Document VjBQgrL7aBZeMZQ8JMrEbaEej
Form Approved 0MB Number: 2070-0092 (IMPORTANT: Type or print; read instructions before completing form) Approval Expires: 11/92
PAGE 1 OF 9
ERA lited States lvi ronmental
Protection Agency
WHERE TO SEND COMPLETED FORMS:
FORM R
TOXIC CHEMICAL RELEASE INVENTORY REPORTING FORM
Section 313 of the Emergency Planning and Community Right-to-Know Act of 1986, also known as Title III of the Superfund Amendments and Reauthorization Act
1. EPCRA Reporting Center P.O. Box 3348 Merrifield, VA 22116-3348 ATTN: TOXIC CHEMICAL RELEASE INVENTORY
-+
2. APPROPRIATE STATE OFFICE (See instructions in Appendix F)
|TRI FACILITY ID NUMBER
...................................................................... ...
|
| 70765TH0UCHIGHW
|
...................-....................................
|Chem., Cat., or Gen.Name |
.................................................................. .............
ETHYLENE GLYCOL -
--------------------------------------------------------- --- ---------------------- 4-
Enter "X" here if this is a revision
IMPORTANT: See instructions to determine when "Not Applicable (NA)" boxes should be checked.
|For EPA use only
PART I. FACILITY IDENTIFICATION INFORMATION
Section 2. TRADE SECRET INFORMATION
2.1 Are you claiming the toxic chemical identified on page 3 trade secret?
C 1 Yes (Answer question 2.2;
EX] No (Do not answer 2.2;
Attach substantiation forms)
Go to Section 3)
2.2 If yes in 2.1, is this copy:
[ ] Sanitized
C ] Unsanitized
SECTION 3. CERTIFICATION (Inportant: Read and sign after completing all form sections.)
I hearby certify that I have reviewed the attached documents and that, to the best of my knowledge and belief, the submitted information is true and complete and that the amounts and values in this report are accurate based on reasonable estimates using data available to the preparers of this report.
EPA Form 9250-1 (Rev. 12/4/94) - Previous editions are obsolete.
DO A 054545 CONFTDFNTIAl
PAGE 2 OF 9
EPA United States Environmental
rotection ,gency
EPA FORM R PART I. FACILITY IDENTIFICATION
INFORMATION (CONTINUED)
........................................................................................................................................................... *
(TRI FACILITY ID NUMBER
|
............................................................................... ...
| 70765TH0WCHIGHW f*....... ...................................
|
|Chen., Cat., or Gen.Name |
....................... -.............
| ETHYLENE GLYCOL
|
................................................................................... ...
........................................................... ............. ................................................... ........................... ....................... ........................................ ........................... ............................................................................................ .................... -- -- --------------------------------------------------------
|SECT ION 4. FACILITY IDENTIFICATION (Continued)
|
...................+----------
------------------------------ ----------------------------------------- ---------------------------- --------------------------------------------------------------------------------------------------------------------- -------------------------- -------------- ------------------------------------- -------------------
(4.2 ( This report contains information for:I
(Important: check only one)
| a. [X] An entire facility
b. [ ] Part of a facility
c. ( ) Federal Facility
|4.3 I Technical Name I I Contact DOYLE A. HANEY
---------................................. +-.................. ...................
4.4 | Public I Name Contact GERRY DAIGRE
Telephone Nmt>er (include area code) (504)353-6128
Telephone Ninter (include area code) (504)353-1602
4.5 SIC Code (4-digit)
a. 2812
Latitude 4.6
and
Longitude
Degrees 030
b. 2821 Latitude Minutes
4.7 Dun & Bradstreet Nunter(s) (9 digits)
c. 2869
d. NA
Seconds 00
Degrees 00,
e. Longitude Minutes
f. Seconds
16 20
008187080
NA
EPA Identification Ninter(s) (RCRA I.D. No.) (12 characters)
LAD008187080 NA
4.9 Facility NPDES Permit Nunter(s) (9 characters)
LA0003301
4.10 Underground Injection Well Code (U1C) I.D.
Number(s)
(12 digits)
LA0049638 NA
SECTION 5. PARENT COMPANY INFORMATION
5.1(Name of Parent Company
!
|( ) NA
|
|
THE DOW CHEMICAL COMPANY
5.2|Parent Company's Dun l Bradstreet Niafeerj
|[ ] NA
|
(9 Digits)
001381581
EPA Form 9250-1 (Rev. 12/4/94) - Previous editions are obsolete.
