Eco Mark Product
Category No.111
Version2.0
Date:
(Company name)
Company seal
Brand name:
<Preparing Attached Certificates>
1. Indicate details of the product under application for certification in ”Fill in this Column.”
Shaded areas in “Fill in this Column” do not require entry.
2. Prepare yourself or have other interests prepare the certificates specified in “Documents to be
Submitted.” Submit these certificates with this document when applying for Eco Mark
Product certification or use.
3. Prepare certificates referring to the examples provided.
4. The issuer(s) in the ”Issued by” column must prepare “Documents to be Submitted.”
5. This cover must be filled in.
Item
Fill in this Column
Planned Display of Eco Mark
(Select where appropriate If you choose <Yes>,
please submit design drawing given below.)
Article 3 of Usage Regulations
Display of intended location of Eco
Mark, display of environmental
information below mark
Article 7 of Usage Regulations
Display of Eco Mark user name
and
address,
display
of
certification number
Item
Issued by
< > Yes
< > Product < > Packaging
< > Catalogue/leaflet < > User manual
< > Other (
)
< > No (If an Eco Mark is displayed, design
drawing must be submitted)
Applicant
Design drawing to be provided (Format free,
text)
Fill in this Column
Documents to be
Submitted
Issued by
If developed by other
< > Own company companies, attach
Applicant
Application Consent
(Select where appropriate)
Form (Example 1).
A copy of notice of
Eco Mark
certification review
< >Unapplicable
results
If a product with Eco < >Applicable
Product category
Are there any changes in addition to
Mark certification
match table
< > Yes < > No
under the category is brand name?
between the
(Select where appropriate)
submitted for
existing eco product
approval as another (If only the brand name has been changed, and one under
brand
the following items do not have to be application
Documents
proved.)
certifying changes,
if any, meet
applicable criteria
Manufacturer
product
of
< > Other companies
111 (Certificates) - 1
Item
6.(1) Category of
applied product
Fill in this Column
Documents to be
Submitted
Issued by
JISA 5908
< > Parting board
JISA 5905
< >Insulation board (IB)
< >Medium Density Fiber Board (MDF)
< >Hard board (HB)
< >Base < >Single wood sheet
< >Decorative
(Select where appropriate)
Entry Table A
Entry Table B: A list
of the raw material
vendors
Applicant
(If vendors are over
10)
4-1.(1)(2)(3)(9)
Ratio of material
to the entire product,
name of materials,
prescription
constituents
4-1.(3) adhesives/
additives
4-1.(4) Wood
preservatives
Applicant
List of certification of
Raw material
the top 10 vendors
supplier
(Example 2)
Use of halogens
< >Yes/< >No
(Select where appropriate)
Use
of
wood
termicides,
wood
preservatives, wood pesticides, and wood
fungicides
< >Yes/< >No
(Select where appropriate)
Wood from dismantled buildings are
< >Used / < >Not Used
Test
result
of
Third
party
hexavalent
4-1.(5)Wood
from
testing body or
chromium
and
dismantled buildings
public
If “Used,” documents provided in the right arsenic based on the
organization
column should be submitted.
detailed enforcement
regulations of the
Soil
Pollution
Control Law
Results
of
tests
according to the JISA
1460,
1901
and
similar methods, or
4-1.(6) Formaldehyde
a certificate or copy Applicant
emissions
indicating emissions or third party
from the product is
graded as F**** or
out of Ministerial
regulations
111 (Certificates) - 2
Addition of toluene and xylene
4-1.(7) Toluene and
< >Yes / < >No
xylene
(Select where appropriate)
Use of coating
< >Yes / < >No
If “Yes,” documents provided in the right
column should be submitted. The following A list of the Usage
4-1.(8)Chemical
information should be entered if coating amount of concerned
Paint
substances of coating with Eco Mark certification (Version 1.0) is substances
manufacturer
used.
(Example 3)
Certification brand name (
)
Certification number
(
)
(Select where appropriate)
Item
4-1.(9)Decorative
work
Fill in this Column
Issued by
Certificate
Example 4
Manager
of
final
product
manufacturing
plant
Use of halogens
< >Yes / < >No
(Select where appropriate)
4-1.(10)
Environmental laws
and regulations
4-1.(11)Energy
saving
Documents to be
Submitted
Fill in process outline and energy use
during the manufacturing process (from the
receipt of material).
* A separate form can be used for the
process outline.
