Transformation, 2nd Party Transformation, In-House Destruction, 2nd Party Destruction, or None Apply.
- If the material is Used, the intended use can be In-House Transformation, 2nd Party Transformation, In-House Destruction, 2nd Party Destruction, or Other.
- If the material is a Heel, the intended use can be Included in Future Shipment, Transformation, Destruction, or Non-Emissive Use.
If copying and pasting data into the table, please refer to the Reference List for the valid list of intended uses.
Intended Use |
Enter the date of the non-objection notice or acknowledgement letter issued by EPA for the shipment if the material imported is used.
Date of Non-Objection Notice or Acknowledgement Letter |
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If the chemical imported is identified as 'Other', enter the name of the class II chemical imported as part of the blend or mixture.
Please refer to the Reference List for the valid list of chemical names.
Class II Chemical |
If the chemical imported is identified as 'Other', enter the quantity of the class II chemical imported as part of the blend or mixture.
Quantity Imported (kg) |
If the chemical imported is identified as 'Other' and the mixture or blend contains more than one class II chemical, enter the name of the second class II chemical imported as part of the blend or mixture.
Please refer to the Reference List for the valid list of chemical names.
Class II Chemical |
If the chemical imported is identified as 'Other' and the mixture or blend contains more than one class II chemical, enter the quantity of the second class II chemical imported as part of the blend or mixture.
Quantity Imported (kg) |
If the chemical imported is identified as 'Other' and the mixture or blend contains more than two class II chemicals, enter the name of the third class II chemical imported as part of the blend or mixture.
Please refer to the Reference List for the valid list of chemical names.
Class II Chemical |
If the chemical imported is identified as 'Other' and the mixture or blend contains more than two class II chemicals, enter the quantity of the third class II chemical imported as part of the blend or mixture.
Quantity Imported (kg) |
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Autopopulated |
Date |
Selection |
Selection |
kg |
Text |
Autopopulated |
Autopopulated |
Autopopulated |
Autopopulated |
Autopopulated |
Autopopulated |
Text |
Text |
Number |
Selection |
Selection |
Date |
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1 |
1/15/2018 |
Australia |
HCFC-22 |
5,000.00 |
2903.71.0000 |
HCFC-22 |
5,000.00 |
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Miami, FL |
abc123456789 |
12345678900 |
New |
None Apply |
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1 |
|
|
|
|
|
|
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|
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x |
x |
|
|
|
|
|
|
|
|
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|
|
x |
x |
|
|
|
|
|
|
|
|
|
Afghanistan |
HCFC-21 |
|
|
|
|
|
|
|
|
|
|
|
New |
In-House Trans |
|
|
|
|
|
|
|
|
|
Albania |
HCFC-22 |
|
|
|
|
|
|
|
|
|
|
|
Used |
2nd Party Trans |
|
|
|
|
|
|
|
|
|
Algeria |
HCFC-31 |
|
|
|
|
|
|
|
|
|
|
|
Heels |
In-House Dest |
|
|
|
|
|
|
|
|
|
Andorra |
HCFC-121 |
|
|
|
|
|
|
|
|
|
|
|
|
2nd Party Dest |
|
|
|
|
|
|
|
|
|
Angola |
HCFC-122 |
|
|
|
|
|
|
|
|
|
|
|
|
None Apply |
|
|
|
|
|
|
|
|
|
Antigua and Barbuda |
HCFC-123 |
|
|
|
|
|
|
|
|
|
|
|
|
In-House Trans |
|
|
|
|
|
|
|
|
|
Argentina |
HCFC-123a |
|
|
|
|
|
|
|
|
|
|
|
|
In-House Dest |
|
|
|
|
|
|
|
|
|
Armenia |
HCFC-123b |
|
|
|
|
|
|
|
|
|
|
|
|
Other |
|
|
|
|
|
|
|
|
|
Australia |
HCFC-124 |
|
|
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Future Shipment |
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Austria |
HCFC-124a |
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Transformation |
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Azerbaijan |
HCFC-131 |
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Destruction |
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Bahamas |
HCFC-132b |
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Non-Emissive Use |
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Bahrain |
HCFC-133a |
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Bangladesh |
HCFC-141b |
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Barbados |
HCFC-142b |
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Belarus |
HCFC-151 |
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Belgium |
HCFC-221 |
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Belize |
HCFC-222 |
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Benin |
HCFC-223 |
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Bermuda |
HCFC-224 |
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Bhutan |
HCFC-225ca |
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Bolivia (Plurinational State of) |
HCFC-225cb |
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Bosnia and Herzegovina |
HCFC-226 |
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Botswana |
HCFC-231 |
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Brazil |
HCFC-232 |
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Brunei Darussalam |
HCFC-233 |
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British Virgin Islands |
HCFC-234 |
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Bulgaria |
HCFC-235 |
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Burkina Faso |
HCFC-241 |
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Burundi |
HCFC-242 |
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Cambodia |
HCFC-243 |
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Cameroon |
HCFC-244 |
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Canada |
HCFC-251 |
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Cape Verde |
HCFC-252 |
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Central African Republic |
HCFC-253 |
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Chad |
HCFC-261 |
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Chile |
HCFC-262 |
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China |
HCFC-271 |
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Colombia |
R-401A |
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Comoros |
R-401B |
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Congo |
R-401C |
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Cook Islands |
R-402A |
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Costa Rica |
R-402B |
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Cote d'Ivoire |
R-403A |
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Croatia |
R-403B |
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Cuba |
R-405A |
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Cyprus |
R-406A |
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Czech Republic |
R-408A |
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Democratic Republic of the Congo |
R-409A |
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Denmark |
R-409B |
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Djibouti |
R-411A |
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Dominica |
R-411B |
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Dominican Republic |
R-411C |
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Ecuador |
R-412A |
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Egypt |
R-414A |
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El Salvador |
R-414B |
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Equatorial Guinea |
R-415A |
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Eritrea |
R-415B |
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Estonia |
R-416A |
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Ethiopia |
R-418A |
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European Union |
R-420A |
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Fiji |
Other |
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Finland |
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France |
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Gabon |
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Gambia |
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Georgia |
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Germany |
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Ghana |
