有害物质测试申请表.doc

PRT有毒有害物质测试申请表 This Test Report is issued by the Company subject to its General Conditions of Service printed overleaf or available on request and accessible at . Attention is drawn to the limitations of liability, indemnification and jurisdictional issues defined therein. Unless otherwise stated the results shown in the test report refer only to the sample(s) tested. This test report cannot be reproduced, except in full, without prior written permission of the Company. Any unauthorized alteration, forgery or falsification of the content or appearance of this report is unlawful and offenders may be prosecuted to the fullest extent of the law. Dongguan PRT Testing No.4First Ring Road, Yuefanshan Park Rd 07690769Consulant Co., Ltd. Shanmei, Houjie Town, Dongguan City www. P E-mail:dgprt333@126.com 下列填写的数据将显示于报告上,请使用正楷字体清晰填写或于网站下载或向我司索取电子版申请表填写,带★号为必须填写项目.请用中英文填写此表) □中文报告 □英文报告 报告抬头公司名称(中/英文: 报告抬头公司地址(中/英文): 申请公司(中/英文): 申请公司地址(中/英文): Contact Person联系人: E-mail 报告编号: Fax传真: Telephone电话: 邮政编码: 测试费用: □已付出 □未付 送测样品具有: □无危险 □腐蚀性 □毒性 □易燃易爆 □放射性 □其它,请注明 Test items 测试项目及样品所需最小重量：(请在所需测试项标注“■”, 以下项目如有指定测试方法请注明.) 11.□ 11.□ TBBP-A 四溴双酚 12.□ Halogen(F,Cl,Br,I) 卤素（氟，氯，溴，碘） 13.□ PCBs 多氯联苯 14.□ DMF 富马酸二甲酯 15.□ Toys 玩具元素迁移 ( □EN71-3, □ASTM F963, ) 16.□ PFOS 全氟辛烷磺酰基化合物 17.□ Formaldehyde 甲醛 18.□ Ni 镍 （□总镍 □镍释放） 19.□ AZO Compounds （偶氮化合物） 20.□ REACH(SVHC) 21.□ MBT/TBT/DBT/TPHT/DOT 1.□ Pb铅 2.□ Cd 镉 3.□ Hg 汞 4.□ Cr(VI)六价铬 （□IEC62321, □EPA3060, □ISO3613） 5.□ RoHS Directive 2002/95/EC 六项测试