Energy use
Process name
(in any unit)
Packaging material:
4-1.(12) Packaging
Packaging method:
material
4-1.(12) Use of
halogens in
packaging material
(plastic
material
only)
< >Used /< >Not Used
(Select where appropriate)
Manual mentioning
criteria4-1.(13) 1)/2) Applicant
4-1.(13) Information
Test result
conforming
JISA5905 or
JISA5908
4-2.(1) Product
quality
111 (Certificates) - 3
Third party
testing body or
Applicant
Example 1-111
Date
Director
Eco Mark Office
Japan Environment Association
Date of issue of this certificate
XXXXX XXXXX
Company name
Seal
Address to send
this certificate
Issuer of
certificate
*Issuer: Applicant
Approval of Eco Mark Use Application
This is to consent to the application for Eco Mark certification and use of
XXX (your company name) (Eco Mark certified) brand name XXXX
(certification no. XX) by XXX (applicant) as brand name XXXX.
End of the document
111 (Certificates) - 4
Product Weight Certificate
Entry Table A-111
Date
(Company name)
Product type (
)
Seal
Submit the form for each product type. If the weight percentage of materials is identical among several
product types, notes should be added.
<Wooden part>
The percentage of reused/unused wood as materials for wooden parts shall be 100%.
< > Conformed / < > Not conformed
Material distribution of wooden part
Parts
Raw material
(Thinned wood, waste
wood, etc.)
Name of raw
material supplier
Weight
percentage
Wooden part
Total weight percentage of wooden part in the entire product:
(%)
<Decorative work, Adhesive, and Additives>
Parts
Decorative work
Adhesive
Additive
Name of prescription constituents
Weight
percentage
e.g. PE
e.g. Melamine resin
Function:
e.g. Formaldehyde
catcher
Total weight percentage of decorative work, adhesive, and
additives in the entire product:
(%)
* If 10 or more material suppliers are involved, a list of suppliers (Entry Table B) should be
submitted.
* The combination of the total of weight percentage for wooden part and the total for decorative
work, adhesive, additives, etc. should be 100.
111 (Certificates) - 5
Entry Table B-111
Date
Director
Eco Mark Office
Japan Environment Association
Date of issue of this certificate
XXXXX XXXXX
Company name
Seal
Address to send
this certificate
Issuer of
certificate
*Issuer: Applicant
Raw Material Certificate List
The following list includes reused/unused wood and waste plant fibers.
No.
e.g.
Reused/unused wooden material
Thinned wood
Name of raw material supplier
XX Forest Association, XX Prefecture
End of the document
111 (Certificates) - 6
Example 2 (Thinned wood) -111
Date
Director
Eco Mark Office
Japan Environment Association
Date of issue of this certificate
XXXXX XXXXX
Company name
Seal
Address to send
this certificate
Issuer of
certificate
*Issuer: Raw material supplier
Raw Material Certificate
This is to certify that the following thinned wood materials are supplied to (Eco
Mark product manufacturer) as reused/unused wood. Photographs of the concerned
forest should be attached.
Place of
production
Example: city, prefecture, country
Type of tree
Amount
Year of tree
planting
Percentage
e.g.: 20%
of thinned
300 trees/1500 trees (per 1 ha)
trees
e.g.: First thinning in 1980
Which time
Percentage of thinned trees: 30%
of thinning?
500 trees/2000 trees (per 1 ha)
Second thinning in 2004
Tip end
diameter*
Average distribution
cm to
cm
* Information should be entered as a reference.
Percentage of thinned trees: (Number of thinned trees per hectare)/
(Number of tress planted trees per hectare) x 100
Place of production: Place where woods were harvested.
End of the document
111 (Certificates) - 7
Example 2 (Waste wood) -111
Date
Director
Eco Mark Office
Japan Environment Association
Date of issue of this certificate
XXXXX XXXXX
Company name
Seal
Address to send
this certificate
Issuer of
certificate
*Issuer: Raw material supplier
Raw Material Certificate
This is to certify that the following waste wood materials are supplied to (Eco Mark
product manufacturer) as reused/unused wood or plant fibers.
Details of waste wood material
< > Used wood
Recycled material: (
e.g.
Waste
Wood
Content
)
%
packaging material
< > Remainder material generated in wood
processing plants
< > Shavings generated in plywood and lumber
plants
< > Low quality chips not used as raw material for
paper
< > Other (
)
< > Trimmed branches
< > Bark
< > Other (
)
Total
%
%
%
%
100%
If “Trimmed branches”, “Bark”, or “Other”, generation process, tree type, and
other details should be given. (Separate forms are allowable.)