OO TOF^TT AV
COMP
---------------- . - - - -.......--------------------------------------------------------------- ---
--- -- - - --
........................................................................................................................................... ...........................
EPA EPA FORM R
United States Environmental
PART II. CHEMICAL-SPECIFIC INFORMATION
rotection .gency
.I......................................................................................................................................................... .
I SECT ION 1. TOXIC CHEMICAL IDENTITY (Important: DO NOT complete this section I if you complete Section 2 below.)
. . .................................. ........ ....................................................................................................................................... ......................................................-..................................................-
1.1| CAS Nunber (Important: Enter only one nunber exactly as it appears on the Section 313 list.
................................................ ........ ............................................... -................................................................................................*
PAGE 3 OF 9
|TR! FACILITY 10 NUMBER .....................................................
| 70765THDWCHIGHW
4..... ......................
|Chem., Cat., or Gen. Name + .........
| ETHYLENE GLYCOL
+
| 000107-21-1
I
---- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
1.2| Toxic Chemical or Chemical Category Name (Important: Enter only one name exactly as it appears on the Section 313 list.) |
......................................................................................................................................................................................................................................................................................... *
ETHYLENE GLYCOL
.....1.3| Generic Chemical Name
................................
... ...........................
.(.Im..p--o-r-ta.n.t.:...C.o.m..p.le.t.e..o.n.l.y..i.f..P.a.r.t..I.,..S.e.c.t.io.n..2...1...is..c.h.e..ck.e.d..."y.-e-s--."-
NA
I SECT ION 2. MIXTURE COMPONENT IDENTITY (Important: DO NOT complete this I section if you complete Section 1 above.)
*--+
---------------------------------------------------------------------------------
|SECT ION 3. ACTIVITIES AND USES OF THE CHEMICAL AT THE FACILITY --+---------------------------- ----------------------------------------------------------------------------
Manufacture the toxic chemical: 3.1
a. [ ] Produce b. [ ] Import
Process 3.2 the toxic
chemical
a. CX] As a reactant b. [] Ai a formulation component
(Important: Check all that apply.) If produce or import:
c. [ ] For on-site use/processing d. ( ] For sale/distribution e. [ 1 As a byproduct f. I ) As an impurity
c. t ) As an article component d. C ] Repackaging
Otherwise use 3.3 the toxic
chemical:
a. ( ] As a chemical processing aid b. DC) As a manufacturing aid
Section 4. MAXIMUM AMOUNT OF THE TOXIC CHEMICAL ON-SITE AT ANY TIME DURING THE CALENDAR YEAR
4.11
07
(Enter two-digit code from instruction package.)
EPA Form 9250-1 (Rev. 12/4/94) - Previous editions are obsolete.
c. [X] Ancillary or other use i
DO A 054547 OONFTDFNTTAl
+-------- -----------EPA
United States Environmental 'rotection
gency
EPA FORM R
PART II. CHEMICAL-SPECIFIC INFORMATION (CONTINUED)
PAGE 4 OF 9
-----
-------------------------------------------------------------
|TRI FACILITY ID NUMBER
|
................................................................... ...
| 70765THDWCHIGHW
|
.......................... .............
|Chem., Cat., or Gen.Name | ........................................................ *
| ETHYLENE GLYCOL
|
| SECTtON 5. RELEASES OF THE TOXIC CHEMICAL TO THE ENVIRONMENT ON-SITE
A. Total Release (pounds/year) B. (enter range code from instructions or estimate)
Basis of Estimate (enter code)
C. X From Stormwater
5.1 Fugitive or non-point air emissions
C 1NA
4000
E
5.2 Stack or point air emissions
C 1NA
18930
0
5.3 Discharges to receiving streams or water bodies (enter one name per box)
|5.3.1 Stream or Water Body Name
r
|5.3.2 Stream or Water Body Name
1
f5.3.3 Stream or Water Body Name
1
5.4 Underground injections on-site
5.5 Releases to land on-site
DONA NA
5.5.1 Landfill
5.5.2 Land treatment/ application farming
5.5.3 Surface impowxinent
5.5.4 Other disposal
DONA NA DONA NA DONA NA DONA NA
P
I ' ] Check here only if additional Section 5.3 information it provided on page 5 of this form.
