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OMB Control No. 20XX-XXXX
Approval Expires XX/XX/XX
United States Environmental Protection Agency
Pressed Wood Manufacturing Industry Survey:
Hardboard and Structural Composite Manufacturers
Questionnaire
Please return the completed response no later than Weekday, Month Day, Year.
Completing the survey is voluntary, but it is important that you respond. EPA needs
information from all companies (including those making products with low formaldehyde
emissions) to determine whether further action is needed, and to understand the impact of
potential actions on manufacturers. Your participation will help EPA understand your
company and the industry as a whole.
Survey ID:
The information collected by EPA may be disclosed to contractors of the Agency. This access will only occur to enable the contractors to
perform required tasks for the Agency. These contractors, including staff, will comply with Agency procedures for contractor handling of
confidential information collected in connection with TSCA. By returning the survey to EPA, I consent to this disclosure to EPA's
contractors.
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OMB Control No. 20XX-XXXX
Approval Expires XX/XX/XX
The public reporting and recordkeeping burden for this collection of information is
estimated to average 14 hours per response. Send comments on the Agency's need for
this information, the accuracy of the provided burden estimates, and any suggested
methods for minimizing respondent burden, including through the use of automated
collection techniques to the Director, Collection Strategies Division, U.S. Environmental
Protection
Agency
(2822T),
1200
Pennsylvania
Ave.,
NW,
Washington,
D.C.
20460.
Include the OMB control number in any correspondence. Do not send the completed
questionnaire to this address.
An Agency may not conduct or sponsor, and a person is not required to respond to, a collection of information,
unless it displays a currently valid OMB control number.
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OMB Control No. 20XX-XXXX
Approval Expires XX/XX/XX
Please verify that the information that we have for your company is accurate. Please correct any errors or
complete any missing information on the lines following Questions 1 through 8 below. Please consult
appropriate staff at your company as necessary to obtain the correct information.
Check red box if response is confidential business information (CBI)
1. The name of your company:
2. The name of your plant:
3. The address of your plant (mailing address and physical address, if different):
Physical
Address Line 1:
Address Line 2:
City:
State:
ZIP
Mailing
Address Line 1:
Address Line 2:
City:
State:
ZIP
4. The name and address of the ultimate parent company that owns this plant:
Parent Company:
Address Line 1:
Address Line 2:
City:
State:
ZIP
5. Your company’s website address:
6. Your contact information:
Name:
Title:
Telephone:
E-mail:
I. General Manufacturer Identification Information
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OMB Control No. 20XX-XXXX
Approval Expires XX/XX/XX
7. Size of ultimate parent company:
a. The approximate number of employees (worldwide) of the ultimate parent company that owns this plant:
less than 50
50-99
100-249
250-499
500-999
1,000-1,499
1,500 or more
Number:
b. The approximate 2009 gross revenue (worldwide) of the ultimate parent company that owns this plant:
less than $1 million
$1-$49 million
$50-$99 million
$100-$499 million
$500 million or more
Gross Revenue ($):
8. Size of this plant:
a. The approximate total number of employees (full time and part time) in total at this plant:
less than 25
25-49
50-99
100-149
150-249
250-499
500 or more
Number:
b. The approximate 2009 gross revenue of this plant:
less than $1 million
$1-$49 million
$50-$99 million
$100-$499 million
$500 million or more
Gross Revenue ($):
Check red box if response is confidential business information (CBI)
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OMB Control No. 20XX-XXXX
Approval Expires XX/XX/XX
* Check red box if response is confidential business information (CBI)
CBI*
Pressed
Wood
Category
(Column 1)
Check if
produced
at your
plant.
(Column 2)
In the 5-year period from 2005
through 2009, what was the
average annual total
production?
(please specify basis).
(Column 3)
Provide your plant's
rated maximum capacity
(Column 4)
To your
knowledge, are
any of your
products used in
non-structural
applications?
(Column 5)
Example:
Hardboard
Avg. annual production:
1 million sq. ft
basis:
1/8"
Max capacity:
5 million sq. ft
basis:
1/8"
Yes
a. Glulam
Avg. annual production:
basis:
Max capacity:
basis:
b. Hardboard
Avg. annual production:
basis:
Max capacity:
basis:
c. I-Joists
Avg. annual production:
basis:
Max capacity:
basis:
d. Oriented
Strandboard (OSB)
Avg. annual production:
basis:
Max capacity:
basis:
e. Softwood
Plywood
Avg. annual production:
basis:
Max capacity:
basis:
f. Structural
Composite Lumber
(SCL)*
Avg. annual production:
basis:
Max capacity:
basis:
g. Other Structural
Composite. Please
specify:
Avg. annual production:
basis:
Max capacity:
basis:
* Includes laminated veneer lumber (LVL), laminated strand lumber (LSL), parallel strand lumber (PSL),
and oriented strand lumber (OSL).
