Management of toxic substances: information required to apply for a 2-butoxyethanol permit

Schedule 2: Information to be Contained in an Application for a Permit

Section 1 - Applicant information

Name of applicant (e.g. corporation): _________________________________________________________________
Civic and postal addresses: _________________________________________________________________________
Telephone no.:___________________________________________________________________________________
Fax no (if any): __________________________________________________________________________________
E-mail address (if any): ____________________________________________________________________________

Name and title of the person authorized to act on behalf of the applicant: ________________________________________
Civic and postal addresses: __________________________________________________________________________
Telephone no.:____________________________________________________________________________________
Fax no. (if any): ___________________________________________________________________________________
E-mail address (if any): _____________________________________________________________________________

Section 2 - Information respecting the product containing 2-butoxyethanol

Calendar Year: ________________________________________
Name of Product Concentration
Estimated Quanitity to be Manufactured and Unit of Measurement Estimated Quantity to be Sold / Offered for Sale and Unit of Measurement Estimated Quantity to be Imported and Unit of Measurement Proposed Use for the Product Permit Issued

Sections 3, 4 and 5 - Declaration respecting the provision of information

  • I am enclosing evidence that there is no technically or economically feasible to reduce the concentration of 2-butoxyethanol in the
    product to the limit set out in column 2 of schedule 1 for that product.
  • I am enclosing evidence that explains what measures have been taken to minimize or eliminate any harmful effect of 2-butoxyethanol
    on human health.
  • I am enclosing a description of the plan prepared respecting 2-butoxyethanol identifying the measures to be taken so that the
    concentrations of 2-butoxyethanol in the product to be manufactured or imported will be within the limit prescribed by these Regulations.

Section 6 - Identification of the period within which the plan is to be fully implemented

Implementation period: ______________________________________________________________________________

Section 7 - Civic and postal addresses of the location where records, certification and supporting documents are kept

Name of Product Civic and Postal Addresses

Section 8 - Confidentiality

An applicant that submits a request, in accordance with section 313 of the Canadian Environmental Protection Act, 1999, that information
contained in the application be treated as confidential must include with that request the identification of the following:

  1. any information that constitutes a trade secret;
  2. any information the disclosure of which would likely cause material financial loss to, or prejudice the competitive position of the applicant;
  3. any information the disclosure of which would likely interfere with contractual or other negotiations being conducted by the applicant; and
  4. any financial, commercial, scientific or technical information that is confidential and is treated consistently in a confidential manner by the applicant.


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