DO A 054548 CONFTDFNTTAl.
+--.............................................................. --.................................... .......... --.....................................................................
EPA Form 9250-1 (Rev. 12/4/94) - Previous editions are obsolete.
Range Codes: A * 1-10 pounds; B 11-499 pounds; C 500 - 999 pounds.
%
EPA
United States Environmental
-otection gency
EPA FORM R
PART 11. CHEMICAL-SPECIFIC INFORMATION (CONTINUED)
PAGE 5 OF 9
|TRI FACILITY ID NUMBER |
70765THDWCHIGHW
|Chem., Cat., or Gen. Name | .......................-..............................
| ETHYLENE GLYCOL
|
Section 5.3 ADDITIONAL INFORMATION ON RELEASES OF THE TOXIC CHEMICAL TO THE ENVIRONMENT ON-SITE
5.3 Discharges to receiving streams or water bodies (enter one name per box)
A. Total Release (pounds/year) (enter range code from instructions or estimate)
B. Basis of Estimate
(enter code)
|5.3.4 Stream or Water Body Name
C. X From Stormwater
15.3.5 Stream or Water Body Name
15.3.6 Stream or Water 8ody Name
I SECT ION 6. TRANSFERS OF THE TOXIC CHEMICAL IN WASTES TO OFF-SITE LOCATIONS
6.1 DISCHARGES TO PUBLICLY OWNED TREATMENT WORKS (POTW)
'*.1.A Total Quantity Transferred to POTWs and Basis of Estimate
.1.A.1 Total Transfers (pounds/year) | (enter range code or estimate)
6.1.A.2 Basis of Estimate (enter code)
NA
|6.1.B POTW Name and Location Information
6.1.B.11 POTW Name ------------- +.. -- - --
Street Address
6.1.B.2I POTW N Street Address
City
County
City
County
State
Zip Code
State
Zip Code
If additional pages of Part II, Sections 5.3 and/or 6.1 are attached, indicate the total niafcer of pages in this box [ ] and indicate which Part II, Sections 5.3/6.1 page this is, here. [1 )
(example: 1,2,3,etc.)
EPA Form 9250-1 (Rev. 12/4/94) - Previous editions are obsolete.
Range Codes: A * 1-10 pounds; B * 11-499 pounds; C * 500 - 999 pounds.
DO A 054549 CONFIDFNTIAL
.....................................................................................................................................................................................................................................................................................................................................................
EPA EPA FORM R
United States Environmental
rotection I .gency
PART II. CHEMICAL-SPECIFIC INFORMATION (CONTINUED)
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
............................ .............................-
..................................................
...........................
|SECT ION 6.2 TRANSFERS TO OTHER OFF-SITE LOCATIONS
----------------------------------------------------------------------
16.2.1 Off-site EPA Identification Nuifcer (RCRA ID No.)
I NA
----------------------------------------------------------------------
| Off-Site Location Name +---------------------------------------------------------------------------------------------------------------------
| Street Address
- - - --- --
-- -- --------------------- -----------------------------------------------------------
-- -- - -- -- --
+---------------
I City
I County
PAGE 6 OF 9
|TRI FACILITY ID NUMBER
|
---- ---------------- -------- -------------+
| 70765THDUCHIGHU
|
.................................................................................
