Fill in the relevant parts and attach this form to your IUCLID 5.4 file under Section 13.
(For further practical details, see Data Submission Manual Part 21, Section 5.9)
DOWNSTREAM USER REPORT
DESCRIPTION OF CONDITIONS OF USE
Company
Date
Substance
Ref
Environmental Exposure1
Use not covered
Reason why use
is not covered in
supplier
Exposure
Scenario
Substance
quantity2
Operational
Conditions and
Risk
Management
Measures
(OC/RMM) 3
Title/Activity
Own
Downstream
Quantity
Own
Downstream
Other OC/RMM
Own
_______________________
Own
Downstream
Downstream
Tick all not covered or matched in ES
Annual Site Quantity: ___________________(units)_______
Maximum Daily Quantity:___________(units)______
Substance supplied downstream
Yes
No

Technology/process techniques determining the initial
release of substance from process to waste, waste water or
exhaust air

Air filters, incineration, waste water treatment, other
technical measures to reduce release to air and water
Human Exposure1
Use not covered
Reason why use
is not covered in
supplier
Exposure
Scenario
Substance
concentration2
Operational
Conditions and
Risk
Management
Measures
(OC/RMM) 3
Title/Activity
Own
Downstream
Concentration
Own
Downstream
Other OC/RMM
Own
Downstream
____________________
Own
Downstream
Tick all not covered or matched in ES
Concentration range in own processes _____________%__
Concentration range in supplied product ____________%__
Substance supplied downstream
Yes
No

Operational conditions

Technical and organisational risk management measures

Product form/design/composition aspects that influence
exposure
Add additional sections as required when more than one use is not covered
Refers to quantity/concentration of the substance.
3
If you are preparing a Downstream User Chemical Safety Report (CSR), provide information only on
those processes that are to be assessed in the CSR. The CSR is not submitted to ECHA.
1
2
- Page 1 of 3 -
This example is for a Downstream User who is a formulator of paints. The daily quantity used
is greater than covered in the exposure scenario. Also, the mixing activity differs from the ES
and spray painting by professionals is not covered.
DOWNSTREAM USER REPORT
DESCRIPTION OF CONDITIONS OF USE
Company
Substance
Company Name
Substance name (or trade
name)
Date
Ref
dd/mm/yy
DUR-1234
Environmental Exposure1
Use not covered
Formulation of coatings (ERC2)
Title/Activity
Reason why use
is not covered in
supplier
Exposure
Scenario
Quantity
Other OC/RMM
_____________________
Own
Downstream
Own
Downstream
Own
Downstream
Own
Downstream
Tick all not covered or matched in ES
Substance
quantity2
Operational
Conditions and
Risk
Management
Measures
(OC/RMM) 3
Annual Site Quantity: ________10_________(units)_tonnes
Maximum Daily Quantity: ________400_____(units)_litres
Substance supplied downstream
Yes
No
Daily site quantity exceeds the amount covered in the ES. We
recently installed a modern waste water treatment plant with low
release factor which ensures minimal environmental impact.
Human Exposure1
Use not covered
Reason why use
is not covered in
supplier
Exposure
Scenario
Substance
concentration2
Operational
Conditions and
Risk
Management
Measures
(OC/RMM) 3
Mixing of coating preparation (PROC5).
Title/Activity
Own
Downstream
Concentration
Own
Downstream
Other OC/RMM
Own
Downstream
___________________
Own
Downstream
Tick all not covered or matched in ES
Concentration range in own processes__10-100_____%___
Concentration range in supplied product __10________%__
Substance supplied downstream
Yes
No
Substance (in powder form) is charged to vessel in water soluble
bags, giving no potential for exposure. On-site risk assessment
indicates that LEV controls specified in ES are not required.
- Page 2 of 3 -
This example is for a Downstream User who is a formulator of paints. The daily quantity used
is greater than covered in the exposure scenario. Also, the mixing activity differs from the ES
and spray painting by professionals is not covered.
DOWNSTREAM USER REPORT
DESCRIPTION OF CONDITIONS OF USE
Company
Substance
Company Name
Substance name (or trade
name)
Date
Ref
dd/mm/yy
DUR-1234
Human Exposure1
Use not covered
Reason why use
is not covered in
supplier
Exposure
Scenario
Substance
concentration2
Operational
Conditions and
Risk
Management
Measures
(OC/RMM) 3
Non-industrial spraying (PROC11). Use by professionals
Title/Activity
Own
Downstream
Concentration
Own
Downstream
Other OC/RMM
Own
Downstream
___________________
Own
Downstream
Tick all not covered or matched in ES
Concentration range in own processes__10-100_____%___
Concentration range in supplied product __10________%__
Substance supplied downstream
Yes
No
Substance is used in multipack high performance coatings.
Application is by professional applicators using spray, brush and
roller. Application will be outdoors in many cases due to the
nature of the items being painted – for example; ships, bridges
and chemical plants.
- Page 3 of 3 -