PART / PRODUCT INFORMATION |
| Part / Product Name |
ALL PRODUCTS |
| Part / Product Number |
ALL PRODUCTS |
| Part Number Revision |
|
| Effective Date of Part Revision |
|
Material/Substance Category Name |
Maximum Concentration Value (MCV) |
Above MCV? (Y/N) |
Intentionally Added? (Y/N) |
Provide concentration if available |
Describe All Uses (including allowable uses) and Physical Locations |
| |
| List A Substances |
| Asbestos |
0 ppm |
N |
|
|
|
| Azo Colorants |
0 ppm |
N |
|
|
|
| Cadmium/Cadmium Coumpounds |
100 ppm |
N |
|
|
|
| Hexavalent Chromium/Hexavalent Chromium Compounds |
1000 ppm |
N |
|
|
|
| Lead/Lead Compounds (Lead in PVC insulation) |
1000 ppm (300 ppm) |
N |
|
|
|
| Mercury/Mercury Compounds |
1000 ppm |
N |
|
|
Include mass of mercury used in lamps (grams) |
| Class I Ozone Depleting Substances |
0 ppm |
N |
|
|
|
| Class II Ozone Depleting Substances |
1000 ppm |
N |
|
|
|
| Polybrominated Biphenyls (PBB) and Polybrominated Diphenyls (PBDE) |
1000 ppm |
N |
|
|
|
| Polychlorinated Biphenyls (PCB) |
0 ppm |
N |
|
|
|
| Polychlorinated Naphthalenes (> 3 Cl) |
0 ppm |
N |
|
|
|
| Radioactive Substances |
0 ppm |
N |
|
|
|
| Short-chained Chlorinated Hydrocarbons (C10-C13) |
0 ppm |
N |
|
|
|
| Tributyl Tin (TBT) and Triphenyl Tin (TPT) |
0 ppm |
N |
|
|
|
| Tributyl Tin Oxide |
0 ppm |
N |
|
|
|
| List B Substances |
| Antimony/Antimony Compounds |
1000 ppm |
N |
|
|
|
| Arsenic/Arsenic Compounds |
1000 ppm |
N |
|
|
|
| Beryllium/Beryllium Compounds |
1000 ppm |
N |
|
|
|
| Bismuth/Bismuth Compounds |
1000 ppm |
N |
|
|
|
| Brominated Flame Retardants (other than PBB, PBDE) |
1000 ppm |
N |
|
|
|
| Nickel |
1000 ppm |
N |
|
|
|
| Phthalates |
1000 ppm |
N |
|
|
|
| Polyvinyl Chloride (PVC) |
1000 ppm |
N |
|
|
|
| Selenium/Selenium Compounds |
1000 ppm |
N |
|
|
|
List C Substances
|
| Carbon Black |
0 ppm |
N |
|
|
|
| Crystalline Silica |
0 ppm |
N |
|
|
|
| Fluoropolymers (No intentional additon except in part <500 grams (or <5% by weight) |
>500 gms or >5% by weight |
N |
|
|
|
| Natural Rubber Latex |
0 ppm |
N |
|
|
|
| Polyvinylidene Chloride (PVDC) |
0 ppm |
N |
|
|
|
I certify that I am authorized to declare this Material Composition Declaration Form on behalf of Pacific Bearing Company. I also certify that I have implemented processes to ensure the accuracy of the data provided for the products I manufacture, and methods of verifying and auditing the information acquired through my supply chain, as necessary.
Certified By: Glen Michalske
Title: President
Date: 12/01/05