FINISHED GOODS DISCLOSURE

Transcription

1 FORM Finished Goods Disclosure Document Number: Version: VH-PST-FORM Effective Date: May 1, 2018 Page 1 of 6 FINISHED GOODS DISCLOSURE Product Name: WPS ID Number for WERCSmart: Today s Date: Manufacturing Name: Manufacturing Address: Contact Manufacturing Contact: Contact Phone: I. Composition a. Please enter the raw materials, concentration range, and CAS numbers for all substances in the formula. Concentration must add up to 100%. Chemical Name CAS Number OR WPS ID Component Wt% II. Product Information a. Please submit a copy of the US label and SDS b. Please submit a copy of the Canada label and SDS (if sold in Canada) GHS Classification and Signal Word III. Regulatory Information

2 Are all substances in the formula listed on the US TSCA Inventory? If any substances are not listed on the US TSCA Inventory, are they exempt from listing? Not Applicable For any substances exempt from listing, please provide the basis for exemption: Are any substances in the formula subject to a TSCA Consent Order and/or SNUR? Additional TSCA Requirements: Section 4 Section 5 Section 6 Section 7 If yes, please state any restrictions for Rust-Oleum s use of the substance: Are any substances in the formula subject to TSCA 12(b) notification requirements? If yes, please disclose the following substances for reporting: Canada: Are all substances in the formula listed on the DSL Inventory? Are any substances in the formula listed on the NDSL Inventory? Neither DSL or NDSL Exempt from Inventory Are any substances in the formula subject to a SNAc Notice? For any substances on the NDSL Inventory or Exempt please provide the description, CAS#, and weight percent: CAS Number / Trade Secret Registry Number / EPA Accession Number Chemical Name % by Weight (no ranges) Basis for Exemption Global Inventories: Australia (AICS) China (IECSC) EU (EINECS) EU- REACH Mexico (INSQ) Japan (ENCS) Korea (KECI) 2018 Rev 2.0 Page 2 of 6

3 New Zealand (NZIOCS) Philippines (PICCS) Pesticide/Biocide/Fungicide Is this product considered a pesticide or product s claims pesticidal? Is this product regulated under FIFRA, PCPA, or BPD? CPSC Information Please disclose whether the product exhibits any of the hazard characteristics in 16 CFR (b): [Check if applicable] Toxic Corrosive Irritant Sensitizer Flammable Combustible Pressure Generating Please disclose any substances requiring special labeling pursuant to 16 CFR : [Check if applicable] Benzene > 5% Xylene > 10% Toluene > 10% Diethylene Glycols > 10% Ethylene Glycols > 10% Methanol > 4% Turpentine > 10% Petroleum Distillates > 10% California Proposition 65 Identify all Proposition 65 listed constituents and their concentrations in the formula: If present please identify Proposition 65 category: Carcinogen Reproductive Toxin California Safer Consumer Products Regulations Please disclose Chemicals of Concern: VOC Information Is this product subject to VOC regulations in any jurisdiction? If No, please state why: CARB Consumer Products, CARB Aerosol Coatings, SCAQMD, OTC, LAADCO, EPA Please give the following: VOC Category: 2018 Rev 2.0 Page 3 of 6

4 VOC Limit(s): Actual VOC Content: % g/l MIR CONEG, RoHS, and Pb Content Please disclose whether any of the following heavy metals are used in this product: Lead, <90 ppm? Cadmium Mercury Hexavalent Chromium [Cr(VI)] Date and Place of lead content testing: Is the sum total of all of the above list present at <100 ppm? SEC - Conflict Minerals Rule Please disclose whether any of the following conflict minerals are used anywhere in your supply chain: Tin Tantalum Tungsten Gold Cassiterite (derivatives) Columbite-tantalite (derivatives) Wolframite (derivatives) Transportation UN Number: Hazard Class: Packing Group: Harmonized Tariff Code: US DOT IMDG IATA TDG ADG Storage NFPA Classification: NFPA Level: (aerosols) Chemical Heat of Combustion (BTU/lb): Packaging Primary packaging: Secondary packaging: Label: Valve assembly (aerosols): Trigger assembly (pumps): Other (specify): Blue Box (Canada Only) Child Resistant Closure? Paper Packaging Plastic Packaging Aluminum Packaging Steel / Metal Packaging Glass Components IV. Technical Data Sheet Physical/Chemical Property Data: Resin Type Pigment Type 2018 Rev 2.0 Page 4 of 6

5 Solvent System Weight Percent Solids Volume Percent Solids Fill Weight Mix/Dilution Ratio Weight per Gallon Flash Point Freeze/Thaw Stable to how many cycles? ph Induction Period Pot Life Recommended Dry Film Thickness (DFT) per Coat Recommended Wet Film Thickness (WFT) per Coat Wet Film to Achieve DFT (unthinned material) Theoretical Coverage as 1 mil DFT (25µm) Practical Coverage at Recommended DFT (assumes 15% material loss) Dry Times at 70 F (21 C) and 50% Humidity: Dry Heat Resistance Shelf Life To Touch (Tack Free) To Handle To Recoat Fully Dry HMIS Values Health: Flammability: Physical Hazard: Fill Volume Specific Gravity Viscosity Boiling Point V. Certification By signing, you are certifying that you understand the requirements and that all provided information is correct to the best of your knowledge. Company: Authorized Representative: Signature: Title/Position: Date: 2018 Rev 2.0 Page 5 of 6

6 Phone Number: GLOSSARY OF TERMS ADG: Australian Dangerous Goods Code (see AICS: Australian Inventory of Chemical Substances (see BPD: Biocidal Products Directive (Europe) (see CPSC: Consumer Product Safety Commission (see CARB: California Air Resources Board (see DOT: US Department of Transportation 49 CFR Parts 100 to 185 (see DSL: Domestic Substances List (Canada) (see EINECS: European Inventory of Existing Commercial Chemical Substances (see ELINCS: European List of Notified Chemical Substances (see ENCS (-METI): List of Existing and New Chemical Substances (see FIFRA: Federal Insecticide, Fungicide and Rodenticide Act (USA) (see IATA: International Air Transport Association Dangerous Goods Regulations IECS: Inventory of Existing Chemical Substances (China) (see IMDG: International Maritime Dangerous Goods Code KECI: Korean Existing Chemicals Inventory (see LAADCO: Lake Area Air Directors Coalition (Midwest States) (see NDSL: Non-Domestic Substances List (Canada) (see NLP: No Longer Polymer (Europe) (see OTC: Ozone Transport Commission (Northeast States) (see PCPA: Pest Control Products Act (Canada) (see PICCS: Philippines Inventory of Chemicals and Chemical Substances (see REACH SVHC listed substances (referring to RRRP: Reduced Regulatory Requirement Polymer (Canada) (see TDG: Transport of Dangerous Goods (Canada) (see TSCA: Toxic Substances Control Act (USA) (see WPS ID: WERCS Professional Services identification number as assigned by UL s WERCSmart portal (see Rev 2.0 Page 6 of 6