• 1. Information respecting seller:

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

  • (b) name, title, civic and postal addresses, e-mail address, if any, telephone number and fax number, if any, of the person authorized to act 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. Information respecting sales during a calendar year:

  • (a) calendar year

  • (b) total quantity, in kilograms, of virgin tetrachloroethylene sold to dry-cleaning facilities

  • (c) total quantity, in kilograms, of recycled tetrachloroethylene sold to dry-cleaning facilities

  • (d) for each dry-cleaning facility:

    • (i) name, civic and postal addresses of the owner or operator of the facility

    • (ii) for each sale, the quantity, in kilograms, of virgin tetrachloroethylene sold and the date of the sale

    • (iii) for each sale, the quantity, in kilograms, of recycled tetrachloroethylene sold and the date of the sale