Regulatory compliance documents
Declaration of Conformity
Code of the applicant
Number
D33J39
Please check all the related technical documents in accordance with the Commodity Inspection Act before signing the form.
Obligatory Applicant
5293
Address
(03) 328-9289
Telephone
Commodity Name
CS110-48
Commodity Type Model
CNS 13438 (095/06/01);
CNS 14336-1 (99);
CNS 15663 5 (102)
Standard(s) and version
TBDYS-WTW-P21070518; BSBDYS-WTW-P21070518
Test Report Number
Testing laboratory name and designation number
SL2-IN-E-0049 / SL2-IN-T-0015
The form of the DoC marking appears like this
or
(D )
D33J39 RoHS
D33J39
D33J39
D33J39
RoHS(xx, xx) RoHS RoHS(xx, xx)
I hereby declare that the listed commodity conforms to Declaration of Conformity requirements stipulated in the Commodity
Inspection Act. I agree to take any legal obligations should violations against the Declaration of Conformity occur.
Obligatory Applicant
110
DATE
year
10
month
Signature
20
day
1.
2.
1. 2. 3. 4. 5. 6.
1. 2. 3.
Declaration of the Presence Condition of the Restricted Substances Marking
(No.)
Certificate NoApplication No.
(Picture)
Product Label and Commodity Inspection Mark.
(Description and Picture)
Sample and its location
CS101-8, CS101-8FP, CS110-24, CS110-24FP, CS110-48, CS110-
Equipment name
nit
Lead (Pb)
48P, CS110-48FP, CS210-8FP, CS210-24FP, CS210-48FP
Type designation (Type)
Restricted substances and its chemical symbols
Mercury (Hg)
Cadmium (Cd)
Hexavalent chromium
(Cr+6)
Polybrominated biphenyls
(PBB)
Polybrominated diphenyl ethers
(PBDE)
-
PCBA
Chassis
-
-
Wiring cbale
Carton
-
-
Adapter
1.0.1 wt %0.01 wt %
Note 1"Exceeding 0.1 wt %" and "exceeding 0.01 wt %" indicate that the percentage content of the restricted substance exceeds the reference percentage value of presence condition.
2.
Note 2"" indicates that the percentage content of the restricted substance does not exceed the percentage of reference value of presence.
3.
Note 3The "-" indicates that the restricted substance corresponds to the exemption.
49 28
I hereby ensure that "the presence conditions of the restricted substance" provided above have been proved by testing or appropriate quality control measures, and make sure the relevant documents provided are correct and ready. Also, I agree to cooperate with BSMI, as the Article 49 of the Commodity Inspection Act stipulates, to provide the relevant documents, if needed, for verification within 28 working days when BSMI carries out the market surveillance activities.
to
The Bureau of Standards, Metrology and Inspection
Applicant
Person in charge
110
(Signature)
10 20
DATE
(year)
(month)
(day)
Product Label
Commodity Inspection Mark
The location of sample of the marking
Microsoft Word 2010 Microsoft Word 2010