“Safety Data Sheet (SDS)” Service Application Form.docVIP

“Safety Data Sheet (SDS)” Service Application Form 化学品安全技术说明书申请表 Section A – To be completed by Applicant A部 – 由申请人填写 Please fill the form in English. Select the appropriate items by “√”. 请用英文填写. 选择适当的项目,并在空格内填上“√”. Applicant 申请人/公司 Applicant Address 申请人/公司地址 Tel 电话 Fax 传真 Contact Person 联络人 e-mail 电邮 Bill / Invoice to 发票抬头 Billing / Invoice Address 发票地址 Is this application involved in legal proceedings? 申请是否牵涉法律诉讼? □ Yes 是 ■No 否 (If yes, please specify the case.) (如有，请注明。) ___________________________________________________ Quotation Upon Request 是否需要报价单? □ Yes 是 ■ No 否 (If a quotation is requested, testing will only start upon your written acceptance of the quotation.) (如需报价单，测试会在收到书面同意书后进行。) Service Required 所需服务 ■Regular标准服务 (3-5 working days) (3-5个工作 天) □ Express (Add 40 %) 加快服务 (加 40 %) Accepted subcontracting of test to qualified subcontractor of GTS? 是否接受GTS将测试服务外判合资格的承包商? □ Yes 是 ■ No 否 Pick-up Delivery 收货服务 □ Yes 是 ■ No 否 Return sample residue if laboratory testing required? 如要检测，是否需要退还残余样本? □Yes 是 ■ No 否 □ Not available 不适用 The information in SDS was obtained from sources which we believe are reliable. However, the information is provided without any warranty, express or implied, regarding its correctness. The conditions or methods of handling, storage, use or disposal of the product are beyond our control and may be beyond our knowledge. For this and other reasons, we do not assume responsibility and expressly disclaim liability for loss, damage or expense arising out of or in any way connected with the handling, storage, use or disposal of the product. 化学品安全技术说明书的资料是依据我们相信可靠的来源中获得。但是，我们对所提供的数据并没有明示或隐含的保证。该产品的处理、储存、使用或弃置状况和方法是我们无法控制和可能超越我们的知识范围。在任何情况下，我们均不会承担因不当处理、储存使用或弃置该化学品时所造成的损失，损害或相关费用。 Section B – Information for SDS To be completed by Applicant B部 – 化学品安全技术说明书数据 由申请人填写 注：标红信息为必填信息，附录1, 2为选填部分，能提供的尽量提供。 Please fill the form in English. Select the appropriate items by “√”. 请用英文填写. 选择适当的项目,并在空格