End of the document
* Check appropriate items and fill in blanks.
111 (Certificates) - 8
Example 2 (Construction waste wood) -111
Date
Director
Eco Mark Office
Japan Environment Association
Date of issue of this certificate
XXXXX XXXXX
Company name
Seal
Address to send
this certificate
Issuer of
certificate
*Issuer: Raw material supplier
Raw Material Certificate
This is to certify that the following construction waste wood materials are supplied to
(Eco Mark product manufacturer) as reused/unused wood.
Details of construction waste wood
< > Wood from dismantled buildings(Wood and wooden materials
disposed as waste in construction work as dismantling of
Constbuildings)
ruction < > Wood and wooden materials produced by construction of new
waste
buildings and building extensions
wood < > Wood and wooden materials produced by renovation
< > Wood and wooden materials disposed as waste in construction
related to other work
Generation process, tree type, and other details should be given. (Separate
forms are allowable.)
For construction waste wood, separate documents should be submitted to
demonstrate that materials subject to preservatives, termicides, and
pesticides are differentiated and eliminated during recycling. (e.g.
differentiation and elimination manual, work flow)
End of the document
* Check appropriate items and fill in blanks.
111 (Certificates) - 9
Example 2 (Less useful wood-1/3) -111
Date
Director
Eco Mark Office
Japan Environment Association
Date of issue of this certificate
XXXXX XXXXX
Company name
Seal
Address to send
this certificate
Issuer of
certificate
*Issuer: Raw material supplier
Raw Material Certificate
This is to certify that the following less useful wood materials are supplied to (Eco Mark
product manufacturer) as reused/unused wood or plant fibers. If bamboos collected after
felling in bamboo groves for the purpose of maintenance and preservation are used,
photographs or map of the surroundings of bamboo groves should be submitted.
Raw material types of less useful wood
Content
< > Abandoned lumber in the forest
%
< > Shrub
%
< > Root
< > Wood obtained from logs damaged by disease,
Less
pests, disasters
useful < > Bent logs
%
wood
%
%
%
< > Small-diameter log
< > Bamboo cut down in bamboo groves for the
purpose of maintenance and preservation of the
surrounding environment.
< > Other
Total
111 (Certificates) - 10
%
%
100%
Example 2 (Less useful wood-2/3) -111
[Details] (Other than bamboo)
< > Natural regenerated forests < > Plantation
Type of forest
forests
Acquisition of third party certificate (a copy of
certificate should be applied)
Sustainably
< >Yes (name
) < >No
managed
forests*1)
Attachment 1
< > Conformed/< > Not conformed
Place of
Example: city, prefecture, country
production
Type of tree
Amount
Year of
planting*2)
Tip end
diameter*3)
cm
*1) Fill in the blank if small diameter logs in accordance with conditions “a” or “b” in
“3. Terminology” are used as raw materials. Environmental policy on the forest
should be submitted (one to several pages in A4 size).
*2) Fill in the blank if the forest is a plantation.
*3) Fill in the blank if small diameter logs are used as raw materials.
Place of production: Place where woods were harvested.
Generation process, tree type, and other details should be given. (Separate
forms are allowable.)
Details of logging or cutting should be given. (e.g. clear cutting, patch logging,
and strip logging etc.)
End of the document
* Check appropriate items and fill in blanks.
111 (Certificates) - 11
Example 2 (Less useful wood-3/3) –111
[Details] (Bamboo)
Bamboo type
(Place of production/Example)
- City, Prefecture, Country
Place of
production and
Surrounding
conditions
(Surrounding conditions)
- Forest or agricultural lands. Bamboo groves invade
those lands and suppress appropriate growing.
(Describe specifically)
Explanation that To solve the problem stated above, explain what actions
are taken.
felling is
performed for the
purpose of
maintenance and
preservation
Management
plan
State annual number of times felling is performed, as
well as the owner and manager of bamboo forest.
Amounts
Place of production: Place where bamboos were harvested.
End of the document
111 (Certificates) - 19
Example 2 (Waste plant fiber) -111
Date
Director
Eco Mark Office
Japan Environment Association
Date of issue of this certificate
XXXXX XXXXX
Company name
Seal
Address to send
this certificate
Issuer of
certificate
*Issuer: Raw material supplier
Raw Material Certificate
This is to certify that the following waste plant fiber materials are supplied
to (Eco Mark product manufacturer) as reused/unused wood.
