Product Submission
File Number
RECOGNIZED
PRODUCT
SUBMISSION FORM
For New Product Submissions to the Ministry
PLEASE COMPLETE FORM in FULL
Incomplete applications will be returned.
Send/submit an email with this form completed in an electronic word format document to our e-mail
address: RPL@gov.bc.ca
(In addition, you may mail supporting product information with a copy of the completed form
to our mailing address or attach PDF files of supporting documentation to the email)
Please provide requested information in the fields provided (you can type directly in the grey shaded field boxes) as this information
will be used by the Recognized Products Evaluation Standing Committee to assist in the review of the product use and application.
1)
Supplier’s Name:
Address:
City:
Prov./State Postal/ZIP:
Tel:
Contact:
Email:
Fax:
2)
Manufacturer’s Name
(if different than supplier):
Address:
City:
Prov./State Postal/ZIP:
Tel:
Contact:
Email:
Fax:
3) Applicant’s Contact Information
Print Name
Date
Email address for contact person:
4)
Product Name:
Product Application Details (Describe the product’s application and/or use):
Identify suitable Category from the Ministry’s Recognized Product List or propose a related Alternate Category:
* Where is the product listed for acceptance or approval in other North American Transportation Agencies?
Provide supporting documentation with contact name, email, and telephone reference of where the products is
approved or listed in other jurisdiction’s Product’s List:
* Provide supporting information/materials/results (i.e. details of product trials or tests) :
* Starred fields must be completed or applications will be returned.
New Products Submission Form – January 2015
Page 1 of 2
Recognized Product Submission Form (cont’d)
5)
Has this product been evaluated for environmental impact?
Yes
Is this product WHMIS controlled?
No
No
If yes, attach environmental studies.
6)
Yes
if yes, attach/send MSDS (note: MSDS must conform to WHMIS standards).
Provide/Attach details:
Does this product meet the requirements of a recognized specification agency (i.e., CSA, ASTM, CGSB, AASHTO)?
Yes
No
If so, state agency and specification number(s):
Provide independent supporting letter/reports confirming compliance to standards and/or successful testing results.
7)
Provide all other information that you is relevant to assist the RPL Committee to appraise this product’s use?
Provide/Attach details:
8)
Provide details that can support the
Product’s Function: Safety: Environmental: Durability: Life Cycle: Permanent Installation:
Some criteria the RPL Committee uses to evaluate a product submission
A response for the product’s submission will be issued upon receipt of application, initial appraisal, and committee result.
Received
Date:
Initial Response
Reply/Discussion:
Review Result
Advise Applicant:
Committee Result
Notification
AcceptedUse:
Proven Use:
Tran-24100-40/54506A
Not Required:
Product Name/Description:
Rejected for Use:
Advise Applicant:
Product Number:
160000 – OPERATIONAL MATERIALS – Recognized Products
Ministry Reviewer(s):
Date:
Comments:
MINISTRY OF TRANSPORTATION
and INFRASTRUCTURE
Geotechnical Materials
and Paving Engineering
Electronic Submission
INTERNET ADDRESS:
http://www.gov.bc.ca/tran
mailto:RPL@gov.bc.ca
http://www.th.gov.bc.ca/publications/eng_publications/geotech/rpl.htm
PO Box 9850 Stn. Prov Govt
Victoria BC V8W 9T5
tel:250.387.4360 fax:250.387.7735
New Products Submission Form – January 2015
Page 2 of 2