CHEMICAL PROTECTIVE GLOVES. 2 Manufacturer s name and address and legal representative (surname, first name):

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1 Testing and Certification of Personal Protective Equipment Category III (PPE) CHEMICAL PROTECTIVE GLOVES ATTACHMENT 1 to the order of placed with Institut für Arbeitsschutz der DGUV (IFA) Alte Heerstrasse Sankt Augustin Germany (Date) (Customer s name and registered office) 1 Model article type of chemical protective gloves: 2 Manufacturer s name and address and legal representative (surname, first name): 3 EC-Type examination of chemical protective gloves 3.1 Test standards DIN EN 374 Part 1 Protective gloves against chemicals and microorganisms Terminology and performance requirements

2 2 3.2 We request you to carry out an EC type examination for chemical protective gloves conforming to EC Directive 89/686/EEC for the following chemicals: The glove is to be marked with the pictogram for protection against chemical hazards. (Erlenmeyer with chemical coding) Details of at least 3 test chemicals (A L) from the list conforming to the requirements of DIN EN (please cross ) A Methanol G Diethylamine B Acetone H Tetrahydrofuran C Acetonitrile I Ethyl acetate D Dichloromethane J n-heptane E Carbon disulphide K Sodium hydroxide 40 % F Toluene L Sulphuric acid 96 % The glove is to be marked with the pictogram for waterproof protective gloves and low protection from chemical hazards (glass beaker with question mark). Test chemicals: The glove is to be marked with the pictogram for protection against microorganisms (conforming to DIN EN 374-1: 2003, Section 3.2). 3.3 We promise that the supplied items are taken from current production and have been submitted without modification that, without confirmation by the test body, we do not change the technical specifications for chemical protective gloves, the information for the user and the technical background information. Major modification represents a type change necessitating a new type examination.

3 3 We declare that, even in contact with the skin, possible residues of the chemicals used in production and the material parts of the above-mentioned chemical protective gloves are not known to cause irritation of the skin or allergic reactions or to have other harmful effects on health. Please submit the relevant list and include it in the manufacturer s information booklet 3.4 Attachments The following items are attached to this order (in duplicate in each case): 1) The technical production documents conforming to Annex III of the Directive: General and detail drawings, calculations, results of prototype testing (and particularly the penetration tests conforming to DIN EN 374 Part 1 and Part 2 (with determination of the performance level for the AQL); and permeation measurements conforming to DIN EN 374 Part 1 and Part 3 with details of measurement results and detection method) and of wearing tests, if any Complete list of the basic requirements in terms of safety and health and of the harmonized standards and other technical specifications concerned with the design of the chemical protective gloves 2) Manufacturer s information booklet 3) Brochures, data sheets, sales documents, example or design of the minimum sales unit (if these are not available at the time of order placement, they must be submitted to the test body before initial publication at the latest) 4) Detailed photographs of the chemical protective gloves (if possible as data files) 5) Drawing of the gloves and the dip mould employed including a piece list 6) Test reports on the results of development tests and wearing tests carried out by another test body or on the manufacturer s site (in the case of permeation tests, with details of the detection method and measurement results) 7) Copy of the valid certificate for certification of the QM system and description of the control and test/inspection equipment 8) Details of the materials employed Certificate from a chemical/technical test body Leather PCP content Latex Protein content (conforming to DIN EN 455-3:2000)

4 4 These chemical protective gloves or parts thereof have been tested in advance for compliance with the harmonized standards or draft standards or individual sections of these standards. If so, please supply the relevant certified copies. Test body: Test Report No. Test date: 4 Technical information on the chemical protective gloves being tested 4.1 Details of the test object Designation: _ Glove sizes: _ Colour: Manufacturer s type: Standard marking: Range of uses and applications:

5 5 4.2 Description of construction safety features 1) Materials, surface design, material thicknesses We are supplying the test body with the following items: 2 pairs of each manufactured size (size measurement, air and water leakage test) 10 pairs of the biggest size 2 pairs of the biggest size per test chemical (for protective gloves against chemical hazards) 4 pairs of size 8 (dexterity) The IFA reserves the right to request further samples. The test objects must be sent free house to the IFA. Photographs of the chemical protective gloves may be used for publication (with details of source). (Place, date) (Stamp, legally binding signature) 1) List on a separate sheet if necessary.

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