|Chem., Cat., or Gen. Name |
................................................................................+
I ETHYLENE GLYCOL
I
------------------------------------------+-------------------------------------- -----------------------------------------------------------------------------------
| State
|Zip Code
| Is location under control of reporting
I ) YES
t ) NO
|
+---------------------------------------- +-------------- -------------------------------------- +-------------------------------------- ------------------------------------------------------------------------------- +
A. Total Transfers (pounds/year) (enter range code or estimate)
B. Basis of Estimate (enter code)
C. Type of Waste Treatment/Disposal/ Recycling/Energy Recovery (enter code)
i. 1. i. , k 3-
4-
|SECT ION 6.2 TRANSFERS TO OTHER OFF-SITE LOCATIONS
- - ------------------------- --- -- - - ------------------ -- -- -- -- --
--- ----
[6.2.2 Off-site EPA Identification Nimber (RCRA ID No.)
.. .. 3-
1
1 1
1
+
Off-Site Location Name | Street Address | City
| Couity
| State
|2ip Code
| Is location under control of reporting
I ) TES
C ] NO
A. Total Transfers (pounds/year) (enter range code or estimate)
B. Basis of Estimate (enter code)
C. Type of Waste Treatment/Disposal/ Recycling/Energy Recovery (enter code)
1, ,
i. S
i. 1 ,1
k 3.
3. 1
k
............ -................. ................................................................................................................................................................................................................................................. ...........y
If additional pages of Part II, Section 6.2 are attached, indicate the total nunber of pages in
DO A 054550
his box [ ] and indicate which Part II, Sections 6.2 page this is, here. Cl ]
CONFIDENTIAL
, (example: 1,2,3,etc.)
........+..................... ........... ..........
............................................................................................................................................................................................................................................................................. ...................................
EPA Form 9250-1 (Rev. 12/4/94) - Previous editions are obsolete.
Range Codes: A * 1-10 pounds; B * 11-499 pounds; C * 500 - 999 pounds.
%
EPA
United States Environmental rotection
gency
EPA FORM R
PART II. CHEMICAL-SPECIFIC INFORMATION (CONTINUED)
PAGE 7 OF 9
...........
-........................................ ................*
|TRI FACILITY ID NUMBER | ........................................................ ..
| 70765T HDWCHIGHW
|
..........................................
|Chem., Cat., or Gen. Name | ------------------------ -------------------- *
| ETHYLENE GLYCOL
|
.............. .........................
I Section 7A. ON-SITE WASTE TREATMENT METHOOS AND EFFICIENCY
C ] Not Applicable (NA) - Check here if no on-site treatment is applied to any waste stream containing the toxic chemical or chemical category.
a. General Waste Stream (enter code )
b. Waste Treatment Method(s) Sequence [enter 3-character code(s)]
c. Range of Influent Concentration
d. Treatment Efficiency Estimate
7A.1b
7A.1c
7A.1d
3i 6i
11 F11 i i
1 2 | NA
' i 51
.
i 7I
i 1
| i
i
i
099.99
X
e. Based on Operating Data?
7A.1e
Yes [X]
No []
7A.2a
|7A.2b 1 9-
3i
.
6i
ii 2i
F11 i
NA
11 !
7A.2c
i ^i
i 5i
i 1
i 71
i 8I
i
j 7A.2d
|
7A.2e
|
099.99
X
Yes [X]
No C]
7A.3a
7A.3b 1
3i
61
11 7A.3c
i j i 2j B11 NA
i
i i
1 i 5i
i 2
.
i 71
i 8I
i
j 7A.3d
|
7A.3e
|
098.00
X
Yes C)
No CX]
7A.4a
7A. 4b 1
3i
.
61
7A.5b
3i
i 7A.4c
1 j 2i
P11 i
NA
i
1
i *I
i 5i
i 2
i 71
1I 1 ^i
i 1
2i i
5i i
i i 7A.5c
i
i
|
7A.4d
|
7A.4e
000.00
X
Yes [)
No CX]
j
7A.5d
j
7A.5e
6I ..........
i 7I -
i 8I -
i
| If additional pages are attached, indicate the total nunber of pages in this box [ ] and indicate which page this is, here [1]
......................................................................................... .................................. .......................-...........................................
