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PAGE 1 OF 9
ERA
lited States Environmental Protection Agency
FORM R
TOXIC CHEMICAL RELEASE INVENTORY REPORTING FORM
Section 313 of the Emergency Planning and Comnunity Right-to-Know Act of 1986, also known as Title III of the Superfund Amendnents and Reauthorization Act
|TRI FACILITY ID NUMBER
|
70765THDWCHIGHW
|Chem., Cat., or Gen. Name -----------------------------------------------
| DICHLOROBROMOMETHANE
................................................................................ ...
WHERE TO SENO COMPLETED FORMS:
1. EPCRA Reporting Center P.0. Box 3348 Merrifield, VA 22116-3348 ATTN: TOXIC CHEMICAL RELEASE INVENTORY
2. APPROPRIATE STATE OFFICE (See instructions in Appendix F)
....................................................... ... ...............
Enter MX" here if this is a revision
IMPORTANT:
See instructions to determine when "Not Applicable (NA)U boxes should be checked.
|For EPA use only | +------------------------------
PART I. FACILITY IDENTIFICATION INFORMATION
......................... +--...............--------------- ------------------------
SECTION 1.
I Sect ion 2. TRADE SECRET INFORMATION
REPORTING YEAR
2.1 Are you claiming the toxic chemical identified on page 3 trade secret?
( I Yes (Answer question 2.2;
DO No (Do not answer 2.2;
Attach substantiation forma)
Go to Section 3)
---- -1995
| | 2.2| If yes in 2.1, is this copy:
C ] Sanitized
C 1 Unsanitized
------------------------- + +
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------
SECTION 3. CERTIFICATION (Important: 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 amocnts and values in this report are accurate based on reasonable estimates using data available to the preparers of this report.
State LA
Zip Code 70765-0150
EPA Form 9250-1 (Rev. 12/4/94) - Previous editions are obsolete.
DO A 054472 CONFIDENTIAL
.......................................................................................................................................................... .
EPA United States 'nvironmental
rotection | Agency
EPA FORM R PART l. FACILITY IDENTIFICATION
INFORMATION (CONTINUED)
.............................................................................................................................................................................................................................
PAGE 2 OF 9
--------------------------------
|TRI FACILITY ID NUMBER ---- - --------..............
| 70765THDUCHIGHW .. ............................................. ..
|Chem., Cat., or Gen. Name ---------------------------------------------
| DICHLOROBROMOMETHANE
|
................ ................. ............... --
SECTION 4. FACILITY IDENTIFICATION (Continued)
4.2 This report contains information for:!
(Important: check only one)
| a. [X] An entire facility
b. [ ] Part of i facility
c. [ ] Federal Facility
4.3 Technical 1 Name Contact | DOYLE A. HANEY
1 Telephone Nunber (include area code) (504)353-6128
4.4 Public 1 Name Contact | GERRY DAIGRE
1 Telephone Nurfcer (include area code) (504)353-1602
|
1
|
11 11
4.5 SIC Code (4-digit)
a. 2812
Latitude +-
A.6 I and
Longitude
Degrees 030
b. 2821 Latitude
| Minutes
19
4.7 Dun A Bradstreet Nunber(s) (9 digits)
.8 EPA Identification Nunber(s) (RCRA I.D. No.) (12 characters)
4.9 Facility NPDES Permit Nuber(s) (9 characters)
A.10 Undergrouid Injection Well Code (UIC) I.D.
Nunber(s)
(12 digits)
c. 2869
d. NA
Seconds
|
Degrees
--------------------- 4-----------------------
00 091
1 a. i b. i a. i b. 1 a. i b. 1 a.
b.
e. Longitude Minutes
f. Seconds
16 20
008187080
NA
LAD008187080
NA
LA0003301
LA0049638
NA
|SECTION 5. PARENT COMPANY INFORMATION 5.1jName of Parent Company 1
| C I NA
|
THE DOW CHEMICAL COMPANY
5.2|Parent Company's Dun A Bradstreet Nimfcer|
1 M NA
1
(9 Digits)
001381581
EPA Form 9250*1 (Rev. 12/4/94) - Previous editions are obsolete.
00 A 054473 CONFIDENTIAL
-- - - - --........-- ..... -- ---------------- .... -- ----- ........ -- -------- -- ........---------- ---------............... +
EPA EPA FORM R
United States environmental
otection
| agency
PART II. CHEMICAL-SPECIFIC INFORMATION
----------------------------------------------------------------------------------------------------------------------------------
PAGE 3 OF 9
|TRI FACILITY ID NUMBER ........................... ...........................
| 70765TH0WCHIGHU ............ ................... -............. |Chem., Cat., or Gen. Name + ................................ ..