9. Primary pressed wood products manufactured and production volume.
II. Primary Pressed Wood Products Manufactured
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Copy #1 of Question 10
OMB Control No. 20XX-XXXX
Approval Expires XX/XX/XX
1. Pressed Wood Category Abbreviations:
2. Binder/Resin Categories:
3. Certification Standard Categories:
GL
Glulam
HB
Hardboard
IJ
I-Joist
OSB
Oriented strandboard
SWPW
Softwood plywood
SCL
Structural composite lumber
OTR
Other structural composites -
please specify
CNSL
Cashew Nut Shell Liquid
MF
Melamine-formaldehyde
MUF
Melamine-urea-formaldehyde
pMDI
Polymeric Diphenylmethane
Diisocyanate
PF
Phenol-formaldehyde
PF-MDI
Phenol-formaldehyde-MDI
PMUF-MDI
Phenol-melamine-urea-
formaldehyde-MDI
PUF-MDI
Phenol-urea-formaldehyde-MDI
PUFT
Phenol-urea-formaldehyde Tannin
PVA
Polyvinyl Acetate
SBR
Soy-based resins
TBR
Tannin-based resins
UF
Urea-formaldehyde
O
Other - please describe
+s
addition of scavenger to resin (for
example, "MF+s")
+c
addition of catalysts to resin
+a
addition of other additives to resin
E1/E2
European Standard (specify level in table above)
F
Japanese Standard (specify “*” level in table above)
HUD
HUD Standard
O
Other - please specify
None
No certification standard category was
met/will be met
N/A
Not applicable/not required
Add Copy
* Check red box if response is confidential business information (CBI)
10. Resin Types and Certification Standards. Please complete the following table for each pressed wood category produced at your plant. For the purpose of
this survey, adhesive/emissions class means a class of pressed wood product that differs from others based on binder/resin technology, formaldehyde emission
certification standard category, and/or formaldehyde emission profile. If you produce products in more than one adhesive/emissions class, have changed the
adhesive/emissions classes of your products in the last five years, or plan to change the adhesive/emissions classes of your products in the next three years,
please list each class in a separate row. For average and maximum emissions, calculate the average and maximum emissions over one year if possible. If the
average and maximum emissions cannot be calculated over one year, report the average and maximum emissions based on available data.
Click the button below to have the electronic version of this form automatically generate an additional copy of Question 10. If you are using the paper version of
this form, please use the extra copies provided and make additional copies as necessary.
Pressed Wood
Category
Adhesive/
Emissions
Binder/ Resin
Category
Emission
Certification
Standard Category
Indicate when Products
in each Adhesive/
Emissions Class were
produced and/or
whether it will be
produced in the future
Formaldehyde emission levels from
finished boards
Share of Production
Volume
CBI
*
(select from
list below)
1
(Col 1)
Class
(Col 2)
(Select from
list below)
2
(Col 3)
(select from list
below)
3
(Col 4)
Last 5
years?
(Col 5)
This
Year?
(Col 6)
3 years
from
now?
(Col 7)
Average
(specify units)
(Col 8)
Max
(specify units)
(Col 9)
Measurement method
(Col 10)
This Year
(%)
(Col 11)
3 years
from now
(%)
(Col 12)
Example: OSB
1
PF
E1
Yes
Yes
Yes
0.5 mg/100g
0.7 mg/100g
EN120 Perforator Test
0%
20%
Example: OSB
2
pMDI
F****
No
No
Yes
0.2 mg/L
0.3mg/L
JISA1901 Japanese Small
Chamber Test
100%
80%
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OMB Control No. 20XX-XXXX
Approval Expires XX/XX/XX
III. Recent or Planned Changes Resulting in Lower Formaldehyde
Emissions
Check red box if response is confidential business information (CBI)
11. Have you made any recent changes (since 2005) to production processes or raw materials that
resulted in lower product formaldehyde emissions?
Yes, for Glulam:
Yes, for Hardboard:
Yes, for I-Joists:
Yes, for Oriented Strandboard:
Yes, for Softwood Plywood:
Yes, for Structural Composite Lumber:
No changes were made since 2005 that resulted in lower product formaldehyde emissions, or
product formaldehyde emissions were not measured after changes made since 2005.
