A 注意:每份申请书对应一份测试报告.如果需要英文报告,请用中文/英文完整填写带有星号的栏目.A                                                                                                        

 

★ Applicant:

      申请厂商:

SGS Ref.  :

 

★Delivery Address:

    邮寄地址:

邮政编码：

ú ú ú ú ú ú

 

联络人:

Tel 电话:

FAX传真:

电子邮箱:     

 

★Sample Description /产品名称:

 

 

 

 

★Part No / 型号(P.O NO):

★Item / Lot No(批号):

★Material 材质:

 

★     买家：大连三洋家用电器有限公司

★     Buyer: Dalian SANYO HOME APPLIANCE Co.,Ltd.

根据欧盟ROHS指令所有测试基于同质材料。

Based on the requirements of ROHS by EU, all the tests should be based on the homogeneous material.

测试项目

镉

铅

汞

六价铬

多溴联苯

多溴联苯醚

包装材料

 

测试方法(由SGS填写)

 

 

 

 

 

 

 

 

 

Test Required: (请在样品所属种类前打√。有其它测试要求，请在空白处填写清楚)

 样品所属种类                                                                                                                 要求测试项目

 1.□ Metal 金属类                                                                                            Cd镉 ,Pb铅 ,Hg汞 ,Cr+6六价铬

 2.□ Plastic & Rubber 塑胶类                                                                        Cd镉 ,Pb铅, Hg汞 ,Cr+6六价铬 , PBB多溴联苯  &PBDE多溴联苯醚   

 3.□ Ink \Pigment\Paint 油墨、颜料、油漆类                                                Cd镉 ,Pb铅, Hg汞, Cr+6六价铬

 4.□ Glass & Keramics 玻璃、陶瓷类                                                           Cd镉 ,Pb铅 ,Hg汞 ,Cr+6六价铬

 5.□ Chemicals  化学品类(生产过程中使用)                                                  Cd镉 ,Pb铅 ,Hg汞 ,Cr+6六价铬

 6.□ Packaging Materials包装材料                                                              Cd镉 ,Pb铅 ,Hg汞 ,Cr+6六价铬    　　  

 7.□ Battery  电池                                                                                          Cd镉 ,Pb铅 ,Hg汞  ( 98/101/EEC)

 8.□ Electrical parts电子元件                                                                      Cd镉 ,Pb铅 ,Hg汞 ,Cr+6六价铬 　　  

 9.□ Other Mixed Components其它混合材质类                                          视样品实物而具体分析测试（ 请提供样品的材质清单）

10. □Others其它测试(If you have other test required, please specify)：

 

 

               

 

★If you need other items in report, please specify  如果您的报告还需要注明其他项目, 請說明

Supplier 供应商：                                                                                                                                                                                                                                                                                                                                                                  

Manufacturer 制造商:                                                                                                                                                                     .

 

Other required(其它要求):    ‹ Photo Request 附照片         ‹ Sample Return样品退回(邮费自付)                                                                    

 

Test Report Edition报告格式: □中文                                    ‹ 英文

 

Service Required 服务类型: 请在相关选择上打勾. （以下测试周期只适用金属测试 ，不适用于有机测试）

 

□      标准服务  5个工作日完成        □  加急服务    4个工作日完成            □  特快服务    2个工作日完成                      

 

取报告方式:     ‹  自取                                                                                   ‹ EMS预收費RMB25                            

 

Authorized Signature :                                                         Date:

申请人签名                                                                              日期

 

E&E RSTS天津客户服务中心:

地址:中国天津经济技术开发区第五大街41号1层C区8-9号                                                                           邮政编码:300457

电话:022- 25293899 -135马清/136汪涛/ 160朱立娜                    传真:022-25295252                 电子邮件: Rita.ma@sgs.com

E&E RSTS上海客户服务中心:

地址: 上海市徐汇区宜山路889号3号楼10层                                               邮政编码: 200233                                                                                                                         

电话 : 021-64951616-2721/2723/2730/2755/2756/2757/2787/2788/2789/2790/2791/2792     13916345759    传真:021-64953679

联系人: 严劲海/ 张婷婷/龚慧莉