Form 7710-25 PMN Form

I I I I I I I I I Il l l l l l l l l l l l Il l l l l

OMB NO. 2070-NEW
Expires: 12/31/2022
NON-CBI SUBMI SSIO N

PMN Page 1

PMN2009P1

U.S. ENVIRONMENTAL PROTECTION AGENCY

PA

Date of receipt:

PREMANUFACTURE
NOTICE
FOR NEW CHEMICAL SUBSTANCES

If sending by Courier:
Office of Pollution Prevention and Toxics
Document Control Office (7407M)
US EPA, 1201 Constitution Ave NW
WASHINGTON, D.C. 20460
Contact Numbers: 202-564-8930/8940

Total Number of Pa es

AGENCY USE ONLY

H sendlng by US Mail:
Office of Pollution Prevention and Toxics
Document Control Office (7407M)
US EPA, 1200 Pennsylvania Ave NW
WASHINGTON, D.C. 20460

Submission Re ort Number

User Fee Pa ment ID Number

49

TS Number

GENERAL INSTRUCTIONS

You must provide all Information recuested in this form to the extent that rt is known 10 or re=ably ascertainable by you. Make reasonable estimates n you do not have actual data

• Before you complete this fonn, you should read the �Instructions Manual tor Premanufacture Nolifiicabon" (the Instructions Manual is available from the Toxic St..estances Control Act

(TSCA) Information Service by calling 202-554-1404, or faxing 202-554-5603).
• If a user fee has been remitted for this notice (40 CFR 700.45). indicate in the boxes above the TS-File Typeapplication/pdfFile Modified2022-03-28File Created0000-01-01