UN POP Certification Test Request Form
Contact Name:
Company Name:
Telephone:
E-mail:
Physical Address:
Product Information
Name of Product:
Part Number:
UN Proper Name:
UN Number:
Weight Rating:
Packaging Group:
Class/Division:
Outer Shipper Material:
Air or Ground Certification:
Are you the manufacturer?
If not, please provide the name
and address of the manufacturer:
Product’s Physical Properties for Liquids Only
Specific Gravity:
Viscosity:
Product’s Physical Properties for Solids Only
Grain
Size:
Weight:
Dimensions:
Ballast’s Physical Properties for Liquids Only
Specific Gravity:
Viscosity:
Ballast’s Physical Properties for Solids Only
Grain
Size:
Weight:
Dimensions:
Notes:
V-080213
Westpak™ will provide the mixture of glycol/water and water physical properties. If client
provides the glycol/water mix, they are responsible to provide those characteristics. The
net mass of all packages is a maximum of 400 kg (882 lbs) and a maximum capacity of
450 L (119 gallons) or less. Over this value is considered a large package and no longer
falls under the non-bulk package category. Westpak™ is currently licensed to certify
wooden and metal large packages only. Westpak™ is not licensed to test plastic,
fiberboard, flexible large packages or infections substances. A total of 5 fully assembled
package systems are required for testing. If a previously certified packaging fails retesting
and the cause of the failure cannot be resolved, the failure must be reported to PHMSA.
Per PHMSA, Westpak will not begin working on a project unless all approval
requirements are satisfied. The certification mark will to be issued unless all documents
are turned in.
List all the information in the box below. The drawings and specs need to be provided for each packaging
component or peripherals such as cables, pouches, etc. Please provide the part number, name, SKU
number or other information to readily identify and track component parts to the manufacturer or supplier.
PHMSA does not allow for suppliers to be referred as manufacturers. PHMSA requires suppliers to
disclose manufacturer’s information. If unable to do so, they must contact the Approvals office at (202)
366-4535 to request permission to do so. Customers are responsible to verify that the package system is
the adequate and meets all requirements established in 49 Code of Federal Regulations (CFR) parts 171180. To verify that your package systems meet all requirements or other questions not related to testing,
please call the PHMSA at their information number at 1 (800) 467-4922.
Package
Component
V-080213
Part Number
Qty Per
Manufacturer (name and address)
Package
Drawings
Attached?
Specs
Attached?
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Package
Component
V-080213
Part Number
Qty Per
Manufacturer (name and address)
Package
Drawings
Attached?
Specs
Attached?
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Closing methods and instructions – Provide in great detail how the packages are packed and closed.
Include details such as how the tape is applied (by machine, tape gun, etc…). The pattern in which the
tape is applied (“H” pattern, 1 strip top, 2 strips bottom, etc…). This includes inner packaging
components such as heat-sealed tubing or bags along with the heat-seal machine information used
(manufacturer, model #, etc…), as well as the temperature and duration settings used. This must be
properly documented on test report along with the methods that were used in the lab. If the tape gun is
shipped to Westpak, document that it was closed with the same tools. Reports cannot be issued unless
this information is provided. When clients do not have closing instructions, we must be notified and the
closing instructions documented on the report will be the new closing method and a statement that reads
as follows will be included on the report “Client did not provide closure instructions.” Under this statement,
the client is mandated to close their package system the same way that is documented in the report by
Westpak™.
Packaging Instructions
V-080213
Packaging Instructions (continued)
V-080213