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Greece |
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Grenada |
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Guatemala |
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Guinea |
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Guinea-Bissau |
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Guyana |
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Haiti |
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Holy See |
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Honduras |
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Hong Kong |
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Hungary |
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Iceland |
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India |
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Indonesia |
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Iran (Islamic Republic of) |
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Iraq |
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Ireland |
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Israel |
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Italy |
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Jamaica |
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Japan |
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Jordan |
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Kazakhstan |
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Kenya |
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Kiribati |
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Kuwait |
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Kyrgyzstan |
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Lao People's Democratic Republic |
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Latvia |
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Lebanon |
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Lesotho |
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Liberia |
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Libya |
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Liechtenstein |
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Lithuania |
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Luxembourg |
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Madagascar |
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Malawi |
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Malaysia |
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Maldives |
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Mali |
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Malta |
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Marshall Islands |
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Mauritania |
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Mauritius |
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Mexico |
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Micronesia (Federated States of) |
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Monaco |
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Mongolia |
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Montenegro |
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Morocco |
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Mozambique |
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Myanmar |
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Namibia |
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Nauru |
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Nepal |
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Netherlands |
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New Zealand |
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Nicaragua |
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Niger |
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Nigeria |
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Niue |
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North Korea (Democratic People's Republic of Korea) |
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Norway |
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Oman |
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Pakistan |
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Palau |
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Panama |
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Papua New Guinea |
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Paraguay |
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Peru |
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Philippines |
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Poland |
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Portugal |
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Qatar |
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Republic of Moldova |
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Romania |
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Russian Federation |
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Rwanda |
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Saint Kitts and Nevis |
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Saint Lucia |
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Saint Vincent and the Grenadines |
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Samoa |
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San Marino |
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Sao Tome and Principe |
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Saudi Arabia |
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Senegal |
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Serbia |
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Seychelles |
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Sierra Leone |
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Singapore |
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Slovakia |
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Slovenia |
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Solomon Islands |
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Somalia (Federal Republic of) |
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South Africa |
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South Korea (Republic of Korea) |
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South Sudan |
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Spain |
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Sri Lanka |
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Sudan |
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Suriname |
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Swaziland |
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Sweden |
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Switzerland |
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Syrian Arab Republic |
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Tahiti |
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Taiwan |
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Tajikistan |
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Thailand |
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The Former Yugoslav Republic of Macedonia |
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Timor-Leste |
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Togo |
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Tonga |
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Trinidad and Tobago |
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Tunisia |
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Turkey |
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Turkmenistan |
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Tuvalu |
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Uganda |
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Ukraine |
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United Arab Emirates |
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United Kingdom of Great Britain and Northern Ireland |
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United Republic of Tanzania |
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#NAME? |
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Uruguay |
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Uzbekistan |
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