Application Form and Information Submission

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Application Form and Information Submission
Application for an Enco Certification Mark for a Textile Floor-covering Cleaning & Maintenance Formulation according the EGTS 1503
Standard, Issue 1-2014 (Dry Compound type Products only.)
CONTACT DETAILS
Applicant’s full name………………………………………………………………….
Company represented………………………………………………………………….
Applicants position……………………………………………………………………
Applicant’s correspondence address…………………………………………………..
Applicant’s telephone no………………………………………………………………
Applicant’s email address……………………………………………………………..
Company Website…………………………………………………………………….
Company Registration No……………………………………………………………
Company VAT No……………………………………………………………………
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PRODUCT
Product name………………………………………………………………………….
Product purpose………………………………………………………………………..
Product Dilution Applied for………………………………………………………….
Product manufacturing site…………………………………………………………….
…………………………………………………………………………………………
…………………………………………………………………………………………
As the Responsible Person for the submission of this application I confirm that all information supplied is correct
Signature of Responsible Person……………………………………………………..
Date……………………………………………………………………………………
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PRODUCT FORMULATION (Ref: Section 5.4.1 of the Standard)
Water Content………………………………………. (% Wt/Wt)
Ingredient &
Chemical Name
Function in
product
CAS Number
(if applicable)
Continue on a separate sheet if necessary
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DID
Number (if
applicable)
Concentration
in product (%
& W/W)
Safety Data
Sheet
Attached?
% Activity
of
Ingredient
TOXICITY REQUIREMENT – CDV METHOD (Ref: Section 5.5.1 of the Standard & DID List Parts A & B)
Ingredient Chemical name
Critical
Dilution
Volume
Degradation Factor
Chronic Toxicity Factor
TOTAL CDV
% Solid Content of product
Adjusted TOTAL CDV
Where a CDV, DF or TF value has been estimated indicate with a capital “E” (via method in DID List Part B)
CDV = (% concentration in product x Degradation Factor / Chronic Toxicity Factor) x 1000
i.e. for ingredient Sodium Lauryl Sulphate
DID part A list number is 2005
Degradation Factor = 0.05
Chronic Toxicity Factor = 0.0028
% concentration in the product (or, g/100g of product) = 0.5
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CDV = (0.5 x 0.05 / 0.0028) x 1000 = 8928.6
The total of all CDVs must be =/< 180,000 (after accounting for % solid content)
Total CDV for …………………………….. =
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BIODEGRADABILITY (Ref: Section 5.6.1 of the Standard)
Surfactant Chemical Name
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Aerobically
Biodegradable?
Yes/No
Determined By:
DID
Published Data (state publication below)
Detergent Regulation test
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For Anaerobic Biodegradation is
the Non-biodegradable portion at
0.4g or less per litre of product as
supplied?
EXCLUDED SUBSTANCES (Ref: Sections 5.7.1 to 5.7.6 of the Standard)
Criteria
Does the undiluted product have an Oral Lethal Dose <5,000mg/kg?
Does the undiluted product have an Inhalation Lethal Concentration <20mg/litre at 1 hour?
The 100% dry product shall not contain substances present at >0.1% with the following EU Risk phrases:
R23, R24, R25, R26, R27, R28, R39, R48, R65, and R68 (H330, H311, H301, H300, H310, H370, H372,
H304, H371)
The 100% dry product shall not contain substances present at >0.1% with the following EU Risk phrases
R34 or R35 (H314).
The 100% dry product shall not contain substances present at >0.1% with the following EU Risk
phrases: R40, R45, R46, R49, R60, R61, R62, R63, R64, and R68 (H351, H350, H340, H350i, H360FD,
H351f, H361d, H362).
The 100% dry product shall not contain substances present at >0.1% with the following EU Risk
phrases: R42 and R43 (H334, H317)
The 100% dry product shall not contain substances present at >0.1% with the following EU Risk
phrases: R50, R51, R52, R53, and R59 (H400, H411, H412, H413, EUH059)
The undiluted product shall not contain the following substances:
Alkyl phenol ethoxylates
Formaldehyde
Nitromusks or polycyclic musks of any sort
Sodium hydroxyl methyl glycinate
Diazolidinylurea
5-bromo-5-nitro-1,3-dioxane
2-Bromo-2-nitropropane-1,3-diol
Heavy metals including lead hexavalent chromium or selenium
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Reason
Toxicity
Toxicity
Toxicity
Toxic by eye contact
Carcinogen, mutagen,
reproductive toxin
Sensitisers
Environmentally
hazardous
Yes
No
SUBSTITUTION (Ref: Section 5.7.7 of the Standard)
EDTA and/or its salts have been substituted by?
EDTA and/or its salts have not been able to be substituted?
EDTA and /or its salts were not used in this product at all?
REACH (Ref: Sections 5.7.8 of the Standard)
Substances of Very High Concern under REACH regulations (to current date) are present? Yes / No
BIOCIDES (Ref: Section 5.8.1 of the Standard)
Name of Biocide
For preservation of
product only – Yes/No?
Classified under R50-R53
(toxic to aquatic life)
Yes/No?
2-octyl-2H-isothiazol-3-on
5-Chlor-2-Methyl-4isothiazolin-3-on / 2Methyl-2H-isothiazol-3-on
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If Yes to previous question
– is Log Pw of biocide less
than 3.0?
Or, is BCF for biocide less
than 100?
FRAGRANCES (Ref: Section 5.9 of the Standard)
Fragrance Name
Fragrance name
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Percentage content in the product as supplied
Manufactured according to COP
of International Fragrance
Association – Yes/No?
Contains Nitromusks/Polycyclic
musks – Yes/No?
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Substance in the fragrance with
risk phrases R43 and/or R42
(H334, H317)?
If so:
Name
Percent content
DAMAGE TO THE ATMOSPHERE (Ref: Section 5.10 of the Standard)
Criteria
The 100% dry product contains 1% or less of substances that could cause smog, tropospheric ozone or poor indoor
air quality?
The 100% dry product contains substances that cause ozone depletion?
Yes
No
Yes
No
PHOSPHORUS (Ref: Section 5.11 of the Standard)
Criteria
The product as used contains 0.5g (Wt/Wt) or less of total phosphorus?
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PACKAGING (Ref: Sections 6.1 – 6.7 of the Standard)
Criteria
Yes
No
Not
Applicable
Yes
No
Not
Applicable
For plastic packaging – is either recyclable, refillable, mass reduced, or, contains at least 25% recycled/postconsumer materials
For plastic packaging – clearly marked to show type of packaging for recycling (DIN6120 Parts 1 & 2, and
DIN7728 Part 1)
Is the package Child Resistant to European Standard EN 862 (2006) or has the packaging passed the
alternative requirements detailed in section 6.3 of EGTS:1503?
Heavy metals (including lead, mercury, cadmium and hexavalent chromium) are present at levels less than
100ppm?
Phthalates and chlorinated substances (PVC and phthalate softened PVC) have been deliberately used in the
packaging materials?
(an exception is made if the post-consumer portion of the package contains these substances.)
LABELLING (Ref: Section 7.1 of the Standard)
Criteria
Package marked – Dry powder not to be diluted in water before use?
Package marked – used produced is to be swept or vacuumed from surface and not disposed of to drain?
Package marked - with appropriate environmental information for disposal of unused product, used product
and empty packaging?
Package marked – with Enco Certification Mark and with description as described in the Standard?
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