Environmental Product Declaration
Name of Product | Product Description
Environmental Product Declaration Program Operator
NSF International
789 N. Dixboro Rd.
Ann Arbor MI 48105 USA
www.nsf.org
Date of Issue: June 7, 2012
Period of Validity: 5 years
Declaration#: 123456
2012 NSF International
Disclaimer: It is not recommended to compare LCA studies or EPDs from another organization as there may be differences in methodology,
assumptions and data quality. For additional information contact the product manufacturer.
Environmental Product Declarations
Name of Product | Product Description
Company Street Address
City, State Zip
Company Name
Company Phone
Company Website
ENVIRONMENTAL PRODUCT DECLARATION VERIFICATION
EPD Information
Program Operator
Declaration Holder
Product
Product
NSF International
Name of the Client
Date of Issue
Date of Issue
This EPD was independently verified by NSF
International in accordance with ISO 14025:
Internal
External
This life cycle assessment was independently
verified by in accordance with ISO 14044 and the
reference PCR:
Period of Validity
Period of Validity
Declaration Number
Declaration Number
[Signature of NSF Representative]
Name of Representative
Contact Information for Representative
[Signature of LCA Representative]
Name of Representative
Contact Information for Representative
LCA Information
Basis LCA
Title of LCA
Date of Issue
LCA Preparer
Name of Preparer
Organization of Preparer
Contact Information for Preparer
This life cycle assessment was critically reviewed
in accordance with ISO 14044 by:
Name of Critical Reviewer
Organization of Reviewer
Contact Information for Reviewer
PCR Information
Program Operator
Reference PCR
Date of Issue
NSF International
Reference PCR
Date of Issue
PCR review was conducted by:
Name of Chair
Organization of Chair
Contact Information for Chair (through the program
operator)
Environmental Product Declaration Program Operator
NSF International
789 N. Dixboro Rd.
Ann Arbor MI 48105 USA
www.nsf.org
Date of Issue: June 7, 2012
Period of Validity: 5 years
Declaration#: 123456
Page 2
2012 NSF International
Environmental Product Declarations
Name of Product | Product Description
ENVIRONMENTAL PRODUCT DECLARATION: DETAILED VERSION
Product Description
Product classification and description
Provide product name, product manufacturer, model number (if applicable), and a description of the product. Identify
the product or range of products.
Example:
Functional Unit
Provide information for the entire physical product and state the functional unit.
Cut-off Rules
If applicable, define cut-off rules.
System Boundaries
Identify the system boundary, including each life cycle stage: raw material acquisition and pre-processing, production,
product distribution and storage, use and maintenance, and end of life management. Include a system boundary
example.
Environmental Product Declaration Program Operator
NSF International
789 N. Dixboro Rd.
Ann Arbor MI 48105 USA
www.nsf.org
Date of Issue: June 7, 2012
Period of Validity: 5 years
Declaration#: 123456
Page 3
2012 NSF International
Environmental Product Declarations
Name of Product | Product Description
Example:
Material Acqusition &
Pre-Processing Stage
Production Stage
• [Scope]
Distribution, Storage,
& Use Stage
• [Scope]
• [Scope]
End-of-Life Stage
• [Scope]
Material acquisition and pre-processing stage
Provide a description of the acquisition and primary/intermediate pre-processing of materials used (primary or
secondary). Provide boundary details and include transportation of all stages.
Example: Material Transport Distances, Material Acquisition, and Pre-Processing Stage to Production Stage
Raw Material/
Classification
grouping
Distance (miles)
Rail
Truck
Water
Veneer
26 Wood
Products
162 miles
332 miles
5982 Miles picking 5 ports for an average of all water
transport (Asia, Australia, Africa, Europe & South America)
Particle
Board
26 Wood
Products
162 miles
332 miles
0 miles (NA due to this mode of transport not being
significant for this commodity, to our knowledge)
MDF
26 Wood
Products
162 miles
332 miles
0 miles (NA due to this mode of transport not being
significant for this commodity, to our knowledge)
Production
Define the production process.
• Describe the production of the components or semi-finished product(s).
• Describe the transport of components or semi-finished products between processes and/or facilities.
• Describe the prodution of the final product by assembling of the components or semi-finished products.
• Describe the use of catalysts or other ancillary materials during production.
• Describe any additional preparing of the finished product including forming, surface treatment, machining and
other processes, as appropriate.
• Include/describe packaging materials of the final product.
• Include/describe equipment support chemicals.
• Include/describe personnel support equipment.
Distribution, storage, and use
Define the distribution, storage, and use processes.
• Describe transportation to the use location and during use.
• Describe storage at the use location.
• Describe normal use.
• Describe repair and maintenance occurring during the usage time.
• Describe preparation of a product.
Environmental Product Declaration Program Operator
NSF International
789 N. Dixboro Rd.
Ann Arbor MI 48105 USA
www.nsf.org
Date of Issue: June 7, 2012
Period of Validity: 5 years
Declaration#: 123456
Page 4
2012 NSF International
Environmental Product Declarations
Name of Product | Product Description
End-of-life stage
Define and provide details of the end-of-life stage.
• Describe collection of end-of-life products and packages.
• Describe dismanting of components from end-of-life products.
• Describe shredding and sorting.
• Describe incineration and sorting of bottom ash.
• Describe landfilling, landfill maintenance, and decomposition emissions.
