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Supplier Name / Address:
供应商名/地址 |
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Material
Designation and Manufacturer:
物质名称&制造商 |
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Color
颜色 |
Coating Material (If Apply)
涂层材料 |
Pin/Tap or Clip Material (If Apply)
Pin/tap/clip材料 |
Tin plating Alloy for Pins/Tap or Clip
(If Apply)
PIN/Tap/clip的电渡层 |
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| *If Columns A9, or D9 & E9 Applies to your product please
provide separate survey for those items. |
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| Please
complete the table below by indicating if any of the substances listed are
used in the manufacture of or |
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| contained in
products, components, supplied to Falco. Use
spreadsheet "Reference Document to fill out "FSSHS". |
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| Item 项目 |
Group |
Substance
物质 |
Amount present in Material
(PPM)
含量（单位：PPM） |
Information
信息/ (Method of inspection)检查方法 |
SGS Test Date
测试日期 |
SGS File
Number
测试文件号 |
| 1 |
RoHS |
Cadmium and its Compounds
镉及镉化合物 |
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| 2 |
Lead and its Compounds
铅及铅化合物 |
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| 3 |
Mercury and its Compounds
汞及汞化合物 |
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| 4 |
Hexavalent Chromium and its
Compounds六价铬及其化合物
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| 5 |
Polybrominated Biphenyls (PBBs) and their
Ethers/Oxides(PBDEs,PBBEs)
多溴化联苯(PBB）和多溴联苯醚（PBDE）.多溴化联苯醚类（PBBEs) |
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| 6 |
HALOGENS |
CHLORINE |
Polychlorinated
Biphenyls (PCB) and Terphenyls (PCT),Polychlorinated
phenyls多溴化联(二)苯和三联苯和多溴化联苯基 |
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| 7 |
Polychlorinated Naphthalenes
(PCN)多氯化萘 |
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| 8 |
Short-chain Chlorinated Pararffins (CP)
(C 10-13,Cl≧50 wt%)
短链氯化石蜡 |
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| 9 |
Polyvinyl chloride (PVC)and its PVC
blendsPVC（聚氯乙烯）及其混合物 |
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| 10 |
Other Chlorinated Organic Compounds.
其他有机氯化物 |
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| 11 |
Pentachorophenol (PCP) |
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| 12 |
Aldrin
阿耳德林 |
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| 13 |
Chlordane
氯苯乙酮 |
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| 14 |
DDT
DDT（2,2-双（对氯苯基）-1,1,1-三氯乙烷）（CAS编号：50-29-3） |
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| 15 |
Dieldrin
狄氏剂 |
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| 16 |
Endrin
异狄氏剂 |
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| 17 |
Halogenated Dioxins & Furans,
卤化二氧芑&呋喃 |
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| 18 |
Hexachlorobenzene(C6Cl6)
六氯苯 |
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| 19 |
Monomethyldichloro Diphenylmethane.
单甲基二氯二苯基甲烷 |
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| 20 |
Monomethyltetrachloro
Diphenylmethane
单甲基四氯二苯基甲烷 |
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| 21 |
Mirex(Perchlordecone)灭蚁灵(用于防治作物蚁类)
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| 22 |
BROMINE |
Brominated Flame Retardants other than
PBDEs,PBBEs溴化阻燃剂BDBPT，不同于PBDEs
&PBDEs |
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| 23 |
Tetrabromobisphenol-A-bis-(2,3-dibromopropylether)
(TBBP-A-bis)
-(2,3-)(TBBP-A-bis)四溴基双酚-A,（2，3二溴基丙基） |
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| 24 |
Others Brominated Organic
Compounds |
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| 25 |
Monomethyldibromo
Diphenylmethane
单甲基二溴二苯基甲烷 |
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| 26 |
OTHERS |
Halogenated
flame retardants/ additives
卤化阻燃剂 |
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| 27 |
Other
Halogens as Fluorine, Iodine, Astatine & their compounds. |
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| 28 |
METALLIC COMPOUNDS |
Beryllium
and its Compounds
铍及其化合物 |
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| 29 |
Bismuth and
its Compounds
铋及其化合物 |
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| 30 |
Nickel and
its Compounds
镍及其化合物 |
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| 31 |
Thallium
and its Compounds
铊及其化合物 |
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| 32 |
Magnesium
and magnesiun alloys
镁及其化合物 |
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| 33 |
Cobalt and
its Compounds
钴及其化合物 |
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| 34 |
Gold
Compounds黄金化合物 |
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| 35 |
Palladium
Compounds钯化合物 |
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| 36 |
Silver
Compounds银化合物 |
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| 37 |
Copper
Compounds铜化合物 |
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| 38 |
OTHERS |
Organic
tin compounds有机锡化合物 |
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| 39 |
Asbestos
and Asbestos Materials
石棉及化合物
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| 40 |
Azo Compounds偶氮化合物
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| 41 |
Ozone depleting substances (CFC,HCFC,Halon, etc.)
消耗臭氧的物质 |
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| 42 |
Radioactive substances
有辐射能的物质 |
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| 43 |
Antimony and its Compounds
锑及其化合物 |
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| 44 |
Arsenic and its Compounds
砷和砷化合物 |
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| 45 |
Phthalates邻苯二甲酸盐 |
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| 46 |
Selenium and its Compounds
硒及其化合物 |
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| 47 |
Organophosphorus compound
有机磷的化合物 |
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| 48 |
Formaldehyde
甲醛 |
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| 49 |
N-p-phenylenediamine
N-p苯二胺 |
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| 50 |
2,4,6-tritertiarybutylphenol
2,4,6-三叔丁基酚 |
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| 51 |
Diethylhexylphthlate(DEHP)
酸氢盐（DEHP） |
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| 52 |
Plastic, Expanded Polystyrene
(EPS)塑料、扩张聚苯乙烯EPS |
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| 53 |
Creosotes |
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| 54 |
Triphenyl Phosphate (TPP)
磷酸三苯脂 |
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| 55 |
Triaryl Phosphate (TAP)
三芳基的磷酸盐 |
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| 56 |
Ethylene
Glycol Ethers
一甲基二氯二苯甲烷 |
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| 57 |
Cynaides
氰化物
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| 58 |
Aerosol,
silicone based
气溶胶，硅树脂 |
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| 59 |
Tellurium and its Compounds
碲及其化合物 |
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Signature
签名: |
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Position
职务: |
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Phone:
电话: |
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Email Address:
邮箱 |
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Supplier
Seal
公司盖章 |
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