Confidential Statement of Formula - EPA Form 8570-4
This file contains the confidential statement of formula for pesticide products as required by the Environmental Protection Agency (EPA). It includes instructions for filling out the form, details about the necessary information, and submission guidelines. Suitable for applicants and registrants of pesticide products.
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How do I fill this out?
To fill out this form, gather all necessary information related to the chemical composition of your pesticide product. Ensure you understand the purpose of each section. Follow the instructions carefully to provide accurate details.
How to fill out the Confidential Statement of Formula - EPA Form 8570-4?
1
Gather all necessary information related to your pesticide product.
2
Fill out the applicant/registrant and producer information.
3
Specify the product name, registration number, and product manager details.
4
List components in the formulation with their chemical names, trade names, and CAS numbers.
5
Submit the completed form to the EPA with the required signatures and contact information.
Who needs the Confidential Statement of Formula - EPA Form 8570-4?
1
Pesticide product applicants need this form for product registration.
2
Pesticide registrants use this form to report changes in formulation.
3
Producers of pesticide products must submit this form for EPA evaluations.
4
Environmental compliance officers use this form to ensure regulatory adherence.
5
Chemical suppliers provide details about the ingredients to be listed in the form.
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What are the instructions for submitting this form?
Submit the completed form to the EPA via email, fax, or physical mail. Email submissions can be sent to the Information Policy Branch at info.policy@epa.gov. Fax the form to (202) 555-0140. Physical mail can be sent to: U.S. Environmental Protection Agency, Office of Pesticide Programs (7505C), 401 M Street, S.W., Washington, D.C. 20460. Ensure all information is accurate and the form is signed before submission.
What is the purpose of this form?
The Confidential Statement of Formula (EPA Form 8570-4) is a mandatory document required by the Environmental Protection Agency (EPA) to evaluate pesticide products for registration. This form provides comprehensive details about the chemical composition of a pesticide product, including active and inert ingredients, as well as their respective quantities. Accurate submission of this form ensures compliance with the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA). Applicants and registrants of pesticide products must submit the Confidential Statement of Formula with their application for new registration or amended registration involving formula changes. The form is critical for the EPA to assess the safety, efficacy, and environmental impact of the pesticide product. By providing precise details about the product's formulation, applicants help the EPA make informed decisions regarding product approval. Filling out the form requires careful attention to detail, as it involves listing each component of the pesticide formulation, along with its chemical name, trade name, and CAS number. Additionally, applicants must indicate the purpose of each ingredient and certify the limits of active and inert ingredients. Ensuring the accuracy of this information is vital for the successful registration of the pesticide product.
Tell me about this form and its components and fields line-by-line.
- 1. Name and Address of Applicant/Registrant: Enter the name and address of your firm or authorized agent.
- 2. Name and Address of Producer: Specify the name of the producer and the address of the production site.
- 3. Product Name: Specify the complete name of the pesticide product as it will appear on the label.
- 4. Registration Number/File Symbol: Enter the EPA registration number or file symbol if known.
- 5. EPA Product Manager/Team Number: Enter the name and team number of the EPA Product Manager assigned to this product, if known.
- 6. Country Where Formulated: Specify the country where the product is formulated.
- 7. Weight per Gallon/Bulk Density: For liquids, specify pounds per gallon. For powders or granulates, enter the bulk density.
- 8. pH: Enter the pH of aqueous formulations and water-soluble products. Otherwise, enter 'N/A'.
- 9. Flash Point/Flame Extension: Specify the flash point for pressurized products or products likely to burn.
- 10. Components in Formulation: List each component of the formulation, along with its chemical name, trade name, and CAS number.
- 11. Supplier Name and Address: Provide the supplier's name and address for each component.
- 12. EPA Registration Number: Specify the EPA registration number for each active ingredient, if available.
- 13. Component Amount: Specify the quantity of each component used in the formulation.
- 14. Percent by Weight: Specify the weight percentage of each component in the formulation.
- 15. Certified Limits: Provide the maximum and minimum percentage limits for active and inert ingredients.
- 16. Purpose in Formulation: Specify the purpose of each ingredient in the formulation.
What happens if I fail to submit this form?
Failing to submit the Confidential Statement of Formula can result in delays or rejection of your pesticide product registration by the EPA. Non-compliance with submission requirements may lead to regulatory penalties.
- Registration Delays: Delays in processing your application due to incomplete or missing information.
- Rejection of Application: The application may be rejected if the necessary forms are not submitted.
- Regulatory Penalties: Non-compliance with EPA requirements can result in fines or legal action.
How do I know when to use this form?
- 1. New Registration: Submit this form with your application for new pesticide product registration.
- 2. Formula Change: Submit this form when there is a change in the formulation of an existing product.
- 3. Regulatory Compliance: Ensure compliance with EPA regulations by submitting this form.
Frequently Asked Questions
How do I fill out the EPA Form 8570-4?
Gather all necessary information about your pesticide product, fill out the required fields, and ensure accuracy before submission.
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How do I ensure the accuracy of the information in the form?
Double-check all entered information and ensure it matches the required details before submitting the form.
What do I do if I need to change the formulation details?
Edit the existing form using the PDF editor on PrintFriendly and update the formulation details as needed.
Is there a way to save my progress on the form?
You can save the form at any stage and come back later to complete it on PrintFriendly.
What if I make a mistake on the form?
You can always edit the form using PrintFriendly's PDF editor to correct any mistakes before submission.
How do I download my completed form?
Once you have filled out and reviewed the form, use the download option to save the completed PDF to your device.
Can I submit the form online?
Yes, after completing and downloading the form, you can submit it online as per the EPA's submission guidelines.