................... ................................... ........................................................................................................................................ .................................-
EPA Form 9250-1 (Rev. 12/4/94) - Previous editions are obsolete.
qq fa 054551
CONFTDFNTTAl
EPA
United States Environmental 'rotection gency
EPA FORM R PART II. CHEMICAL-SPECIFIC
INFORMATION (CONTINUED)
PAGE 8 OF 9
|TRl FACILITY 10 NUMBER ......................... ..............................
| 70765THDUCHIGHW
I
.................................................................................. .
|Chem.t Cat., or Gen. Nana
--------------------------------
| ETHYLENE GLYCOL f-....................................... ..........
Section 7B. ON-SITE ENERGY RECOVERY PROCESSES
[X] Not Applicable (NA) - Check here if no on-site energy recovery is applied to any waste stream containing the toxic chemical or chemical category.
Energy Recovery Methods Center 3-character code(s)l
1
1 |
11 na |
2i i
3i i
4i i
I Section 7C. ON-SITE RECYCLING PROCESSES
IX] Not Applicable (NA) - Check here if no on-site recycling is applied to any waste stream containing the toxic chemical or chemical category.
................................................ Recycling Methods tenter 3-character code(a)]
i i na |
61 1
...........................+
21 f1
.........
| i
+.............
3|
1
I
.........
i
+.............
*i
|
*i
.............
i
.......... ........... 5
..................... 10
.............................. ...
EPA Form 9350-1 (Rev. 12/4/94) - Previous editions are obsolete.
................................................................ .
S45S? CNFJD FNTTAI
EPA
United States Environmental rotection agency
EPA FORM R
PART II. CHEMICAL-SPECIFIC INFORMATION (CONTINUED)
Section 8. SOURCE REDUCTION AND RECYCLING ACTIVITIES
All estimates can be reported using up to two significant figures.
Colunn A 1994
(pounds/year)
8.1 Quantity released *
71000
Quantity used for energy 8.2 recovery on-site
0
Quantity used for energy 8.3 recovery off-site
0
Column B 1995
(pounds/year)
23000
0
0
8.4 Quantity recycled on-site
... .4
8.5 Quantity recycled off-site
0
0
PAGE 9 OF 9 ----------------------------------------------- *
tTRI FACILITY ID HUMBER
|
........ .... ...........................
| 7D765THDWCHIGHW
|
..... ...............-................................
|Chon., Cat., or Gen. Name |
-.............................................................................................
I EWLENE GirCOL
I
Colunn C 1996
(pounds/year) 23000
0
0
0
Colunn 0 1997
(pounds/year) 23000
0
0
0
Quantity treated on-site
150000
8.7 Quantity treated off-site
8.8 Quantity released to the environment as a result of remedial actions, catastrophic events, or one-time events not associated with production processes (poinds/year)
|8.9 (Production Ratio or Activity Index
| 0001.09
+-------- +-- ................................... ....................................................... .......................................... ..................... -..................................
8.10
(Did your facility engage in any source reduction activities for this chemical during
+|t-h-e--r-ep-o-r-ti-n-g--ye-a-r.?...I.f.-n-o--t-,- .e.n.t.e.r.."N.--A" -I-n-S--e-c-ti-o-n-8-.-1-0-.1---an-d--a-n-s-w-e-r -S-e-c-t-io-n--8-.1--1-. --------------------
Source Reduction Activities | [enter code(s)]
Methods to Identify Activity (enter codes)
18.10.1 |
NA
jb. jc-
8.10.2 |
l* jb. |c-
8.10.3 |
jcjb.
8.10.4 |
jb. jc-
8.11| Is additional optional information on source reduction, recycling, or | pollution control activities included with this report? (Check one box)
i YES [J
NO [X)
* Report releases pursuant to EPRCA Section 329(8) including "any spilling, leaking, pimping, pouring, emitting, emptying, discharging, injecting, escaping, leaching, dunping, or disposing into the environment." Do not include any quantity treate
on-site or off-site.
EPA Form 9250-1 (Rev. 12/4/94) - Previous editions are obsolete.
OO A 054553 CQNFIDFNTI Al