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Toxic Chemical Release Inventory Reporting Forms and Instructions

Toxic Chemical Release Inventory Reporting Forms and Instructions

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General Information<br />

Sample Letter — <strong>Reporting</strong> by diskette. Send one copy to EPCRA <strong>Reporting</strong> Center <strong>and</strong> one to appropriate state agency<br />

(see Appendix F). TRI-ME automatically creates this letter for you if you elect to create a diskette submission.<br />

Facility Name<br />

Facility Address<br />

Facility City/State/Zip Code<br />

TRI Facility ID<br />

Date<br />

TRI Data Processing Center<br />

P.O. Box 1513<br />

Lanham, MD 20703-1513<br />

Attn: <strong>Toxic</strong> <strong>Chemical</strong> <strong>Release</strong> <strong>Inventory</strong><br />

Magnetic Media Submission<br />

To Whom It May Concern:<br />

Enclosed please find one (1) microcomputer diskette containing toxic chemical release reporting information for:<br />

YOUR FACILITY NAME<br />

This information is submitted as required under section 313 of the Emergency Planning <strong>and</strong> Community Right-to-Know Act<br />

of 1986 <strong>and</strong> section 6607 of the Pollution Prevention Act of 1990.<br />

We are submitting a total of 1 <strong>Chemical</strong> Report(s) for our facility.<br />

These 1 chemical report(s) are described below:<br />

<strong>Chemical</strong> Name <strong>Reporting</strong> Year CAS Number Report Type<br />

Zinc (fume or dust) 2003 7440-66-6 5-page Form R<br />

Our technical point of contact is:<br />

[TECHNICAL CONTACT NAME] Phone Number: 505 555-1212<br />

<strong>and</strong> is available should any questions or problems arise in your processing of these diskettes.<br />

If the enclosed diskette contains one or more Form R chemicals, then I hereby certify that I have reviewed the enclosed<br />

documents <strong>and</strong> that, to the best of my knowledge <strong>and</strong> belief, the submitted information is true <strong>and</strong> complete <strong>and</strong> that the<br />

amounts <strong>and</strong> values in this report(s) are accurate based on reasonable estimates using data available to the preparers of this<br />

report(s).<br />

If the enclosed diskette contains one or more Form A chemicals, then I hereby certify that to the best of my knowledge <strong>and</strong><br />

belief, for each toxic chemical listed in the Form A statement, the annual reportable amount as defined in 40 CFR 372.27(a)<br />

did not exceed 500 pounds for this reporting year <strong>and</strong> that the chemical was manufactured, processed or otherwise used in<br />

an amount not exceeding 1 million pounds during the reporting year.<br />

Sincerely,<br />

Signature<br />

8 <strong>Toxic</strong>s <strong>Release</strong> <strong>Inventory</strong> <strong>Reporting</strong> <strong>Forms</strong> <strong>and</strong> <strong>Instructions</strong>

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