1. Seller Information

• (a) name, civic and postal addresses, e-mail address, if any, telephone number and fax number, if any

• (b) number of facilities and civic address for each facility

• (c) name, civic and postal addresses, e-mail address, if any, telephone number and fax number, if any, of the person authorized to submit the report on behalf of the seller

2. Confidentiality

Indicate if a request for confidentiality is being made under section 313 of the Canadian Environmental Protection Act, 1999 and the reason for the request.

3. Solvent Information

Total quantity, in kilograms, of

• (a) solvent sold (identify each purchaser by name and civic address, and specify date of sale);

• (b) solvent returned by purchasers (identify each purchaser by name and civic address, and specify date of return);

• (c) recycled solvent sold (identify each purchaser by name and civic address, and specify date of sale);

• (d) recycled solvent returned by purchasers (identify each purchaser by name and civic address, date of return);

• (e) reclaimed solvent sold (identify each purchaser by name and civic address, and specify date of sale); and

• (f) reclaimed solvent returned by purchasers (identify each purchaser by name and civic address, and specify date of return).