The primary purpose for the change was to lower product formaldehyde emissions.
The change was made for other reasons.
The change was made for other reasons.
The primary purpose for the change was to lower product formaldehyde emissions.
The change was made for other reasons.
The primary purpose for the change was to lower product formaldehyde emissions.
The change was made for other reasons.
The primary purpose for the change was to lower product formaldehyde emissions.
The change was made for other reasons.
The primary purpose for the change was to lower product formaldehyde emissions.
The change was made for other reasons.
The primary purpose for the change was to lower product formaldehyde emissions.
12. Do you plan to make any changes in the next three years to production processes or raw
materials expected to result in lower product formaldehyde emissions?
Yes, for Glulam:
Yes, for Hardboard:
Yes, for I-Joists:
Yes, for Oriented Strandboard:
Yes, for Softwood Plywood:
Yes, for Structural Composite Lumber:
No changes are planned in the next three years that are expected to result in lower product
formaldehyde emissions.
The primary purpose for the change is to lower product formaldehyde emissions.
The change will be made for other reasons.
The change will be made for other reasons.
The primary purpose for the change is to lower product formaldehyde emissions.
The change will be made for other reasons.
The primary purpose for the change is to lower product formaldehyde emissions.
The change will be made for other reasons.
The primary purpose for the change is to lower product formaldehyde emissions.
The change will be made for other reasons.
The primary purpose for the change is to lower product formaldehyde emissions.
The change will be made for other reasons.
The primary purpose for the change is to lower product formaldehyde emissions.
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OMB Control No. 20XX-XXXX
Approval Expires XX/XX/XX
Copy #1 of Question 13
Add Copy
13. Issues That May Affect Ability To Reduce Formaldehyde Emissions. If you currently use a resin with
added formaldehyde, please explain the issues you would need to address in order to reduce
formaldehyde emissions (without eliminating added formaldehyde). Complete Question 13 for each
pressed wood category manufactured at your plant that has added formaldehyde. If your responses
would differ for different products within a pressed wood category, then report them separately.
Click the button below to have the electronic version of this form automatically generate an additional
copy of Question 13. If you are using the paper version of this form, please use the extra copies
provided and make additional copies as necessary.
Check red box if response is confidential business information (CBI)
IV. Issues That May Affect Ability To Reduce Formaldehyde Emissions
or Switch to a No Added Formaldehyde Production Technology
a. Please specify the Primary Pressed Wood Category:
Glulam
Hardboard
I-Joists
Oriented Strandboard
Softwood Plywood
Structural Composite Lumber
Other Structural Composites. Please specify:
b. Please explain what changes would be necessary to raw materials used and production technology in
order to reduce the formaldehyde emissions from your products. If possible, please provide information
about the costs that would be associated with these changes.
Expand Answer
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OMB Control No. 20XX-XXXX
Approval Expires XX/XX/XX
Copy #1 of Question 14
Check red box if response is confidential business information (CBI)
14. Issues that May Affect Ability To Switch to NAF Production Technology. If you currently use a resin
with added formaldehyde, please explain the issues you would need to address in order to use a no-
added formaldehyde (NAF) resin technology. Complete Question 14 for each pressed wood category
manufactured at your plant that has added formaldehyde. If your responses would differ for different
products within a pressed wood category, then report them separately.
Click the button below to have the electronic version of this form automatically generate an additional
copy of Question 14. If you are using the paper version of this form, please use the extra copies
provided and make additional copies as necessary.
a. Please specify the Primary Pressed Wood Category:
b. Please explain what changes would be necessary to raw materials used and production technology in
order to adopt a no-added formaldehyde production technology. If possible, please provide information
about the costs that would be associated with these changes.
Add Copy
Glulam
Hardboard
I-Joists
Oriented Strandboard
Softwood Plywood
Structural Composite Lumber
Other Structural Composites. Please specify:
Expand Answer
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OMB Control No. 20XX-XXXX
Approval Expires XX/XX/XX
THE END
Thank you. Please see the sheet labeled Instructions for
Returning the Completed Questionnaire to EPA for directions
on how to return this questionnaire to EPA.
| File Type | application/pdf |
| File Title | Pressed Wood Survey (fillable) HB-SC PB 03-15-10D.pdf |
| Author | SorensenL |
| File Modified | 2010-03-15 |
| File Created | 2010-03-15 |