5900-553 HFC Process Agent Use Annual Reporting Form

U.S. Environmental Protection Agency (EPA)

OMB Control Number: 2060-0734

Expiration Date: MM/DD/YYYY

American Innovation and Manufacturing (AIM) Act

Hydrofluorocarbon (HFC) Process Agent Use Annual Report

Worksheet Instructions:

Complete and submit an HFC Process Agent Use Annual Report if your facility uses regulated HFCs as a process agent. All sections of the report must be completed prior to submission.

Version:

r0.1

Updated:

7/2/2025

External Links:

HFC Allocation Rule Reporting HelpDesk

AIM Act Paperwork Reduction Act Burden

Reporting Form Navigation:

Section 1 - Facility Identification

Section 3 - HFC Emission Reduction Plans

Section 2 - Process Agent Use Information

EPA may request additional information or ask follow up questions to verify the accuracy of this submission and supporting documentation, including pursuant to Clean Air Act section 114 as authorized under the AIM Act.

Section 1 - Facility Identification

Instructions: Complete the following facility information.

Facility Name:

Facility ID:

Reporting Year:

Section 2 - Process Agent Use Information

Instructions: Provide the quantity of each HFC that was used as a process agent during the reporting period, along with the amount of products and byproducts manufactured and the quantity of stack point source emissions.

Process Agent, Product, and Byproduct Information

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6b

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6d

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8d

HFC

Quantity Used as Process Agent (kg) §84.31(g)(2)(ii)

Stack Point Source Emissions Quantity (kg) §84.31(g)(2)(iv)

Name of Product Manufactured

Quantity of Product Manufactured (kg) §84.31(g)(2)(iii)

Byproduct (1)

Byproduct (2)

Byproduct (3)

Name of Byproduct Manufactured

Total Quantity of Byproduct Manufactured (kg) §84.31(g)(2)(iii)

Quantity of Byproduct Eventually Destroyed (kg) §84.31(g)(2)(iii)

Quantity of Byproduct Eventually Used as Feedstock (kg) §84.31(g)(2)(iii)

Name of Byproduct Manufactured

Total Quantity of Byproduct Manufactured (kg) §84.31(g)(2)(iii)

Quantity of Byproduct Eventually Destroyed (kg) §84.31(g)(2)(iii)

Quantity of Byproduct Eventually Used as Feedstock (kg) §84.31(g)(2)(iii)

Name of Byproduct Manufactured

Total Quantity of Byproduct Manufactured (kg) §84.31(g)(2)(iii)

Quantity of Byproduct Eventually Destroyed (kg) §84.31(g)(2)(iii)

Quantity of Byproduct Eventually Used as Feedstock (kg) §84.31(g)(2)(iii)

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Section 3 - HFC Emission Reduction Plans

Instructions: Provide a description of any HFC emission reduction actions planned or currently under investigation. §84.31(g)(2)(v)

This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-0734). Responses to this collection of information are mandatory (40 CFR 84.31). 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. The public reporting and recordkeeping burden for this collection of information is estimated to be 6 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, Information Engagement Division, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

EPA Form # 5900-553