Details of waste plant fiber
< > Agricultural residues generated during harvest
and processing of agricultural products
Waste
plant < > Used packaging material
fiber
< > Other (
Content
%
%
)
%
Total
100%
Generation process, type of plant fiber, and other details should be given. (Separate
forms are allowable.)
End of the document
* Check appropriate items and fill in blanks.
111 (Certificates) - 20
Example 3-111
Date
Director
Eco Mark Office
Japan Environment Association
Date of issue of this certificate
XXXXX XXXXX
Company name
Seal
Address to send
this certificate
Issuer of
certificate
*Issuer: Paint manufacturer
Certificate of Chemical Substance
This is to certify that paints supplied for (product under application for Eco
Mark certification) meet Criterion 4-1.(8) in terms of chemicals listed below.
Details are given in the following table.
Substance
Total content of Cadmium, mercury,
hexavalent chromium, lead
Lead
Arsenic
Antimony
TBT
TPT
Amount
%
%
< > Not Used/< >Used
< > Not Used/< >Used
< > Not Used/< >Used
< > Not Used/< >Used
End of the document
* Check appropriate items and fill in blanks.
111 (Certificates) - 21
Example 4-111
Date
Director
Eco Mark Office
Japan Environment Association
Date of issue of this certificate
XXXXX XXXXX
Company name
Seal
Address to send
this certificate
Issuer of
certificate
*Issuer: Finished Product Plant manager
Environmental Laws and Agreements Compliance Certificate
This is to certify that (the finished product manufacturer) has been
observing the following requirements in the manufacturing of the (product
under application for Eco Mark certification).
The production process has been conforming to relevant environmental laws and
regulations and agreements on pollution control for preventing air pollution, water
contamination, noise, vibration, odor, and emission of hazardous materials in the past
five years (*) since application.
Example of relevant regulations:
Air Pollution Control law
Water Pollution Control law
Noise Regulation Law
Vibration Regulation Law
Offensive Odor Control Law
XX Prefecture XX Environment
Protection Ordinance
XX City Agreement on Pollution Control
The plant shall specify the applicable
laws and agreements.
Ordinances or agreements shall be
specified if any is effective in the local
community in which the plant is located.
End of the document
(*) Otherwise, provide a statement indicating no laws and agreements have been
violated since the establishment of the company.
If the issuer is other than the plant manager, indicate the issuer is a person who also holds the post
of plant manager or who is in an executive position equivalent to plant manager.
The certificate is effective, if the date of issue is within about three months before/after application
for Eco Mark certification.
111 (Certificates) - 22
Example manual for Eco Mark Product Category No.111—Example 5—
(Product name)
Example of manual on use
(1) Material
Thinned wood is used for raw materials.
(2) Decorative work
Prescription constituents for decorative work are (
). Resin containing
halogens and organic halogenide are not added.
(3) Adhesive
Prescription constituents for adhesive are (
). Halogens are not used.
(4) Additives
Prescription constituents for additives are (
). Halogens are not used.
(5) Wood preserving agents
Wood termicides, wood preservatives, wood pesticides, and wood fungicides are not
used.
(6) Construction waste wood
<<Choice>> Wood from dismantled buildings are not used.
<<Choice>> Wood from dismantled buildings is used only after differentiating and
eliminating materials subject to preservatives, termicides, and pesticides.
Construction waste wood meet the requirements for hexavalent chromium
and arsenic provided by the detailed enforcement regulations of the Soil
Pollution Control Law.
(7) Formaldehyde emissions
F****grade of the JIS standard.
Or falling outside the scope of regulations by the Building Standards Act.
(8) Toluene and xylene
Not added.
(9) Coating
<<Choice>> Not used
<<Choice>> Meets the requirements for heavy metals and heavy metal compound in
Eco Mark certification criteria.
(10) Precaution
Users of the product should be warned that adequate draft and ventilation be
established during use, particularly used in the room with high temperature and
humidity.
(11) Disposal/Recycling
Recycling should be carried out based on the information provided by (1)-(9) above. If
disposal is the only option, ask an industrial waste management contractor to
perform the disposal.
For more details, please call:
Contact: Department of XX, XXX Corporation
111 (Certificates) - 23
TEL: XX-XXXX-XXXX