Allocation Rules
Provide clearly defined allocation procedures (if applicable). Define the allocation methods used. If there are
deviations from the allocation rules, provide rationale with justified documented evidence.
Example:
Calculation Rules and Data Quality Requirements
Types and sources of data
Address primary data used for facilities and processes that fall under operational control of the reporting company.
Address secondary data for facilities and processes outside of the control of the reporting company.
Data quality assessment
Data for manufacturing process, current technology, and current measurement capability as addressed in 7.2 of the
PCR.
• Address the time-related coverage.
• Address the geographical coverage.
• Address the technology coverage.
• Address precision.
• Address completeness.
• Address representativeness.
• Address consistency.
• Address reproducibility.
• Address sources of the data.
• Address uncertainty of the information.
Examples:
USLCI
ILCD
Table 9-2: Criteria to Evaluate the Data Quality Indicators (Adapted from Weidema and Wesnaes, 1996)
Optional: Include database information as representative data.
Environmental Product Declaration Program Operator
NSF International
789 N. Dixboro Rd.
Ann Arbor MI 48105 USA
www.nsf.org
Date of Issue: June 7, 2012
Period of Validity: 5 years
Declaration#: 123456
Page 5
2012 NSF International
Environmental Product Declarations
Name of Product | Product Description
Data Source
Identify the source of the input data.
Electricity modeling
Electricity is modeled on a regional basis.
LCIA methodology
Disclosure of environmental impact categories per functional unit.
Global warming potential (GWP 100 years) [kg CO2-eq.] – IPCC (most recent version)
Acidification potential (AP) [kg SO2] – TRACI 2.0
Photochemical ozone creation potential (POCP, or “Smog”) [kg NOx eq.] – TRACI 2.0
Eutrophication potential (EP) [kg phosphate-eq.] – TRACI 2.0
Human Health Impact – A human health impact assessment shall be performed in conformance with a documented
standard methodology (e.g., USETox as implemented in TRACI 2.0)
Sensitivity analysis
Address the sensitivity analysis performed for any major assumptions in the LCA model. Provide a clear description
of the environmental impact for each of the assumptions.
Parameters to be Declared in the EPD
Materials composition
Indicate the material composition of the reference product (in kg per functional unit and in percentage of total weight.
Disclose chemicals listed on the MSDS for all materials that make up 1% or more of the product weight by weight.
95% of product weight shall be accounted for.
Example: Material Composition Table
Material
Weight
(Kg)
Percentage
of Total
Weight (%)
Maple
2.38
8.99%
Wood
11.57
43.73%
Steel Frame
4.67
17.65%
Foam
2.26
8.54%
Polyester
1.18
4.46%
Nylon
.78
2.95%
Aluminum
2.26
8.54%
Polypropylene
1.36
5.14%
Total
26.46
100%
BioBased
Content
Environmental Product Declaration Program Operator
NSF International
789 N. Dixboro Rd.
Ann Arbor MI 48105 USA
www.nsf.org
PreConsumer
Recycled
Content
PostConsumer
Recycled
Content
Biodegradable
Content
Recyclable
Content
Y/N
Contains
Hazardous
Substance
Y/N
Hazardous
Substance
Name
Date of Issue: June 7, 2012
Period of Validity: 5 years
Declaration#: 123456
Page 6
2012 NSF International
Environmental Product Declarations
Name of Product | Product Description
Life cycle inventory data
Inventory assessment categories by life cycle stage and in total.
Life Cycle Inventory Data
SOx
NOx
CO2
Methane
N2O
CO
Phosphates
Nitrates
Dioxins
Heavy Metals
Consumption
Emissions to air
Water
Energy
Primary Energy Demand
Fossil Fuel Based Energy
Nuclear
Renewable
Waste
Incineration with energy recovery
Incineration without energy recovery
Disposal
Hazardous Waste
Recycling
Life Cycle Inventory Data
{kg}
{kg}
{MJ}
{kg}
Impact assessment categories
Report impact assessment categories by life cycle stage and in total. (See LCIA Methodology, section 7.5)
• Global warming potential
• Acidification potential
• Photochemical ozone creation potential
• Eutrophication potential
Environmental Product Declaration Program Operator
NSF International
789 N. Dixboro Rd.
Ann Arbor MI 48105 USA
www.nsf.org
Date of Issue: June 7, 2012
Period of Validity: 5 years
Declaration#: 123456
Page 7
2012 NSF International
Environmental Product Declarations
Name of Product | Product Description
Other Environmental Information
Provide any additional pertinent information (handling, noise, risk related issues, HSE). Include methodology that
supports any additonal information provided, including Human Health Assessment Impacts.
References
List all references utilized in the EPD.
Example:
• ANSI/BIFMA e3 Furniture Sustainability Standard
• ISO 14025: 2006 Environmental labels and declarations – Type III environmental declarations – Principles
and procedures
• ISO 14040: Environmental management - Life cycle assessment – Principles and framework
• ISO 14044: Environmental management - Life cycle assessment – Requirements and guidelines
• EPA, Tool for the Reduction and Assessment of Chemical and Other Environmental Impacts (TRACI)
Environmental Product Declaration Program Operator
NSF International
789 N. Dixboro Rd.
Ann Arbor MI 48105 USA
www.nsf.org
Date of Issue: June 7, 2012
Period of Validity: 5 years
Declaration#: 123456
Page 8
2012 NSF International