Declaration of Stakeholder Interest

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Methylenediphenyl Diisocyanate and Diamine Substances Group

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Companies that have an interest in substances described in the Methylenediphenyl Diisocyanate and Diamine Substances Group, as well as polymeric MDA (CAS RN^[1] 25214-70-4) may identify themselves as stakeholders for those substances by completing this form. It is important to note that polymeric MDA was not identified in the methylenediphenyl diisocyanates and diamines substances group, however, information is being collected on this CAS RN as it is believed to be a commercially relevant mixture containing 4,4-MDA (CAS RN 101-77-9). Stakeholders will be informed of future decisions regarding these substances and may be contacted for further information.

Stakeholder Identification

 I have an interest in all substances in the Methylenediphenyl Diisocyanate and Diamine Substances Group, and CAS RN 25214-70-4.
 I am interested in the following substance(s) in the Methylenediphenyl Diisocyanate and Diamine Substances Group, and/or CAS RN 25214-70-4 (list the CAS RN for the substance(s) of interest):

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Company Name:

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Federal Business Number^[2]:

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Head Office Address:

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Canadian Head Office Address (if different from above):

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Contact Name:  Mr.  Ms.  Dr.

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Title of Contact:

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Contact Address (if different from Head Office Address):

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Telephone Number: ( ______ ) ______ - ________

Fax Number: ( ______ ) ______ - ________

Email Address:

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Request for Confidentiality

 Pursuant to section 313 of the Canadian Environmental Protection Act, 1999, I request that the following parts of the information that I am submitting be treated as confidential. (Specify the parts [e.g. sections, tables, attachments, previously submitted unpublished studies or data, etc] of the information that you request be treated as confidential.).

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 I do not request that the information that I am submitting in this declaration be treated as confidential and I consent to it being released without restriction.

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Name (print)

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Title

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Signature

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Date

Please return this form to the Substances Management Coordinator, Chemical Management Plan.

200 Sacré-Coeur Blvd., 8^th Floor
Gatineau, Quebec
K1A 0H3
Fax: 819-953-7155
Email: Substances@ec.gc.ca

Voluntary Information

In addition to the type of information requested in the mandatory section 71 notice (entitled Notice with respect to certain methylenediphenyl diisocyanate and diamine, and phenol, methyl- substances), interested stakeholders are encouraged to provide any additional information on the substances described in the Methylenediphenyl Diisocyanate and Diamine Substances Group,and CAS RN 25214-70-4, to help inform the risk assessment process. Organizations that may be interested in submitting additional information include those that manufacture, import, export or use a substance, whether alone, in a mixture, in a product, or in a manufactured item.

Examples of the type of information that could help inform the risk assessment process include, but are not limited to:

• Analogues or alternatives for these substances;
• Quantities of the substances manufactured, imported, used, and/or exported per calendar year, for the last 5 years;
• Customer contact information;
• Supplier information (name, location and contact information);
• Unpublished data or studies on physical-chemical properties, bioaccumulation, persistence, toxicity, metabolism, degradation, or the release of the substances from the final mixture, product or manufactured item;
• Environmental releases, such as
  • air dispersion modelling of MDI in ambient air (e.g., emission summary and dispersion modelling report, per Ontario Regulation:  Air Pollution - Local Air Quality (O. Reg. 419/05)
  • sampling and analysis of MDI in ambient air; and
  • sampling and analysis of stack releases of MDI.
• Storage and transportation container information (e.g., size and type of containment used, and a description of how the empty containers are handled/cleaned); and
• Waste management information, such as:
  • name and location of waste management facilities;
  • type of wastewater that is treated at your facility;
  • type of wastewater treatment methods used at your facility;
  • whether your facility wastewater effluents are re-used in the process;
  • volume of each effluent stream potentially containing the substance annually in m³ (indicate whether the streams are combined with other effluents prior to discharge), and the total volume of all effluent streams discharged in m³ annually;
  • your facility’s wastewater effluent flow rates (e.g., average daily volume or 90th percentile in m³ or liters per day), and periods of discharge;the fate, quantity (kg) and treatment methods used for your facility wastewater sludge;
  • name of the corresponding receiving water bodies where your facility wastewater effluents are discharged to; and
  • effectiveness of waste management practices.

This information will help the Government of Canada improve decision making for these substances and ensure all activities are considered before moving forward with further actions regarding these substances.

Footnotes

^[1] CAS RN: Chemical Abstracts Service Registry Number. The Chemical Abstracts Service information is the property of the American Chemical Society and any use or redistribution, except as required in supporting regulatory requirements and/or for reports to the Government of Canada when the information and the reports are required by law or administrative policy, is not permitted without the prior, written permission of the American Chemical Society
^[2] Federal business number is a nine-digit registration number issued by the Canada Revenue Agency (CRA) to Canadian businesses that register for one or more of the following: corporate income tax; importer/exporter account number; payroll (source) deductions (trust accounts); or goods and services tax. This number can be found on all forms issued to a business by the CRA. The first nine digits that appear on these forms is the Federal business number.