I DICHLOROBRCMOMETHANE
+'
SECTION 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.
|
+------------- -------------- --.............................. ................................. -............................................... ------------------ ----------- ----------------- ----------------------- ------------------------------------------------------------------------- ----------------------------- ---------------------------------------------------- +
| 000075-27-4
|
+-------------------------------------------------------------------------------------------------------------------------------------------------------------------- -
1.2| Toxic Chemical or Chemical Category Name (Important: Enter only one name exactly as it appears on the Section 313 list.)
)
...........................................................................................................................................................................................................................................................................................................................................................................................................
| DICHLOROBRCMOMETHANE
--+--------------------------------------------------------------------------------------------------------------------
1.3.| ..G.e.n.e.r.ic...C.h.e.m..ic.a.l..N.am..e..(I.m..p.o--rta.n.t.: ..C..o.m.p.l.e.te..o..n.ly...if..P..a.r.t..I,..S..e.c.t.io.n...2..1...is...c.h.e.c.k.e.d..".y.e.s..."
| ........---- NA
[SECTION 2. MIXTURE COMPONENT IDENTITY (Important: 00 NOT complete this | section if you complete Section 1 above.)
2.1 Generic Chemical Name Provided by Supplier (Important: Max. of 70 chars., including nunbers, letters, spaces, and punct.)
NA
|SECT ION 3. ACTIVITIES AN--D U.S.E..S..O.F..THE CHEMICAL AT THE FACILITY
Manufacture the toxic chemical: 3.1
a. CX] Produce b. I ] Import
--+--------------
Process 3.2 the toxic
chemical
a. C ] As a reactant b. I ] As a formulation component
--.......................... -...
Otherwise use 3.3 the toxic
chemical:
a. [ ] As a chemical processing aid b. C ] As a manufacturing aid
(Important: Check all that apply.) If produce or import:
c. [ ] For on-site use/processing d. [ ] For sale/distribution e. [ ] As a byproduct f. CX] As an impurity
.............+
c. [ ] As an article component d. [ J Repackaging
c. [ ] Ancillary or other use
Section 4. MAXIMUM AMOUNT OF THE TOXIC CHEMICAL ON-SITE AT ANY TIME DURING THE CALENDAR YEAR
4.1|
02
(Enter two-digit code from instruction package.)
EPA Form 9250-1 (Rev. 12/4/94) - Previous editions are obsolete.
i
00 A O54474 CNFTDFNTTal
EPA
United States Environmental 'rotection Agency
EPA FORM R
PART II. CHEMICAL-SPECIFIC INFORMATION (CONTINUED)
PAGE 4 OF 9
........................................................................................... --
|TR1 FACILITY ID NUMBER
.................. ............. ....................... ....................
|
| 70765THDWCHIGHW
|
.................................-.....................
|Chew., Cat., or Gen. Name | -----------------------------------------------
| DICHLOROBROMOMETHANE
|
................. .............................................................. +
| SECTION 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 1 Estimate (enter code)
C. X From Stormwater
5.1 Fugitive or non-point air emissions
5.2 Stack or point air emissions
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
CX1NA NA
( )NA
2300
O
|5.3.3 Stream or Water Body Name
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
( 1NA
50
CXJNA NA
0
5.5.3 Surface impoundnent 5.5.4 Other disposal
DONA NA DONA NA
t J Check here only if additional Section 5.3 information it provided on page 5 of this form.
EPA Form 9250-1 (Rev. 12/4/94) - Previous edition* are obsolete.
Range Codes: A = 1-10 poinds; B * 11-499 pounds; C * 500 - 999 pounds.
DO A 054475 CONFTDFNTIAl
PAGE 5 OF 9
EPA
EPA FORM R
|TRI FACILITY ID NUMBER
United States 'nvirormental
PART II. CHEMICAL-SPECIFIC INFORMATION (CONTINUED)
| 70765THDWCHIGHW .............. ....................................--
-oteetion Agency
|Chem., Cat., or Gen. Name .. ........................... ..
| DICHL0R08R0M0METHANE
.............. .............-................. ..
............. ...... ................................................................................................................................................................................................................-- - -- -- ------------------- --
.......................
.......................................... --..............................................
I Section 5.3 ADDITIONAL INFORMATION ON RELEASES OF THE TOXIC CHEMICAL TO THE | ENVIRONMENT ON-SITE
I |
+...............................................................................................................+...................................................................................................................................................................... ..
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)
C. X From Stormwater
5.3.4 Stream or Water Body Name
|
i
5.3.5 Stream or Water Body Name
|
i
|5.3.6 Stream or Water Body Name
SECTION 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
o.l.A.1 Total Transfers (poinds/year) tenter range code or estimate)
6.1.A.2 Basis of Estimate (enter code)
NA I6.1.B POTW Name and Location Information 16.1.8.11 POTW Name
Street Address
----------- - ------------- -- --------------
6.1.B.2I POTW Name
+---------------- *-----------------------
Street Address
City
Cocnty
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 rxnber of pages in this box [ ] and indicate which Part II, Sections 5.3/6.1 page this is, here. [1 ]
(exanpte: 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.
D0 A 05447b CONFTDfrNTlAl
*-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---
EPA EPA FORM R
United States Environmental rotection
j Agency
PART II. CHEMICAL-SPECIFIC INFORMATION (CONTINUED)
........................................................ ................... ........... ..............................................................
PAGE 6 OF 9
|TRI FACILITY ID NUMBER ------ ..............
| 70765 THOWCHIGHU
|Chem., Cat., or Gen. Name |
.................................... ... ..............................................---
| DICHLOROBROMOMETHANE
|
|SECT ION 6.2 TRANSFERS TO OTHER OFF-SITE LOCATIONS 6-------- ----- --------------------------- --------------....------- --------------- ......
16.2.1 Off-site EPA Identification Nunber (RCRA ID No.) NA
| Off-Site Location Name
... ..........................
| Street Address +------------------------------------------
City
-+ I County
+---------------------------------------------------------- +------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------- --
| State
(Zip Code
| Is location under control of reporting
C 1 YES
C 1 NO
|
------------------------------------------------------------------------------- ------------------ +-------------------- ------------------------------ ----------- ---------- ------------------------- +------------------------------------------------------------- ----------- ----------------------------
A. Total Transfers (pounds/year) (enter range code or estimate)
B. Basis of Estimate (enter code)
C. Type of Uaste Treatment/Disposal/ Recycling/Energy Recovery (enter code)
i-. , 1- 1 , ,i
i.. 13- >. 4- 4- !
|SECTION 6.2 TRANSFERS TO OTHER OFF-SITE LOCATIONS
16.2.2 Off-site EPA Identification Nuiter (RCRA ID No.) | NA
4.... ...................................................
........ ......| Off-Site Location Name
........ ...... ............................................................................
+| ---S---t--r-e---e--t--A--d-d-r-e--s.s...---- ................................
I City
I Cotnty
I
.. ............................................................................................................. ... ............. ............................................ -- --................................................................................................................................................................................................................................................ --+
| State
|Zip Code
| Is location under control of reporting
[ ] YES
[ ] NO
|
+....................... ............... ............................... ------------ -------- --------------------------------4-------------------------------------- ------------------- ------------------------------------ --------------- --+
A. Total Transfers (pounds/year) (enter range code or estimate)
B. Basis of Estimate (enter code)
C. Type of Uaste Treatment/Disposal/ Recycling/Energy Recovery (enter code)
k k 2-
1, 3-
k
i .. i ,i
i
-------------------------------------------------------- ----------........------------------------------------------- ---------------------------------------------- -
If additional pages of Part II, Section 6.2 are attached, indicate the total nimber of pages in
:his bo* [ ] and indicate which Part II, Sections 6.2 pege this is, here. (1 J
I (example: 1,2,3,etc.)
DO A 054477 CONFTDFNTTAL
....................................................................................................................--------------------------------------------------------------- -------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------
EPA Form 9250-1 (Rev. 12/4/94) - Previous editions are obsolete.
Range Codes: A * 1^0 pounds; B * 11-499 pounds;
C * 5<n - 999 poinds.
EPA
United States nvironmental rotection
Agency
EPA FORM R
PART II. CHEMICAL-SPECIFIC INFORMATION (CONTINUED)
PAGE 7 OF 9
--------- ------------ ------------------------------------------- +
|TRI FACILITY ID NUMBER
|
......................................
-f
| 70765THDWCHIGHW
|
.............. .........................
|Chem., Cat., or Gen. Name |
...........................
--................ ................
| DICHLOROBROMOMETHANE
|
............ ....... .........................
- ...................
I Section 7A. ON-SITE UASTE TREATMENT METHODS AND EFFICIENCY
I
[ ] Not Applicable (NA) - Check here if no on-aite treatment it 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)l
c. Range of Influent Concentration
d. Treatment Efficiency Estimate
e. Based on Operating Data?
7A.1b
7A. 1c
! ii | A01
2 | NA
+4
3i i 4i j 5j j 1
* 4*
6i 1 7i i 8i j
+ +4
7A.2a NA
7A. 2b
3i 4
6i
i1 +
i 4i
44
i 7i
i 2|
i 5i
44
i 8i
1
i
4
i
7A.2c
7A.1d
7A.1e
099.00
X
[]
[X]
7A.2d X
7A.2e
Yes
C1
No [1
7A.5a
h 11 *
3i i *i
.
61 i 7I
7A.5b
3i
ii i *i
61 ..........
i 7I
1 21
*4
i 51
i 8I
i 2i
5i i
i 8I
j
i
i
j i
i
7A.5c
Yes No
X
[]
[1
7A.5d X
7A.5e
Yes [1
No C1
If additional pages are attached, indicate the total rusher of pages in this box [ ] and indicate which page this is, here HI.
EPA Form 9250-1 (Rev. 12/4/94) - Previous editions are obsolete.
DO A 054478 CONFTDFNTTAL
EPA
United States Environmental Protection Agency
EPA FORM R PART II. CHEMICAL-SPECIFIC
INFORMATION (CONTINUED)
PAGE 8 OF 9 ---------------------- ----------
|TRI FACILITY ID NUMBER ...........................................
1
| 70765THDWCHIGHW
1
......................................................
|Chem., Cat., or Gen. Name 1 ............................. ..
| DICHL0R08R0M0METHANE
1
....................... ......................----
| Sect ion 7B. ON-SITE ENERGY RECOVERY PROCESSES
|
..................................................................................................................................................................................................................................................................................................................................................................................................................... ...
I [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.
I |
|Sect ion 7C. ON-SITE RECYCLING PROCESSES
|
----------------------------------------------------------------------------------------------------- -------------------------------------------------------------------
[X] 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 [enter 3-character code(s)]
1 | NA | 6I 1
+....... ............
.......
21
1
71 .........
1
+..... 31
1
i .........
1
.........
4!
i
*i +.........
i
.........
51
1
10 j .........
1
EPA Form 9350-1 (Rev. 12/4/94) - Previous editions are obsolete.
DO A 054479 CONFIDENTIAL
EPA
United States nvironmental otection
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.
Column A 1994
(pounds/year)
8.1 Quantity released *
0
Quantity used for energy 8.2 recovery on-site
0
Quantity used for energy 8.3 recovery off-site
0
Coluin B 1995
(pounds/year)
2300
0
0
8.4 Quantity recycled on-site
0
0
8.5 Quantity recycled off-site
0
0
PAGE 9 OF 9
|TRI FACILITY ID NUMBER
----------------------------------------------------------------
| 70765THDUCHIGHU
.......................... .................. ...............................
|Chen., Cat., or Gen. Name
----------------------------------------------------------------
| 0ICH10R0BR0M0METHANE
|
Col urn C 1996
(pounds/year)
Co limn D 1997
(pounds/year)
2300
2300
00
00
00
00
6 Quantity treated on-site
0
00
0
8.7 Quantity treated off-site
0
00
0
8.8 Quantity released to the environment as a result of remedial actions,
catastrophic events, or one-time events not associated with production processes (pounds/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 (the reporting year? If not, enter "NA" In Section 8.10.1 and answer Section 8.11.
................................................................................................. ... ........................................................................................................................................................................
Source Reduction Activities |
Methods to Identify Activity
Center code(s)]
(enter codes)
|8.10.1 1 |8.10.2 1 |8.10.3 1 |8.10.4 1
NA
l-
!* |a. .
|b.
ibk
ib. . .
|c|clc|c-
|8.11| Is additional optional information on source reduction. recycling, or | | pollution control activities included with this report? (Check one box)
11
YES [1
O
NO [X]
Report releases pursuant to EPRCA Section 329(8) including "any spilling, leaking, punping, pouring, emitting, emptying, discharging, injecting, escaping, leaching, duiping, or disposing into the environment." Do not include any quantity treated on-site or off-site.
EPA Form 9250-1 (Rev. 12/4/94) - Previous editions are obsolete.
DO A 054480 CONFTDFNTTA1